Povidone Iodine vs. Cadexomer Iodine: What’s the Difference in Wound Care?

Iodine-based products have been used in wound care for decades because of their strong ability to kill germs. Two commonly used options are povidone iodine and cadexomer iodine. While they both contain iodine, they are not interchangeable—they work differently and are used for different types of wounds.

Understanding these differences helps ensure the right product is used at the right time.

What Is Povidone Iodine?

Povidone iodine is a liquid antiseptic made by combining iodine with a carrier (polyvinylpyrrolidone). When applied, it releases iodine quickly, providing immediate antimicrobial action.

Key Features

• Rapid, broad-spectrum killing of bacteria, fungi, and viruses
• Commonly used for:
  • Skin disinfection
  • Preoperative preparation
  • Short-term wound cleansing or irrigation
• Works immediately, but does not last long
• Has no absorptive or debriding ability

Because iodine is released quickly, povidone iodine can be toxic to healing cells if used at high concentrations. For wound irrigation, diluted solutions are preferred to reduce tissue irritation while still controlling bacteria.

What Is Cadexomer Iodine?

Cadexomer iodine is very different. It contains iodine embedded in tiny, hydrophilic beads made of modified starch. These beads absorb wound fluid and slowly release iodine over time.

Key Features

• Sustained, slow iodine release
• Absorbs exudate (fluid)
• Helps remove slough and debris
• Disrupts biofilm, a major barrier to healing
• Less toxic to healing tissue at clinical doses

Cadexomer iodine does more than kill bacteria—it actively supports wound bed preparation, reduces inflammation, and creates a better environment for healing.

Which One Helps Wounds Heal Better?

Research shows a clear difference when it comes to healing chronic wounds:

• Cadexomer iodine:
  • More than doubles the likelihood of complete healing in chronic wounds
  • Significantly reduces exudate, slough, and biofilm
  • Improves wound bed quality and supports epithelial regeneration
• Povidone iodine:
  • Effective at killing bacteria
  • Does not significantly improve healing rates in chronic wounds compared to standard care
  • Does not delay healing when used appropriately, but also does not accelerate it

What About Biofilm?

Biofilm is a sticky layer of bacteria that protects germs from antibiotics and antiseptics. It is extremely common in chronic wounds.

• Cadexomer iodine has strong evidence for biofilm disruption, including against resistant organisms like MRSA.
• Povidone iodine can kill bacteria but does not provide the sustained activity or debridement needed to manage biofilm long term.

Safety Considerations

Both products are generally safe when used correctly:

• Povidone iodine
  • Low allergy risk
  • Safer at diluted concentrations
  • Best for short-term use
• Cadexomer iodine
  • May cause mild local discomfort (burning or itching)
  • Serious side effects, including thyroid problems, are rare
  • Not suitable for patients with iodine allergy or certain thyroid conditions

Quick Comparison Table

Key Takeaway

Both povidone iodine and cadexomer iodine are valuable tools—but they serve different purposes.

• Use povidone iodine for rapid antisepsis and short-term wound disinfection.
• Use cadexomer iodine for chronic, exudative wounds where infection, biofilm, and slough are preventing healing.

Choosing the right iodine product can make a significant difference in wound outcomes.