Effect Of Povidone-iodine Douched Intraoperative Prosthetic Joint Replacement Surgery On Thyroid Function

Background:The joint replacement surgery is the major procedure torelieve pain and improve joint mobility. Less than10%of prosthesisrecipients develop implant-associated complications after the surgery,mainly due to the aseptic failures. Prosthetic joint infection was one of themost serious complications after prosthetic joint replacement surgery. Inaddition to protracted hospitalisation, patients risk complications associatedwith additional surgery and antimicrobial treatment, as well the possibilityof disability. According to statistics, PJI incidence of primary kneereplacement was1.21%and primary hip replacement was1.07-1.40%.Withthe improvement of science and technology and the level of healthcare system, the infection rate of artificial joint replacement surgerydropped to0.7%. Although the postoperative infection rate had dropped,but with the increase in the amount of artificial joint replacement patients,PJI had no significant decrease. For the patients out of infection undergoingartificial joint arthroplasty, the surgical sterile condition for PJI preventionis very important. Povidone-iodine also known as iodine, because of itsbroad spectrum of strong bactericidal effect, had a strong role in the killingof bacteria, viruses, fungi and mold spores, and has easy to make microbesresistant, non-irritating to the skin and mucous membranes almost, lessprone to allergic reactions, lasting, stable, easy to clean, etc., it is widely used in clinical practice. Considering its role in the killing ofmicroorganisms lasting, and non-toxic to tissue, hypoallergenic, etc., in thisstudy it was for arthroplasty surgery irrigation. Studies had shown that theirrigation of povidone-iodine can not only kill bacteria effectively, reducewound infection, but also can make local tissue dehydration and promotewound dry, promote blood circulation, thereby facilitating wound healing.Studies have shown that the use of povidone-iodine flush of burn patients,would lead to the patient’s body iodine disorder, manifested as disorders ofthyroid function. Long-term use of povidone-iodine to gargle and washhands, would lead to the risk of thyroid dysfunction. Usingpovidone-iodine to lavage septic arthritis may influence thyroid functionand there would be more obvious changes while the treatment last morethan one week. But there had no reports about intraoperative use ofpovidone-iodine effect on thyroid function. In this paper, was to evaluatethe impact on thyroid function after the use of povidone-iodine irrigationduring arthroplasty surgery.Objective：In this study, we collected the blood samples from patientswho received artificial joint replacement preoperative and the day aftersurgery. And by comparing the changes of free triiodothyronine (FT3), freethyroxine (FT4) and thyroid stimulating hormone (TSH), to investigate theeffect of povidone-iodine douched intraoperative prosthetic jointreplacement surgery on thyroid function. Methods: The60patients with primary artificial joint replacementsurgery were randomly divided into two groups, an experimental group anda control group,each of30patients. Patients in the experimental groupusing iodine lavage area in surgery, patients of control group using salinelavage area in surgery. Respectively, at the time of admission and the firstday after surgery, all patients blood collected to detect FT3, FT4, TSH.Result:a. the difference of thyroid function changes between theexperimental and control groups was not statistically significant.(P>0.05)b. all patients in the study, postoperative FT3, FT4, TSH comparedwith before surgery had declined, and the changes of FT3, FT4, TSHbetween preoperative and postoperative were statistically significant (p<0.05).Conclusion:1.The use of povidone-iodine irrigation during artificial jointreplacement surgery, not enough to affect thyroid function in patients. Youcan use povidone-iodine irrigation in clinical area, to prevent ofpostoperative infection.2. Stress such as surgery or anesthesia may lead to changes in thyroidfunction, when the stress disappears, patients may compensate in the shortterm.