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Eunice M. Kohara, Solly Elmann, Cindy Calderon, Todd Shepler, Roman Shinder; Intraoperative Povidone-Iodine Irrigation During Drainage of Suspected MRSA periocular abscesses in the Office Setting. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1454.
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There are numerous strategies used to combat skin and soft tissue infections including topical and systemic antibiotics, and various antiseptic agents such as hydrogen peroxide and povidone-iodine1. Bactericidal efficacy of povidone-iodine against MRSA was previously demonstrated by Haely et al2 and Sakuragi et al3. There have been no studies to date on the use of povidone-iodine against MRSA infections. We have recently shown a high percentage of periocular abscesses following brow epilation caused by MRSA4. Such abscesses are typically drained in the office setting where intraoperative antibiotics are not readily available. As such this study describes the intraoperative use of povidone-iodine irrigation within the incised periocular abscess cavity in patients presenting with abscess following brow epilation.
Charts of 24 patients who were treated with intraoperative 10% povidone-iodine irrigation during incision and drainage of periocular abscess temporally related to brow epilation were reviewed.
24 females with a median age of 30 years (range 12 - 73) were referred for oculoplastic consultation of a periocular abscess temporally associated with brow epilation. Diagnosis was confirmed by clinical examination, and in some cases orbital CT. Treatment in all cases consisted of abscess drainage with irrigation of 10% povidone-iodine, and postoperative oral antibiotics for 1 week. All cases resolved at 1 month follow up without any patients developing orbital cellulitis (Fig 1 & 2).
As the incidence of MRSA-related infections continues to rise, it is vital to implement treatment strategies against MRSA to preserve patient health while not breeding further antibiotic resistance. Use of povidone-iodine irrigation during drainage of periocular abscesses suspected of harboring MRSA in the office setting represents a safe and effective treatment strategy in such patients. This technique may prove efficacious in the treatment of MRSA suspected abscesses at other anatomic locations, and future studies may elucidate this hypothesis.
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