Evaluation of the tissue toxicity of antiseptics by the hen's egg test on the chorioallantoic membrane (HETCAM)

Marquardt, Christoph; Matuschek, Christiane; Bölke, Edwin; Gerber, Peter Arne; Peiper, Matthias; Seydlitz-Kurzbach, J. v.; Buhren, Bettina Alexandra; Griensven, Martijn van; Budach, Wilfried; Hassan, Mohamed; Kukova, Gabriela; Mota, Rosa Maria Salani; Höfer, Dirk; Orth, Klaus; Fleischmann, W.

doi:10.1186/2047-783x-15-5-204

Cited by 33 publications

(36 citation statements)

References 27 publications

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“…On day 11, eggs were frozen at −20 C and the embryos were disposed. After an exposure time of 5 minutes, the main vascular irritation was determined semi-quantitatively and differentiated in four (IS) ranges according to Spielmann et al 3,4 :…”

Section: Evaluation Of the Vascular Irritationmentioning

confidence: 99%

“…2 The hen's egg test on the chorioallantoic membrane (HET-CAM) of chicken embryos is a sensitive screening model to analyze the irritative potential and acute inflammation of tested agents. 3 The HET-CAM was developed by Spielmann et al 4 in order to replace the Draize irritation test on rabbit. 5 In addition, the HET-CAM was used as a model to investigate inflammation, angiogenesis, and mutagenicity.…”

mentioning

confidence: 99%

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Irritative potency of selected wound antiseptics in the hen's egg test on chorioallantoic membrane to predict their compatibility to wounds

Harnoss

Elrub

Jung

et al. 2018

Wound Repair Regeneration

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Antiseptics are being used for prevention of infections in acute wounds and for treatment of infections in acute and chronic wounds. However, some antiseptics' high tissue toxicity might delay the healing process. The aim of this study was to investigate the tissue toxicity of preferentially used wound antiseptics and the influence of antiphlogistic additives via the hen's egg test on the chorioallantoic membrane (HET-CAM). The HET-CAM is a semi-in-vivo method testing the tissue tolerability of wound antiseptics by evaluating the blood vessel reaction of the chorioallantoic membrane in terms of hemorrhage, vessel lysis, and coagulation. For each test day, selected test substances were applied on the membranes of two to three eggs according to the test protocol. The overall irritation was then evaluated by referring to a calculated score. Normal distribution of the resulting scores was confirmed by D'Agostino-Pearson omnibus K2 test. Significant differences between the antiseptics were calculated by Tukey's multiple comparisons test. Severe CAM reactions were observed after short-term application of octenidine based wound gel (0.05%) and chlorhexidine digluconate (0.5% solution), moderate reactions for octenidine (0.05%) in aqueous solution combined with dexpanthenol (1.34%) and allantoin (0.2%) or for hydrogen peroxide (1.5% and 0.5%) in aqueous solution, slight reactions were observed for hydrogen peroxide (1.5%) in aqueous solution in combination with sodium thiocyanate (0.698%) and for the combination of NaOCl/ HOCl (each 0.004%). Polyhexanide (0.04%) in Ringer solution and polyhexanide (0.05%) in Lipofundin, the hemoglobin spray (10%), dexpanthenol, and allantoin showed no irritation. The HET-CAM qualifies as a primary screening test for tissue tolerance of wound antiseptics. Regarding local tolerability, polyhexanide and hypochlorite are superior to other antiseptics.

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Section: Evaluation Of the Vascular Irritationmentioning

confidence: 99%

mentioning

confidence: 99%

Irritative potency of selected wound antiseptics in the hen's egg test on chorioallantoic membrane to predict their compatibility to wounds

Harnoss

Elrub

Jung

et al. 2018

Wound Repair Regeneration

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“…Polyhexanide is an alternative in case of contraindications to iodine [ 1 ] . As octenidine and polyhexanide are toxic to cartilage, other products, such as povidone-iodine, must be used as determined on a case-by-case basis [ 5,6 ] . Alcohol-based preparations must not be used on the genital or anal mucosa.…”

Section: Patient Preparationmentioning

confidence: 99%

“…The auditory canal must be protected from the ingress of antiseptics. As octenidine and polyhexanide are toxic to cartilage, other products, such as povidone-iodine, must be used as determined on a case-by-case basis [ 5,6 ] . If visual assessment of the surgical fi eld has to be ensured, for example in case of biopsies of pigmented tumors or other "colored" lesions, a colorless disinfectant may be used preoperatively.…”

