Considerations for povidone-iodine antisepsis in pediatric nasal and pharyngeal surgery during the COVID-19 pandemic

Stephen R. Chorney, Mark D. Rizzi, Kavita Dedhia

Research output: Contribution to journalComment/debatepeer-review

10 Scopus citations


Purpose: Surgeons resuming elective procedures during the COVID-19 pandemic should consider strategies to mitigate risk of exposure. For otolaryngologists performing surgery on children, unique vulnerability to SARS-CoV-2 results from a regular interface with the upper respiratory tract mucosa. A growing interest in perioperative application of povidone‑iodine (PVP-I) to the nasopharynx and oropharynx has emerged. The purpose of this review is to provide an evidence-based assessment of PVP-I in pediatric oral, nasal and pharyngeal surgery. Methods: A contemporary literature review with algorithmic approach to the potential use of PVP-I in pediatric mucosal surgery. Results: Several formulations of PVP-I have shown rapid in vitro virucidal activity against SARS-CoV-2. Antisepsis using 1.0% PVP-I mouthwash and 0.45% PVP-I throat spray can occur after 30 seconds of contact time. To date, in vivo effectiveness of PVP-I against SARS-CoV-2 has yet to be established and possible risks of its direct use on upper aerodigestive mucosa of children must be weighed. Conclusion: Further research is required prior to strongly recommending PVP-I use in preparation for nasal, oral or pharyngeal surgery in children.

Original languageEnglish (US)
Article number102737
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Issue number6
StatePublished - Nov 1 2020


  • Antiseptic
  • COVID-19
  • Pediatric otolaryngology
  • Povidone-iodine
  • Surgery
  • Tonsillectomy

ASJC Scopus subject areas

  • Otorhinolaryngology


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