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Background It stands to reason that some type of preparation needs to occur before an IV needle is inserted into a vein. For one thing, even as sterile as the needle might be, this is still a foreign object being introduced into the body -- and as such, the body will likely bring its defenses to do everything it can to reject the foreign object. For another thing, the skin itself is a breeding ground for microorganisms. Once a puncture is made into the skin and vein, this is a excellent entry point for skin flora and microorganisms to invade the body, creating all types problems such as bloodstream infections. Because of this, specific medical guidelines among Western countries insist that the entry site of an IV catheter be adequately prepared before the needle is actually inserted. Preparation generally includes a swabbing of the entry site with an antibacterial, antiseptic solution. The theory behind such an action is that preparing the skin within antiseptic solution greatly reduces the amount of microorganisms and/or skin flora that could enter the wound. Such preparation would cut down on the instance of infection, which is an important consideration what one is trying to treat a patient. The topical solutions used tend to contain either an alcohol base or a base of povidone-iodine, which is marketed under the name of Betadine. For many years, either or both of these solutions have been used as a topical preparations solution before insertion of an IV. But despite best efforts, it appears that more than 90 percent of all intravascular device-related septicemias come from either central venous or arterial catheters (Maki and Ringer, 1991). The belief is that depending on the strength of the antiseptic used prior to insertion of any type of venous or arterial catheter can have an impact on potential infection (Maki and Ringer, 1991). This is important, because life-threatening complications in patients with vascular catheters is septicemia (Maki and Ringer, 1991). In the United States, is estimated -- or at least it was more than ten years ago -- that approximately 50,000 patients and hospitals acquired some type of catheter-related septicemia each year (Maki and Ringer, 1991). Such septicemia tends to start with invasion in the insertion tract by microorganisms originating from a patient's skin flora (Maki and Ringer, 1991). In the United States, disinfected in the insertion site with some type of chemical antiseptic -- such as alcohol or Betadine -- is considered an important method to prevent intravascular device-related infection (Maki and Ringer, 1991). In the United States, Betadine -- which is the brand-name for povidone-iodine -- is commonly used while another topical antiseptic of a chlorhexidine basis has been commonly used throughout Europe (Maki and Ringer, 1991). The question we need to try to answer therefore is which is more effective in terms of site preparation prior to IV insertion -- Betadine or alcohol? Even more important, what studies have addressed this issue and what have the conclusions been? In this paper, we will do a brief review of studies that have been conducted on povidone-iodine as the topical agent to prevent or reduce infection caused by a IV usage. As we will see throughout the paper, such literature tends to be scarce on this issue, although more and more researchers are beginning to take a closer look at this problem. Literature Review The literature available determining which antiseptic is more effective -- povidone-iodine or alcohol -- is somewhat lacking, possibly because it has only been recently that studies and research on these two topical antiseptics have been conducted. Furthermore, finding any mention of using pure alcohol as a topical antiseptic prior to starting an IV is also difficult to find.
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