Antiseptic Effectiveness with Fibroblast Preservation

McKenna, Peter; Lehr, Gary S.; Leist, Phyllis A.; Welling, Richard E.

doi:10.1097/00000637-199109000-00011

Cited by 48 publications

(29 citation statements)

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“…Although it is known that this disc-diffusion method may provide semi-quantitative data on antibacterial activity, we decided on its use since it is a good approach method. The microorgansims tested were similar to isolates from wounds and burns used by other authors [8,[19][20][21][22]. The effect of silver nitrate on gonococci was not investigated; we consider that use of this antiseptic should be avoided owing to its well-known irritant effect on the cornea.…”

Section: Discussionmentioning

confidence: 95%

Silver Nitrate: Antimicrobial Activity Related to Cytotoxicity in Cultured Human Fibroblasts

Hidalgo

Bartolomé²,

Barroso³

et al. 1998

Skin Pharmacol Physiol

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The aims of this study were to ascertain whether silver nitrate (AgNO₃) concentrations below those used in clinical practice inhibit bacterial growth, and in parallel study the cytotoxic effects on human fibroblasts. The cytoprotective effects of fetal calf serum (FCS) were also evaluated. The cytotoxic effects of eight different silver nitrate concentrations were determined by assessing mitochondrial activity of viable cells capable of cleaving tetrazolium salts. Antimicrobial activity of AgNO₃, range: 7–550 × 10^–5%, was tested against Staphylococcus aureus, Citrobacter freundii, and Pseudomonas aeruginosa. Silver nitrate concentrations exerting antimicrobial effects were: S. aureus, >70 × 10^–5%; P. aeruginosa, ≥270 × 10^–5%, and C. freundii, ≥550 × 10^–5%. With 2% FCS, the lowest AgNO₃ concentration studied (7 × 10^–5%) showed cytotoxic effects (cell survival 71 ± 19%) at only 2 h of incubation. Under these conditions AgNO₃ cytotoxicity was time- and concentration-dependent in all exposure periods. Cytotoxicity was greatly enhanced causing 76% fibroblast growth inhibition at concenctrations of 14 × 10^–5% and contact time of 2 h. The AgNO₃ concentration of 7 × 10^–5% was also cytotoxic with 5% FCS in the media compared with controls, although cell survival was higher than with 2% FCS. The cytoprotective action of FCS was clearly shown at the concentration of 10% at which AgNO₃ cytotoxicity of 7 × 10^–5% to 28 × 10^–5% was partially or completely inhibited. Our results show that AgNO₃ at concentrations 100–700 times more diluted than that normally used in clinical practice retained effective inhibitory activity against some of the above-mentioned microorganisms. However, even these concentrations are cytotoxic for cultured fibroblasts. Thus, silver nitrate concentrations up to 100 times more diluted can be used, since they possess bacterial growth-inhibiting power, are less cytotoxic and therefore favour wound healing.

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Section: Discussionmentioning

confidence: 95%

Silver Nitrate: Antimicrobial Activity Related to Cytotoxicity in Cultured Human Fibroblasts

Hidalgo

Bartolomé²,

Barroso³

et al. 1998

Skin Pharmacol Physiol

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“…In vitro studies with PVP-I have reported contradictory results [6,7,31,32] . The role of PVP-I in wound healing has also been investigated in animal studies, with varying results [17,33] .…”

Section: Efficacy: In Vivo Studiesmentioning

confidence: 99%

“…Studies evaluating a PVP-I preparation in hydrogel (containing iodine in a 3% concentration) in patients receiving meshed skin grafts after burns or reconstructive procedures have also reported significantly improved epithelialization, decreased transplant loss, and improved healing [46,47] . Table 1 details some of the key studies investigating PVP-I in a variety of settings, including in vitro and human studies (burns, ulcers, skin trauma and lacerations, and pre-and postoperative antisepsis) [6,7,31,32,36,38,[39][40][41][42][43][44][45][48][49][50][51][52][53][54][55][56][57][58][59][60][61] .…”

Section: Efficacy: In Vivo Studiesmentioning

confidence: 99%

“…Clinically used concentration of PVP-I (0.35%) was found to be cytotoxic to osteoblasts, fibroblasts, and myoblasts in vitro McKenna 1991 [31] In vitro 0.005% sodium hypochlorite, 0.001% PVP-I, 0.0025% acetic acid, and 0.003% hydrogen peroxide for effectiveness against common wound isolates without compromising fibroblasts and leukocyte function Bactericidal activity of all agents with the exception of 0.005% sodium hypochlorite was compromised at reduced levels that maintained fibroblast activity been reports of patients developing systemic iodine toxicity from wounds dressed with gauze soaked in PVP-I or when PVP-I solution was used as a continuous wound irrigant [62] . The use of PVP-I in children with a higher skin surface area per body weight and less developed skin barrier could also lead to increased penetration and systemic absorption.…”

Section: Safety Toxicity and Allergenic Activitymentioning

confidence: 99%

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An Asian Perspective on Povidone Iodine in Wound Healing

et al. 2017

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Antiseptics, with a broader spectrum of antimicrobial efficacy, lower risk of antibiotic resistance development, and minimal collateral damage to host tissues, are important alternatives to control the bioburden in wounds. Povidone iodine (PVP-I), in use for several decades, has the broadest spectrum of activity, a persistent antimicrobial effect, an ability to penetrate biofilms, and a lack of acquired or cross-resistance. It demonstrates good skin tolerance and low cytotoxicity. However, some reports on PVP-I have raised concerns over allergy, ineffective penetration, and toxic effects on host cells. The majority of these concerns are based on in vitro or rodent wound studies with diverse study designs and outcomes; these results may not be directly applicable in the clinical reality in humans. In this paper, we discuss the efficacy and safety of PVP-I and outline its place in wound healing in Asia, based on an appraisal of recent literature and clinical practice across the region.

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“…However, several studies indicated fibroblast and keratinocyte cytotoxicity, as well as delayed in collagen maturation and in epithelization by the use of PVI and thus, impaired wound healing. 3 The use of PVI in a large open wound also contraindicated because PVI could induce systemic toxicity; therefore, special caution was needed when this agent used for patients with preexisting thyroid and renal disease. 4,5 Based on literature, PVI has been shown to be inactivated by blood and protein serum, and it has been associated with skin staining and irritation.…”

mentioning

confidence: 99%