Antiseptics for treating infected wounds: Efficacy on biofilms and effect of pH

Abstract

Biofilm recalcitrance is a persistent problem when managing difficult to heal and infected chronic wounds. The wound biofilm is a fundamental factor in the re-occurrence and delayed healing commonly observed in non-healing and infected chronic wounds. However, there is presently no single antimicrobial agent that is completely efficacious against both the planktonic and sessile polymicrobial communities evident in at risk or infected wounds. We will review currently available antimicrobials, with particular emphasis on silver and iodine, employed to help suppress biofilms in wounds. In addition, we will also review the effect of pH on antimicrobial efficacy. Available evidence suggests that it is best to take a multifactorial approach towards controlling biofilm in chronic, "at risk" and infected wounds. This highlights the growing importance of avoiding indiscriminate or inappropriate use of antimicrobials in the treatment of chronic wounds.

Antimicrobial activity of Eucalyptus globulus oil, xylitol and papain: a pilot study

“…Added to these aspects, there is also its progressive and rapid resistance to the antimicrobial agents currently used, such as chlorhexidine, showing a single therapy cannot be successful for its control, therefore, requiring a multifactorial approach (22)(23) .…”

Synergistic bactericidal activity of chlorhexidine-loaded, silver-decorated mesoporous silica nanoparticles

“…In brief, 1.5 g of CTAT was first mixed with 0.5 g of TEAH 3 in 100 mL of deionized water, and the mixture was stirred at 80°C for 1 hour. When the surfactant was completely dissolved, a mixture of 1.0 g of TEOS, 1.0 g of DIS, and 0.2 g of APTES was quickly added into the surfactant solution and reacted for another 3 hours at the same temperature.…”

“…1,2 Up to date, a combination of antiseptics has recently become a common strategy for bacterial infections, which might reduce the ever-increasing risk of antibacterial resistance. 3 Chlorhexidine (CHX) has been commonly used as a preferred antiseptic due to its quicker kill rate and broadspectrum biocide effectiveness with less risk for the occurrence of an opportunistic infection. 4,5 Besides CHX, silver has received substantial attention for centuries, thanks to its effective bactericidal activity and good biocompatibility.…”

Biofilms and Wounds: An Identification Algorithm and Potential Treatment Options

“…Topical antimicrobials that are considered effective on planktonic microbes include polyhexamethylene biguanide hydrochloride, benzalkonium chloride, silver, iodine, and chlorhexidine. 46 In general, it is best to avoid employing antibiotics, either topically or systemically, unless there are clinical findings compatible with a wound infection. Another approach is to use a wound dressing that is able to sequester and immobilize microbes.…”