Betadine vs. Duraprep: what’s the difference?

From 3M:

“Question:  What is the difference between Betadine® (povidone iodine [PolyVinylPyrrilidone-Iodine]) and iodine povacrylex?


Betadine is the tradename for povidone iodine (PVP-I) manufactured by Purdue Pharma. There are many generic PVP-I formulations available today. Considering DuraPrep solution and povidone iodine: There are many similar characteristics between the two Polymer-Iodine complexes. Both complex iodine and release free iodine which is the component that is bactericidal in all iodine-based skin antiseptics. Both have the same pyrrilidone ring (complexing vehicle), but unlike Povidone-Iodine which is water soluble, the addition of the acrylate copolymer in DuraPrep solution provides the ability for the iodine to remain on the skin during irrigation and other stresses during surgery rather than wash away. It allows the continual release of free iodine which kills bacteria while the film is on the skin. This water-insoluble DuraPrep film also provides enhanced drape adhesion and immobilizes the bacteria remaining on the skin after prepping, helping to prevent migration of the skin flora where it may be carried into the incision through irrigation, instruments and gloves. These features enable DuraPrep solution to maintain skin flora counts below baseline for at least 48 hours* after exposure to blood and saline. DuraPrep solution’s novel iodine povacrylex polymer provides many differentiating features compared to traditional PVP-I.”

I started reading on this topic again after a new NEJM article: Chlorhexidine–Alcohol versus Povidone–Iodine for Surgical-Site Antisepsis