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Case Study/Series
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Cadexamer iodine used as palliative dressing with unexpected results First Author: Robert Williams Authors: Bradley Pontani, Robert Williams, MD Introduction: This is a series of wounds on poorly perfused distal lower extremities not amenable to invasive revascularization or hyperbaric oxygen therapy. Cadexamer iodine was instituted as a palliative measure with the following rationale: 1. Antimicrobial effect of iodine would help prevent onset of wet gangrene and thereby potentially delay inevitable proximal amputation. 2. Absorptive capacity of cadexamer beads might facilitate progression of dry gangrene to auto-amputation in the case of toe wounds or sloughing off in the case of more proximal wounds. All patients had diabetes with associated angiopathy and neuropathy. Wounds had resulted from minor trauma but because of infection and malperfusion were all limb threatening. Treatment: Cadexamer iodine was applied to wounds daily. Wounds were cautiously debrided in clinic with minimal blood loss when indicated to remove frankly necrotic and loose tissue in effort to prevent necrotic tissue and old dressing material from building up and forming barrier and mitigate the desired effects of cadexamer iodine. Outcomes: No symptoms of systemic infection were manifested even in patients with wounds that appeared infected clinically prior to initiating treatment. Clinical signs of perwound inflammation resolved with use of the product. Cadexamer iodine facilitated autolytic debridement, granulation, contraction, and even epithelialization of wounds on severely malperfused limbs. |
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