Effect of a wound cleansing solution on wound bed preparation and inflammation in chronic wounds: a single-blind RCT

Bellingeri, Andrea; Falciani, Francesco; Traspedini, P; Moscatelli, Andrea; Russo, Andrea; Tino, G; Chiari, Paolo; Peghetti, Angela

doi:10.12968/jowc.2016.25.3.160

Cited by 69 publications

(56 citation statements)

References 16 publications

(22 reference statements)

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“…a wound with a ++ Escherichia coli (Bellingieri et al . ) plus (+) Staphylococcus (Assadian ) would result in a contamination score of 4 (Table S1, Supporting Information displays the distribution of summed scores at each sampling point).…”

Section: Methodsmentioning

confidence: 99%

Comparison of polyhexanide, cold atmospheric plasma and saline in the treatment of canine bite wounds

Nolff

Winter

Reese

et al. 2018

J of Small Animal Practice

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Objectives To compare the efficacy of polyhexanide, cold argon plasma and saline in reducing bacterial bio‐burden in dog bite wounds. Materials and Methods Prospective blinded randomised clinical trial. Dogs were randomly assigned to one of the treatment groups by lottery and bacterial cultures obtained before and after treatment were compared. Bite wounds were surgically debrided and treated with polyhexanide, cold argon plasma or saline lavage. All wounds were cultured three times: directly after debridement, directly after prelavage with 2 mL/cm2 (saline in the saline and cold argon plasma group, or polyhexanide) and following the definitive lavage. Data were analysed using a generalised linear model for ordinal data. Results A total of 85 dogs were enrolled in this study (polyhexanide n=29, cold argon plasma n=28, saline n=28). Positive bacterial culture results after debridement were obtained in 53/85 (62.3%) wounds. Polyhexanide and saline lavage significantly reduced the bio‐burden, while cold argon plasma treatment did not. This effect was evident after prelavage when polyhexanide performed significantly better than saline and cold argon plasma as well as after final treatment. No significant differences were detected after prelavage or main treatment between saline and cold argon plasma. Clinical Significance Polyhexanide lavage achieved the best immediate and ultimate decontamination of bite wounds.

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Section: Methodsmentioning

confidence: 99%

Comparison of polyhexanide, cold atmospheric plasma and saline in the treatment of canine bite wounds

Nolff

Winter

Reese

et al. 2018

J of Small Animal Practice

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“…The caveat to the recommendations given in this study is that if hardware is involved another agent should be considered first line for instillation, though no firm recommendation was made as to exactly what. Studies supporting antibiotics or antiseptics over saline have also surfaced, including a single‐blinded, randomised controlled trial of 289 patients conducted in 2016 that found that instilling propyl‐betaine and polyhexanide solution (Prontosan) was superior to normal saline at promoting granulation tissue formation ( P = .049) and reducing wound size ( P = .043) when using VACi for pressure or vascular leg ulcers . Other factors which may affect solution choice may include what is available at a given institution and treating provider preference.…”

Section: Discussionmentioning

confidence: 99%

“…Prontosan is a wound irrigation solution which contains betaine, a surfactant, and polyhexanide, an antimicrobial agent . These solutions were opted for given that some recent studies, including the previously mentioned RCT in 2016, have suggested Prontosan may be superior to saline in preparing wound beds for closure …”

Section: Discussionmentioning

confidence: 99%

Instillation negative pressure wound therapy: An effective approach for hardware salvage

Hehr

Hodson

West

et al. 2019

International Wound Journal

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Wound infection involving hardware can be notoriously difficult to treat, often requiring the removal of the infected implant. The goal of this study was to determine the utility of instillation negative pressure wound therapy to help eradicate infection and allow for definitive wound closure in patients without removing the infected hardware. A retrospective review was performed on the outcomes of 28 patients who presented with open wounds with exposed or infected hardware and who were treated with a combination of surgical debridement and negative pressure wound therapy with instillation (NPWTi). Eleven patients were treated for infected spinal hardware, 12 for extremity, and 5 for sternal hardware. Twenty‐five of 28 (89%) patients had successful retention or replacement of hardware, with clearance of infection and healed wounds. Original hardware was maintained in 17 of 28 (61%) patients. In 11 patients, original hardware was removed, with subsequent replacement in eight of those patients after a clean wound was achieved. Average time to definitive closure was 12.6 days. Average follow‐up was 135 days. This series supports NPWTi as an effective adjunct therapy to help expeditiously eradicate hardware infection, allowing for hardware retention.

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“…This has been demonstrated clinically with several clinical studies being reported . Bellingeri et al evaluated 289 patients, comparing propylbetaine‐polyhexanide solution (Prontosan, B Braun, Germany) with saline. It was found that the surfactant‐based solution resulted in 97% faster healing rates.…”

Section: Wound Cleaning: What Is It and Why Is It Necessary?mentioning

confidence: 92%

Surfactants: Role in biofilm management and cellular behaviour

Percival

Mayer

Kirsner

et al. 2019

International Wound Journal

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Appropriate and effective wound cleaning represents an important process that is necessary for preparing the wound for improved wound healing and for helping to dislodge biofilms. Wound cleaning is of paramount importance to wound bed preparation for helping to enhance wound healing. Surfactant applications in wound care may represent an important area in the cleaning continuum. However, understanding of the role and significance of surfactants in wound cleansing, biofilm prevention and control, and enhancing cellular viability and proliferation is currently lacking. Despite this, some recent evidence on poloxamer‐based surfactants where the surfactants are present in high concentration have been shown to have an important role to play in biofilm management; matrix metalloproteinase modulation; reducing inflammation; and enhancing cellular proliferation, behaviour, and viability. Consequently, this review aims to discuss the role, mode of action, and clinical significance of the use of medically accepted surfactants, with a focus on concentrated poloxamer‐based surfactants, to wound healing but, more specifically, the role they may play in biofilm management and effects on cellular repair.

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Effect of a wound cleansing solution on wound bed preparation and inflammation in chronic wounds: a single-blind RCT

Abstract: The authors have no conflict of interest regarding this research. This is an investigator initiated trial. B. Braun Milano SpA kindly provided the material under investigation for both treatment groups, and paid the Ethics Committees' application fees in all participating centres.

Cited by 69 publications

References 16 publications

Comparison of polyhexanide, cold atmospheric plasma and saline in the treatment of canine bite wounds

Comparison of polyhexanide, cold atmospheric plasma and saline in the treatment of canine bite wounds

Instillation negative pressure wound therapy: An effective approach for hardware salvage

Surfactants: Role in biofilm management and cellular behaviour

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