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I thank Dr Goldenheim for reemphasizing an important point from my initial comments, namely, the difficulty in comparing results of numerous studies that have a multitude of variables. While there has been "favorable experience" with povidone-iodine solution in prevention of intra-abdominal infection, other studies have failed to show any advantage over saline or antibiotic solutions. Furthermore, my comments addressed the use of povidone-iodine solution only as it relates to intra-abdominal infection; Dr Goldenheim's comments regarding its efficacy in other settings are irrelevant. I share the concerns of Dr Goldenheim regarding extrapolation of in vitro data to the clinical situation. Nonetheless, the ideal way to evaluate a clinical problem is to minimize the number of variables. This is best accomplished in the in vitro setting, and information obtained in this manner usually is vital to our understanding of clinical problems. The final paragraph of my initial reply merely states
Roslyn JJ. Intraperitoneal Povidone-lodine-Reply. JAMA. 1989;261(13):1881–1882. doi:10.1001/jama.1989.03420130043017
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