Consensus on Wound Antisepsis: Update 2018

@article{Kramer2017ConsensusOW,
  title={Consensus on Wound Antisepsis: Update 2018},
  author={Axel Kramer and Joachim Dissemond and Simon Kim and Christian Willy and Dieter Mayer and Roald Papke and Felix Tuchmann and Ojan Assadian},
  journal={Skin Pharmacology and Physiology},
  year={2017},
  volume={31},
  pages={28 - 58}
}
Wound antisepsis has undergone a renaissance due to the introduction of highly effective wound-compatible antimicrobial agents and the spread of multidrug-resistant organisms (MDROs). However, a strict indication must be set for the application of these agents. An infected or critically colonized wound must be treated antiseptically. In addition, systemic antibiotic therapy is required in case the infection spreads. If applied preventively, the Wounds-at-Risk Score allows an assessment of the… 

Update on the role of antiseptics in the management of chronic wounds with critical colonisation and/or biofilm

PVP‐I represents a viable therapeutic option in wound care and biofilm management, with the potential to treat biofilm‐infiltrated, critically colonised wounds, and a practical algorithm to guide the management of chronic, non‐healing wounds due to critical colonisation or biofilm, using PVP‐ I is proposed.

Antimicrobial stewardship of antiseptics that are pertinent to wounds: the need for a united approach

A unified approach to developing standardized methods of evaluating antimicrobial dressings that will provide an improved basis for practitioners to make informed choices in wound care is called for.

Antiseptics and antimicrobials for the treatment and management of chronic wounds: a systematic review of clinical trials

The new generation of antimicrobial preparations were highly effective, both in the prevention and treatment of infections, and were well tolerated by the tissues and do not interfere with the healing process.

In Vitro Antimicrobial Activity Evaluation of a Novel Fitostimoline® Plus Spray Formulation

Results support the microbiological characterization of Fitostimoline Plus spray confirming the antibacterial activity of polyhexanide (PHMB) and support the microbial infection management in wound healing.

Wound Antiseptics and European Guidelines for Antiseptic Application in Wound Treatment

An overview of the five antiseptics, including octenidine (OCT), polihexanide (PHMB), povidone-iodine (PVP-I), sodium hypochlorite (NaOCl) and nanosilver, and their chemical properties, wound applications, side effects and safety are provided.

Antiseptic Agents for Chronic Wounds: A Systematic Review

Evaluating four common antiseptic agents in chronic wound care complete healing found limited evidence suggested a better wound healing completion with iodine compared to saline, but there was not enough evidence to suggest a difference in wound healing using octenidine or polyhexamide.

Comparison of the Irritation Potency of Selected Wound Antiseptics in the Hen’s Egg Test on Chorioallantoic Membrane (HET-CAM) to Predict their Compatibility to Wounds

The hen's egg test on the chorioallantoic membrane was used as a semi-in-vivo method to test the tolerability of wound antiseptics to tissues and it was suggested that agents with no or low irritation potential on the CAM are to be preferred in the clinical practice if they are clinically effective.

Re-evaluation of polihexanide use in wound antisepsis in order to clarify ambiguities of two animal studies.

Considering the absence of genotoxicity and epigenetic effects together with the interpretation of the animal studies, it is the consensus of the multidisciplinary experts that a carcinogenic risk from PHMB-use for wound antisepsis can be ruled out.

Antiseptic Stewardship for Wound and Mucous Membrane Antiseptics

Overall, povidone iodine seems to exhibit the lowest selection pressure including cross-tolerance to other biocidal agents and antibiotics and chlorhexidine digluconate the highest.

Infectious Disease Management and Control with Povidone Iodine

  • M. Eggers
  • Medicine
    Infectious Diseases and Therapy
  • 2019
Together with its diverse applications in antimicrobial control, broad accessibility across the globe, and outstanding safety and tolerability profile, PVP-I offers an affordable, potent, and widely available antiseptic option.
...

References

SHOWING 1-10 OF 341 REFERENCES

Clinical Use of Polihexanide on Acute and Chronic Wounds for Antisepsis and Decontamination

The handling and the different possibilities of use of polihexanide-containing preparations, including the currently approved indications, contraindications and reservations are described.

Polihexanide – Perspectives on Clinical Wound Antisepsis

With every application of an antiseptic in wound treatment, the therapist treads the narrow path between the benefit of the antimicrobial effect and the risk of reducing the patient’s self-healing powers, e.g. as a result of Published online: September 8, 2010.

[Importance of wound irrigation solutions and fluids with antiseptic effects in therapy and prophylaxis : Update 2017].

As the basic equipment in trauma surgery, a selection of three different antiseptic wound irrigation solutions for the reduction of the rates of posttraumatic and SSI can be recommended.

Antiseptics on Wounds: An Area of Controversy

The authors found that despite cytotoxicty data, most antiseptics have not been shown to clearly impede healing, especially newer formulations like cadexomer� iodine (which speeds healing) and novel silver delivery systems.

Antibiotics and antiseptics for pressure ulcers.

There was some moderate and low quality evidence that fewer ulcers may heal in the short term when treated with povidone iodine compared with non-antimicrobial alternatives, but no clear evidence favouring any particular antiseptic/anti-microbial treatments.

Acetic acid treatment of pseudomonal wound infections--a review.

Classification of Wounds at Risk and Their Antimicrobial Treatment with Polihexanide: A Practice-Oriented Expert Recommendation

The proposed clinical classification of W.A.R. shall facilitate the decision for wound antisepsis and allow an appropriate general treatment regimen with the focus on the prevention of wound infection.

Benefit and harm of iodine in wound care: a systematic review.

Effect of Octenisept antiseptic on bioburden of neoplastic ulcers in patients with advanced cancer.

Octenispet was an effective antimicrobial: Staphylococcus aureus and Proteus mirabilis were eradicated in all ulcers and there was an improvement in their clinical condition.

Antiseptic Effectiveness with Fibroblast Preservation

This study suggests that 0.005% sodium hypochlorite can be used as a debriding and topical antibacterial agent for wounds and skin ulcers without inhibiting fibroblast activity essential to normal wound repair.
...