A Treatise on Regional Iodine Therapy for the Veterinary Clinician

by Mart R. Steffen

This simplified technique has the added advantage of the total elimination of basins, brushes, and sponges for use in the preliminary stages of an operation, as well as the agreeable absence of the wet, sloppy field that inevitably resulted from the use of the older method in veterinary practice. Besides, it spares the patient in more ways than one, especially in the cold months of the year when, in a veterinary practice, operations frequently have to be performed in cold stables, or even in the open.

While the application of tincture of iodine gives ample protection from skin infection in surgical operations, there are a few things to be observed that have to do with making the application correctly. First, in veterinary patients, the hair must be clipped off and the area shaved clean. The area clipped and shaved should be slightly greater in extent than the field actually to be invaded by the knife. When the clipping and shaving have been done, the area should be lightly brushed with a stiff, dry brush, in order to remove dandruff and scurf.

The second—and the most important—point is that the surface that is to be painted with the tincture of iodine be perfectly dry. In the event that the area to be painted should contain a deposit of filth, oily or greasy in nature, this should first be removed by swabbing and wiping with gauze or cotton saturated with gasoline, benzine or ether; these remove oily, greasy or fatty filth and evaporate quickly, leaving the area perfectly dry and clean. Washing with watery solutions, previous to the iodine application, is not recommended under any conditions.

When the area has been clipped, shaved, freed from grease or other filth, and then allowed to become perfectly dry, the tincture of iodine is applied liberally with a soft brush, or with a cotton swab. This is allowed to dry for a minute or two; another application is then made directly on top of the first one, allowed to evaporate to dryness, and the field is ready for the incision.

As iodine readily attacks metals, and spoils the plating on instruments, no instrument should be allowed to come in contact with the painted area while it is still moist; neither should the iodine be used for disinfecting purposes on any utensils or apparatus made of metal. The fact that the iodine may injure instruments can not be considered in the light of a disadvantage, if the above precautions are taken.

Another practice that has come to be recognized quite generally among surgeons is that of painting the edges of the surgical wound with pure tincture of iodine just before the wound is to be closed with sutures. Whether this is good practice, on general principles, is a matter that is open to debate. If the painting is done carefully, so that a pool of iodine tincture is not formed by the surplus gathering by gravitation into the deeper recesses of the wound, this may be considered good practice. On the whole, however, it would appear that the iodine could act, in many instances, as an undesirable irritant when it comes in contact with delicate, freshly incised tissues.

As the object, in modern surgery, is to eliminate all things, even the slightest, that may hinder prompt repair and smooth healing of the invaded tissues, the presence of such an active agent as pure tincture of iodine in a surgical wound may be looked upon as interfering with the carrying out of that object.

On the other hand, in surgical wounds of an already infected character in which primary union would be out of the question, the application of pure tincture of iodine, in liberal amounts, can not be too highly endorsed.

The latter statement applies, with even greater force, to all wounds of an accidental character in the fleshy portions of the anatomy.

It is also the practice of many veterinary surgeons to apply pure tincture of iodine to the wound after the sutures have been put into place. This is a very satisfactory practice, if the painting is done gently and not too freely. An excess of the tincture of iodine—if the wound edges have not been coapted perfectly—may result in cause for stitch abscess when a considerable amount of the iodine becomes pocketed in some part of the wound under the line of suture.