The Effect of Warming on the Disinfectant Efficacy of Povidone-Iodine and Patient Comfort

Corresponding author: Sun LianLian, 13676765501@163.com

DOI: 10.12201/bmr.202510.00057

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  Abstract: Objective:This study aimed to investigate the effects of moderate warming on the available iodine content, bactericidal efficacy of povidone-iodine, and patient comfort, to provide a more comfortable disinfection protocol for clinical practice.Methods:Using 5% povidone-iodine at room temperature (22°C) as the control group, the experimental groups consisted of 5% povidone-iodine solutions warmed to 25°C, 30°C, 35°C, 40°C, and 45°C, respectively. After maintaining each temperature for 1 hour, the available iodine content was determined by titration with a 0.1 mol/L sodium thiosulfate solution. Concurrently, a quantitative suspension bactericidal test was conducted to calculate the log?? reduction values againstStaphylococcus aureus,Escherichia coli, andCandida albicansat different temperatures. A log?? reduction value ≥ 5.00 (indicating a kill rate ≥ 99.999%) was defined as the criterion for high-level disinfection. Based on these initial results, the group warmed to 35°C (closest to body temperature) and the room temperature group were selected for further comparison regarding skin disinfection. Post-disinfection sampling and culture were performed to compare the qualification rate of disinfection, changes in body temperature, and the incidence of shivering between the two groups.Results:The available iodine content in povidone-iodine warmed to 25°C–40°C was significantly higher than that in the room temperature group (P < 0.05), peaking at 35°C (5.05%), but decreasing back to room temperature levels at 45°C. The quantitative suspension bactericidal test demonstrated that within the 22°C–40°C range, the log?? reduction values of 5% povidone-iodine against the three test microorganisms all exceeded 5.0, achieving a 100% sterilization rate. In the clinical disinfection evaluation, both the room temperature group and the warmed group (35°C), each comprising 82 patients, showed a 100% skin disinfection qualification rate. Regarding body temperature changes, the tympanic temperature of patients in the warmed group was significantly higher than that in the room temperature group at both 15 minutes after disinfection and at the end of the surgery. Furthermore, the incidence of intraoperative hypothermia was significantly lower in the warmed group (P < 0.05). Additionally, the incidence of intraoperative shivering was significantly lower in the warmed group compared to the room temperature group (P < 0.05).Conclusion:Warming within an appropriate temperature range can increase the available iodine content of povidone-iodine without compromising its disinfection efficacy. Using povidone-iodine warmed to 35°C for skin disinfection helps maintain intraoperative body temperature stability, reduces the risk of hypothermia and shivering, thereby enhancing the comfort and safety of surgical patients.

  Key words: povidone-iodine; available iodine content; Staphylococcus aureus; Colibacillus; Candida albicans; Disinfectant efficacy

  Submit time: 31 October 2025

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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