Section: Patient Preparationmentioning

confidence: 99%

Pre‐ and perioperative aspects of dermatosurgery

Müller

Hübner

Thieme‐Ruffing

et al. 2017

J Deutsche Derma Gesell

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Die Dermatochirurgie nimmt hinsichtlich vieler Punkte eine Sonderstellung unter den operativen Fächern ein. Hierzu gehört in erster Linie die Tatsache, dass bis auf weni-ge Ausnahmen fast alle Eingriffe traditionell in Lokal-bzw. Regionalanästhesie und oft auch in räumlich-infrastruktureller Trennung von den großen Zentral-Operationssälen stattfinden können. Die peri-und postoperative Überwachung obliegt dabei dem der-matochirurgischen Operationsteam. Das sui generis kleinere OP-Team hat somit eine ganze Reihe perioperativer Notwendigkeiten zu beachten, um die sich in den "großen" chirurgischen Fächern eine Vielzahl verschiedener beteiligter Fachgruppen gemeinsam kümmern. Hierzu gehören neben Hygieneaspekten, Kenntnissen in der Überwachung der Patienten sowie dem Aspekt der surgical site infections auch Fragen zur postope-rativen Schmerztherapie sowie detailliertes pharmakologisches Wissen über die zur Anwendung kommenden Lokalanästhetika und das Handling der damit assoziierten toxischen und allergischen Reaktionen. Eine interdisziplinäre Zusammenarbeit und Verantwortung für den Patienten ist notwendig und erfordert die Erarbeitung und Um-setzung qualitätsorientierter und evidenzbasierter Handlungsanweisungen, die im der-matochirurgischen OP-Setting meist weit über das eigentliche Fach hinausgehen. Ziel dieses Weiterbildungsartikels soll die komprimierte Darstellung der genannten fach-übergreifenden Standpunkte bezüglich der wichtigsten perioperativen Aspekte sein. Summary Dermatosurgery occupies an exceptional position among all surgical disciplines. Above all, this includes the fact that, with very few exceptions, the vast majority of surgical interventions can be performed under local or regional anesthesia, usually in smaller procedure rooms that are spatially separated from larger operating suites. Thus, peri-and postinterventional patient monitoring is the responsibility of the dermatosurgeon and his team. Though inherently smaller, this team still has to observe numerous peri-operative requirements that-in larger surgical specialties-would be attended to by a host of various specialists working in concert. Said requirements include hygienic aspects , knowledge concerning pre-and intraoperative patient monitoring, managing surgical site infections, adequate postsurgical pain management, as well as detailed pharmacological knowledge with respect to common local anesthetics and the toxic and allergic reactions associated therewith. Not only does this require interdisciplinary collaboration and shared responsibility for the patient. It also necessitates the development and implementation of quality-oriented and evidence-based guidelines that, in the dermatosurgical setting, usually extend far beyond the scope of the specialty per

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“…mild topical glucocorticosteroids and topical antibiotics or antiseptics with low cytotoxic potential [31]. Recent studies report infections at the sites of dermatologic adverse effects in 38% of EGFRI rash patients.…”

Section: Discussionmentioning

confidence: 99%

Management of EGFR-inhibitor associated rash: A retrospective study in 49 patients

et al. 2012

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Background: In recent years inhibitors directed against the epidermal growth factor receptor (EGFR) have evolved as effective targeting cancer drugs. Characteristic papulopustular exanthemas, often described as acneiform rashes, are the most frequent adverse effect associated with this class of novel cancer drugs and develop in > 90% of patients. Notably, the rash may significantly compromise the patients' quality of life, thereby potentially leading to incompliance as well as dose reduction or even termination of the anti-EGFR therapy. Yet, an effective dermatologic management of cutaneous adverse effects can be achieved. Whereas various case reports, case series or expert opinions on the management of EGFR-inhibitor (EGFRI) induced rashes have been published, data on systematic management studies are sparse.

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Evaluation of the tissue toxicity of antiseptics by the hen's egg test on the chorioallantoic membrane (HETCAM)

Cited by 33 publications

References 27 publications

Irritative potency of selected wound antiseptics in the hen's egg test on chorioallantoic membrane to predict their compatibility to wounds

Irritative potency of selected wound antiseptics in the hen's egg test on chorioallantoic membrane to predict their compatibility to wounds

Pre‐ and perioperative aspects of dermatosurgery

Management of EGFR-inhibitor associated rash: A retrospective study in 49 patients

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