Antiseptic Agents for Chronic Wounds: A Systematic Review

Abstract

In many parts of the world, antiseptic agents remain non-indicated in chronic wound care. In the current context of bacterial resistance to antibiotics and the development of new-generation antiseptic agents, wound antisepsis represents an asset for the prevention of wound infection. We aimed to evaluate four common antiseptic agents in chronic wound care complete healing. The review protocol was based on the Cochrane Handbook for Systematic Reviews of Intervention and devised in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement guidelines. Five databases and three clinical trials registries were searched from inception to 30 June 2021 without language restrictions. We included randomised trials evaluating the efficacy of antiseptic agents in chronic wound care in adults. Interventions considered were those using antiseptics for cleansing or within a dressing. Risk of bias was assessed using the bias excel tool provided by the Bristol Academy. Evidence quality was assessed using Grading of Recommendation Assessment, Development and Evaluation (GRADE) criteria. Of 838 studies, 6 were finally included, with a total of 725 patients. The included studies assessed iodine (cadexomer or povidone iodine) (n = 3), polyhexanide (n = 2), and octenidine (n = 1). Limited evidence suggested a better wound healing completion with iodine compared to saline (two randomised controlled trials (RCT), 195 patients, pooled RR 1.85 (95%CI (1.27 to 2.69)), moderate-quality evidence). There was not enough evidence to suggest a difference in wound healing using octenidine or polyhexamide. None of the antiseptic agents influenced adverse event occurrence compared to saline.

Reprofiling Hydrogen Peroxide from Antiseptics to Pyolytics: A Narrative Overview of the History of Inventions in Russia

“…It was also shown that the injection of cold and acidic solutions of known antiseptics into the area of purulent wounds provides disinfection of the treated surface, but does not dissolve and remove thick and viscous pus [20,43]. It has been reported that the use of known antiseptic solutions according to current medical standards does not provide effective and rapid dissolution and removal of thick and sticky pus in the treatment of long-term non-healing purulent wounds, bedsores and trophic ulcers [44]. It has been established that the reason for the low effectiveness of traditional treatment of bedsores, trophic ulcers and many other purulent diseases, including COVID-19, is the absence of pyolytics in the medical standards of treatment of these diseases [7,20,41].…”

Advances in the Preparation of Nanofiber Dressings by Electrospinning for Promoting Diabetic Wound Healing

“…Antiseptics are a class of drugs that can prevent the growth or damage of microorganisms in living tissues or on the surface of living tissues. Halogenated compounds, alcohol-based agents, and biguanides are often used as antiseptics primarily for chronic wound care because they effectively inhibit bacterial reproduction and promote resistance to the external environment [ 51 , 52 ]. (4) Alginate dressing: Alginate dressing consists of alginate salts, which are highly absorbent and hemostatic and suitable for highly exuding wounds.…”

Vacuum Therapy in Complex Treatment of Purulent-Necrotic Diseases of Soft Tissues: Clinical Cases

“…Хирургическая инфекция в стационарах проявляется тяжелым течением и часто не поддается стандартным методам лечения. Все это приводит к постоянному росту осложнений гнойнонекротических заболеваний и неблагоприятным исходам [1][2][3][4]. После радикальных хирургических вмешательств по поводу флегмон, абсцессов, некротизирующей инфекции часто образуются обширные раневые дефекты, требующие индивидуального подхода в скорейшем их закрытии методами пластической хирургии.…”