betadine after delivery

  1. I've read several articles talking about how bad betadine is and while I don't buy into it completly it does make me question its use in some situations.

    I've recently started doing something I'm not sure is good. I dread having to strait cath patients after delivery. They are already soar and many of them are very swollen makeing it hard to cath them which cuases even more pain. A few weeks ago I was setting up my stuff to cath a patient and I did'nt do the betadine prep. It always stings them and I did'nt want to do that to her. I still use it for cath's before delivery but havent been after delivery. I still do the sterile set up and use dry swabs from the kit to clean off the opening of the urethra.

    I've been going back and forth on weather or not I'm doing the right thing. on one hand people self cath useing clean technique and do just fine. On the other I was always taught to use betadine in school. I also bought a bottle of pepermint oil to put in the bedpan so mabey I wont have to cath as many patients.

    Please share you opinion
    Last edit by Dayray on Mar 27, '03
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    About Dayray

    Joined: Nov '01; Posts: 720; Likes: 185
    RN in L&D


  3. by   ShandyLynnRN
    At the hospital where I first started OB, they didn't use any betadine for deliveries. We prepped with hibiclens. I never thought about the betadine for caths after deliveries though. I always use the betadine in the kit for caths. I have never really had anyone complain, usually because the reason they can't void is because they are still numb from the epidural.

    At my current hospital, our docs prep with betadine, and if I am cathing them directly after delivery, I just use a red rubber cath, as I figure they have already been cleaned during the delivery prep.

    Like I said, if they can't go because they are still numb from the epidural, then they really don't have any discomfort from the betadine, or the cath itself. Usually, if they are edematous enough after delivery that it looks like they will have trouble, our docs order a foley overnight, or few a few hours, until the swelling goes down. Then we just insert the foley while they are still in delivery position before the area gets contaminated, so I don't use the betadine then.

    I wouldn't think that one time use of betadine to cath would be too detrimental to any perineal lacerations or episiotomies.

    I actually usually clean them up after delivery by using the leftover betadine solution (mixed with SW) from delivery, followed by the sterile water.

    I personally don't see the point in the whole prep before delivery and all the "sterile technique" involved, as a vag delivery is anything but sterile. I can see cleaning the site before suturing, but otherwise, I dont see the point.

    The last place I worked, we had one doc that had us do the hibiclens prep, but she didn't really care if the table was "contaminated" because she was also of the belief that vag deliveries aren't sterile in the first place.
  4. by   hollybear
    yep vag deliveries are far from sterile we do the hibicleans prep here. and use red rubber cath right after delvery,.if i have to cath later on i do it as gently as possible usually very little betadine prep, depending on lacerations present etc.

    on another note, betadine preps before delivery decrease skin elasticity and increase lacerations, acording to article i just read
  5. by   moz
    Hey could you tell me where to find the article, I would like to read it- Thanks
    I, too would love to read that article.. THNX....CHICK
  7. by   ShandyLynnRN
    me three!!!
  8. by   mark_LD_RN
    we even have had one doc where i used to work that poured betadine inside the vagina after delivery. to me that seems a little unnecessary. and seem like it would really alter the natural Ph

    I have read the an article a while back on the drying effects of betadine on the perineum cannot remember where i read it
  9. by   SmilingBluEyes
    WOW, how disgusting and unnecessary Mark.

    We use hibiclens for peri-prep immediately before delivery, if anything. Like stated above, deliveries are NOT sterile and unless there is gross contamination (e.g. poop) there, I just rinse with sterile water right before birth. Otherwise, I keep the perineal area very clean, removing contamination in the least invasive way possible. The fewer chemicals we expose people to, the better in my opinion. As far as PP caths go, I RARELY have to EVER do these. I do all I can to help women void on their own postpartum, including using oil of peppermint/spearmint and warm water. If I do have to cath them, I do use the straight-cath kits and the betadine swab that comes with them to accomplish sterile cath technique. I think this is important to avoid a UTI and have seen NOTHING in writing contraindicating this in cath procedures.
    Last edit by SmilingBluEyes on Mar 28, '03
  10. by   mark_LD_RN
    i have to agree smilingblue eyes, he actual thinks it helps prevent infection I tend to disagree.
  11. by   NurseShell
    We've been taught (within the past couple months) NEVER to use betadine on an open wound...due to retardation of healing process.
  12. by   ShandyLynnRN
    Just a question, as I can understand the docs wanting the area to be "sterile" if there is a need for suturing.

    I have never worked ER or any other place that does suturing. Is it normal procedure to use betadine for other areas for suturing?

    Does anyone know where I can find the research to back up the whole "sterile" table set-up, and "sterile" field for delivery? Have there ever been studies done that indicated that there was a higher purpural infection rate, neonatal infection rate, or episiotomy infection rate from deliveries that didn't use the "sterile" techniques?
  13. by   mark_LD_RN
    there have been studies but none support the betadine usage. our medical director presented the studies to us when we switched from betadine to just hibicleans and water.( we don,t even use sterile water anymore)
    but sorry to say i can not find the studies he cited here,it has been a while.

    and yes in the ER when we suture we clean the wounds but those are dirty contaminated wounds ,and the contaminants being from outside sourcses not ones own body.

    hell i delivered my last one never had time to prep her or even put my gloves on and wife had no infections at all
  14. by   cokie
    not sure, but isn't the betadine to kill any of the pt. own bacteria that is present right at the urethal opening, so that one doesn't scoot it on up into the urethal (too long since school, i wanted to say the pee pee tube), where the bacteria can sit in that nice warm wet environment, crawl on up and cause a major uti. we learned that betadine is best for this as it kills these bacteria on contact and also as it dries.....not sure the other products do this. also, just a question. i work on post partum and i have not seen svd's come over with caths. are these straight caths for inability to urinate, or are these indwellings.......please educate.