Published: 2021-02-24

Povidone iodine ‘WET’ technique: adenotonsillectomy in COVID era

Nithya Venkataramani, Ravi Sachidananda, Nidhi R. Sachidananda


COVID-19 pandemic has significantly changed ENT practice. Most elective ENT (ear, nose, throat) surgeries possess a risk of infection, as well as potentially increasing complication.1 With the current pandemic slowly evolving and ever-increasing demand for elective services to restart, service delivery with minimal risk to healthcare workers is a challenge. ENT procedures like adenotonsillectomy, microdebrider FESS and mastoidectomy and many more are aerosol generating procedures. Adenotonsillectomy is particularly challenging with high risk to the operating room personnel as the viral load is significantly high in the nasopharynx and oropharynx. Evidence from China shows us that the pandemic could last for at least six months2 and modifications of techniques and adapting to the new norm is the key.


Povidone iodine, Adenotonsillectomy, COVID-19

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Lei S, Jiang F, Su W, Chen C, Chen J, Mei W, et al. Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection. E Clin Med. 2020;21:100331.

Reuters. China reports 51 new coronavirus cases, mostly in Wuhan. The Hindu. 2020 May 25. Available at: international/china-reports-over-50-new-coronavirus-cases-mostly-in-wuhan/article31667737.ece. Accessed on June 7 2020.

Woloshin S, Patel N, Kesselheim AS. False Negative Tests for SARS-CoV-2 Infection-Challenges and Implications. N Engl J Med. 2020.

Vukkadala N, Qian ZJ, Holsinger FC, Patel ZM, Rosenthal E. COVID-19 and the Otolaryngologist: Preliminary Evidence-Based Review. Laryngoscope. 2020.

Kirk-Bayley J, Sunkaraneni S, Challacombe S. The Use of Povidone Iodine Nasal Spray and Mouthwash During the Current COVID-19 Pandemic May Reduce Cross Infection and Protect Healthcare Workers. Rochester, NY: Social Sci Res Network. 2020.

Mady LJ, Kubik MW, Baddour K, Snyderman CH, Rowan NR. Consideration of povidone-iodine as a public health intervention for COVID-19: Utilization as Personal Protective Equipment” for frontline providers exposed in high-risk head and neck and skull base oncology care. Oral Oncol. 2020;105:104724.

Chundamala J, Wright JG. The efficacy and risks of using povidone-iodine irrigation to prevent surgical site infection: an evidence-based review. Can J Surg. 2007;50(6):473-81.

Berkelman RL, Lewin S, Allen JR, Anderson RL, Budnick LD, Shapiro S et al. Pseudobacteremia Attributed to Contamination of Povidone-Iodine with Pseudomonas cepacia. Ann Intern Med. 1981;95(1):32-6.

Panlilio AL, Beck-Sague CM, Siegel JD, Anderson RL, Yetts SY, Clark NC et al. Infections and Pseudoinfections Due to Povidone-Iodine Solution Contaminated with Pseudomonas cepacia. Clin Infect Dis. 1992;14(5):1078-83.