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Iodine for chronic wounds: why it’s better for biofilm management

When your patient is suffering from a stalled wound, it may be due to biofilm in the wound. Biofilm poses a significant obstacle to healing and has been shown to be present in up to 90% of chronic wounds and 6% of acute wounds.1

As the understanding of wound biofilm improves, so do the tools to fight it.

What’s in your antibacterial dressing?

As a clinician, you know that debridement is a crucial step to prepare the wound bed for healing by removing necrotic tissue and other metabolic waste. Now research shows that combination therapies as part of an aggressive “Step down, step up” clinical method may be the key to reducing biofilm in order to help chronic wounds heal.2 Antibacterial dressings are also part of that approach, so it’s important to know the right product to choose.

Download a poster to discover the innovative Step down, step up strategy to biofilm management.

You have a wide variety of topical wound therapies available to you to help remove barriers to healing. They incorporate ingredients such as silver, gentian violet and methylene blue. However, few have the long history and evidence-based results as iodine does.

“Unlike silver or gentian violet and methylene blue, iodine more effectively reduces bioburden in the wound dressing,” explains Patricia Turner, BSN, RN, CWOCN, CWS, Medline Director of Clinical Resources, Skin Health-Acute Care.

“In a slow-release dressing, the iodophor makes delivery safe.”

Patricia Turner, BSN, RN, CWOCN, CWS, Medline Director of Clinical Resources, Skin Health-Acute Care

Although early concerns about iodine focused on the pain and irritation it sometimes caused, the proprietary formula of IoPlex Iodophor Foam Dressings releases iodine in a gentle, controlled manner that maintains efficacy against bacteria. “In a slow-release dressing, the iodophor makes delivery safe,” Turner says.

As an added benefit, when the iodine in IoPlex is released, the dressing changes from black to white, which indicates the dressing is ready to be changed. Turner notes, “This reduces confusion and waste, ultimately saving staff time and money.”

Iodine is proven technology

When it comes to choosing an effective antibacterial dressing for biofilm management, it helps to look at the evidence. “Evidence shows that iodine is the most superior, broad spectrum antibacterial agent available,” Turner says, adding “It is effective against bacteria and antibiotic-resistant species.”

“Evidence shows that iodine is the most superior, broad spectrum antibacterial agent available.”

For example, in one study based on an ex vivo porcine skin model, five types of commonly used wound dressings were assessed for their antibacterial abilities against P. aeruginosa biofilm. Cadexomer iodine demonstrated a 7 log kill of mature three-day P. aeruginosa biofilm after 24 hours and 72 hours of exposure.3

These 5 in vitro studies also show evidence that supports the use of an iodine-based dressing such as IoPlex to manage biofilm in the wound:

1 | The graph below illustrates a study that used an in vitro CDC bioreactor biofilm model. It showed that, in all cases but one, IoPlex outperformed all other tested dressings including those with silver and gentian violet and methylene blue.4

CDC bioreactor: 24-hour application of 24-hour growth of biofilm4

In-vitro testing showed that IoPlex was the only competitive dressing to have a greater than 4 log reduction against both S. aureus and P. aeruginosa biofilm strains. IoPlex has potent activity against biofilms. Clinical Significance of these findings have not been determined.

2 | A two-layer hydrogel dressing that releases oxygen and iodine in the wound dressing was more effective than other therapies against both 24-hour Pseudomonas aeruginosa (P. aeruginosa) and Staphylococcus aureus (S. aureus). The study also revealed that the iodine dressing had a sustained antibacterial effect throughout the treatment period, reducing biofilm levels of each organism to below minimum detection levels after 24 hours.5

3 | A controlled-release iodine dressing showed complete disruption of the bacteria in a multispecies biofilm after seven days of use.6

4 | An in vitro porcine explant model found that controlled release iodine dressings decreased mature, three-day P. aeruginosa by eight logs after one and three days.7

5 | In a review of 39 articles that looked at topical agents used for managing chronic biofilm, the results indicated cadexomer iodine had the highest mean log10 reduction of biofilm.8

Target biofilm with iodine
Manage biofilm through slow-release iodine in IoPlex Iodophor Foam Dressing, based on in vitro studies.
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Iodine helps restart healing

Experts agree that chronic wounds take an aggressive, Step down, step up clinical method to help move them out of their stalled stage. Incorporating an iodine-based wound dressing like IoPlex may help. “Wounds respond rapidly to iodine,” Turner says. “And, with the barriers to healing reduced, clinicians can move onto advanced therapies such as collagen or NPWT.”

Key takeaway

Iodine has been used in medicine for centuries, current evidence backs up its efficacy as an antibacterial, and it is now an effective part of biofilm management. In a controlled-release wound dressing, iodine has been shown to be more effective than other common products for biofilm management. Find out more about how iodine in IoPlex may be a significant part of your chronic wound and biofilm management.

Explore these additional resources:
Learn more about biofilm-based wound care 
Watch the webinar: Management of chronic wounds 
Download the educational poster, Step up, step down…and share it with your team