Efficacy of topical cadexomer iodine treatment in chronic wounds: Systematic review and meta-analysis of comparative clinical trials

source extracted confidence: high 2026-04-09
#diabetic-foot #humans #iodophors #varicose-ulcer #wound-healing

Efficacy of topical cadexomer iodine treatment in chronic wounds: Systematic review and meta-analysis of comparative clinical trials

Woo et al., 2021 | Int Wound J | Meta Analysis

Citation

Woo Kevin, Dowsett Caroline, ... Malone Matthew. Efficacy of topical cadexomer iodine treatment in chronic wounds: Systematic review and meta-analysis of comparative clinical trials. Int Wound J. 2021-Oct;18(5):586-597. doi:10.1111/iwj.13560

Abstract

The aim of this study was to summarise the clinical evidence supporting almost 40 years of topical cadexomer iodine (CIOD) use in wound bed preparation by removing barriers to healing such as exudate, slough, bioburden, and infection and allowing chronic wound progression. A systematic review was conducted (Embase/PubMed, November 2020) to identify relevant comparative studies meeting inclusion criteria. Meta-analyses were performed using a fixed-effects (I2  < 50%) or random-effects model (I2  ≥ 50%) depending on statistical heterogeneity. Dichotomous outcomes were reported as relative risk (RR) and continuous outcomes as mean difference (MD), with 95% confidence intervals. In total, 436 publications were identified of which 13 were comparative trials including outcomes of interest. Significant reductions in exudate, pus/debris, slough, bioburden, and infection were reported in chronic wounds treated with CIOD, compared with standard of care (SOC). Meta-analyses highlighted the positive impact of CIOD on mean wound area reduction (MD = 2.35 cm2 , 95% CI = 0.34-4.36, P = .0219) after eight weeks treatment and overall wound healing events compared to SOC; wounds including venous leg ulcers, diabetic foot ulcers, and pressure ulcers treated with CIOD were more than twice as likely to heal than those receiving SOC (RR = 2.30, 95% CI = 1.54-3.45, P < .0001). This meta-analysis demonstrates the efficacy of CIOD on chronic wounds through removal of barriers to healing. CIOD should be considered in wound bed preparation and treatment protocols.

Key Findings

CIOD should be considered in wound bed preparation and treatment protocols.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Diabetic Foot
  • Humans
  • Iodophors
  • Varicose Ulcer
  • Wound Healing

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: iodine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09