The potent antibacterial activity of halogens is due to their affinity for protoplasm. The relative bacterial activities of halogens in solutions free of organic matter are, in decreasing order: chlorine, bromine, and iodine. In the presence of organic matter, iodine is the most effective.
The most common use of elementary iodine is as Iodine tincture, USP. This is a 2% solution of free iodine with 2.4% sodium iodide in 50% ethyl alcohol or isopropyl alcohol.
Elementary iodine is also available in stronger solutions and in aqueous solutions but, in our opinion, iodophors are preferable for our needs.
Anyone who has used tincture of iodine understands the sensation when alchol is placed into an open wound!! It hurts and it is damaging to tissue.
Iodophors are combinations of iodine with detergents, wetting agents, solubilizers, and other carriers that may contain iodine as high as 30% of their weight from which 70-80% may be released as available iodine once the solution is diluted.
These compounds are safe with low toxicity and, relative to other products are almost free of odor.
Although repeated use of iodophors on skin can have a drying action with mild dermatitis, they are not as irritating as alcohol containing products and can therefore be used on wounds.
At UAF, iodophors are obtained in 2 versions, as a surgical scrub and as a solution. Trade names vary depending upon the manufacturer.
The iodophor soap or scrub (Betadine, Vetadine, etc) is used at UAF as the primary compound for our surgical preps.
The iodophor solution (also named Betadine, Vetadine, etc) is used at UAF as the primary compound for the final painting or spraying of a surgical site. Dilute iodophor solution may also be used during the scrub phase of surgical preparation if sudsing is not desired.
READ THE LABELS CAREFULLY TO ENSURE YOU ARE USING A SOAP OR A SOLUTION - THEY LOOK VERY SIMILAR!!
Dilute iodophor solution is also clinically use for cleaning and flushing of wounds.
Although an iodophor soap is a useful scrub for the surgeon's hands, I prefer using a chlorhexidine soap because the latter is less irritating. Likewise, if you propose to do a surgical prep of delicate tissue (i.e. vulva or perivulvar), you are advised to use the less irritating chlorhexidine soap rather than an iodophor.
Chlorine is largely used for disinfection and, although aqueous solutions have been used historically to clean wounds and necrotic tissues, there are better compounds for that!
Chlorine disinfectants are powerful bleaching agents that tend to corrode metals. DO NOT LEAVE A BLEACH SOLUTION IN A STAINLESS STEEL SINK OR BUCKET! USE PLASTICS. They have a strong odor and are not recommended for use in refrigerators and freezers. However, inorganic hypochlorite (bleach) solutions are very effective disinfectants for use in animal and health-care facilities.
Reference: Rutala, W.A. and D.J. Weber. 1997. Uses of inorganic hypochlorite (bleach) in health-care facilities. Clinical Microbiology Reviews 10(4):597-610.
Although products containing organic chlorine are available, we prefer other compounds for use in wound cleaning and antisepsis.