Antimicrobial activity and skin permeation of iodine present in an iodine-impregnated surgical incise drape

Objectives: The antimicrobial efficacy of an iodine-impregnated incise drape against MRSA was evaluated in a skin model. The permeation of iodine from this drape into the skin was also assessed. Methods: The antimicrobial efficacy was evaluated in ex vivo studies following application of the surgical incise drape for various times on the surface of donor skin, which was inoculated with either 1×103 or 1×106 cfu MRSA/cm2 skin and mounted on Franz diffusion cells. In some experiments the MRSA-inoculated skin was pre-incubated for 18 h at room temperature prior to applying the drape. Permeation of iodine into the skin using this model was also determined following application of the incise drape for 6 h. Results: The iodine-impregnated drape demonstrated antimicrobial activity compared with the non-use of drape. This reached significancewhen a high inoculumofMRSAwas appliedwith no pre-incubation period andwhen a low inoculum of MRSAwas applied with a pre-incubation period (P0.002 and P0.014, respectively). Furthermore, in experiments wherein a high inoculum of MRSAwas applied with no pre-incubation period, the iodine-impregnated drape demonstrated superior antimicrobial activity comparedwith the use of a non-antimicrobial drape (P,0.001). MIC and MBC values of iodine were attained to 1500 mm below the skin surface. Conclusions: The iodine-impregnated surgical incise drape had detectable antimicrobial activity. Furthermore, iodine penetrated into the deeper layers of the skin. This property should suppressmicrobial regrowth at and aroun