Feasibility and Clinical Applicability of Polihexanide for Treatment of Second-Degree Burn Wounds

Abstract

Objectives: Due to a partial rejection of mesh split-thickness skin grafts (mesh grafts) after application of povidone-iodine and silver nitrate and due to its better in vitro tolerance, polihexanide was investigated as an alternative and its applicability in the treatment of second-degree burn wounds. Methods: In 4 patients with poorly healing decubitus ulcers the mesh grafts were each divided into three areas which were pre-treated with either undiluted povidone-iodine solution, 1% silver nitrate solution or 0.04% polihexanide solution. After 7 days of application the wound areas were compared clinically and histologically. Thereafter 14 patients (average extent of burns 28% TBSA) were treated in the same way. Results: Clinically and histologically the mesh grafts treated with polihexanide showed by far the best re-epithelialization compared with the deep tissue necrosis and marked fibrin discharge observed for application of povidone-iodine and silver nitrate. The second-degree burn wounds treated with polihexanide epithelialized without any further débridement after an average of 10 days with remarkable freedom from pain. Compared with silver nitrate treatment, no fibrin film was observed on the wound. Conclusion: Polihexanide proved clinically and histologically superior to povidone-iodine and silver nitrate. For the treatment of second-degree burns, which cannot primarily be covered by plastic surgery, polihexanide is suitable because in addition to its antiseptic efficacy it does not inhibit the re-epithelialization process.

Efficacy of Chlorhexidine, Polihexanide and Tissue-Tolerable Plasma against Pseudomonas aeruginosa Biofilms Grown on Polystyrene and Silicone Materials

“…On account of the deficient data situation on the clinical efficacy of CHX for wound treatment [39] and its tissue toxicity [11] , in Germany CHX-based wound antiseptics are no longer authorized. The results in the biofilm model substantiate the results of clinical studies in which the potential of PHMB and products containing PHMB for the treatment of infected wounds could be demonstrated [14,[40][41][42] .…”

Comparison of octenidine dihydrochloride (Octenisept®), polihexanide (Prontosan®) and povidon iodine (Betadine®) for topical antibacterial effects in Pseudomonas aeruginosa-contaminated, full-skin thickness burn wounds in rats

“…It was shown that polyhexanide was efficient eradication of various pathogens in a chronic wound [20]. Daeschlein et al demostrated that polihexanide proved clinically and histologically superior to povidone-iodine for the treatment of second-degree burns and it does not inhibit the re-epithelialization process [21]. According to the results of our study polihexanide prevented the penetration and systemic spreading of P. aeruginosa but could not remove it from the eschar as octenidine did.…”

The Polyhexamethyleneguanidine Stimulation of Seeds Growing and Cell Proliferation

“…On the other hand, higher concentrations of polihexanide inhibited cell proliferation or were directly cytotoxic to the tested cell types in vitro [18]. Apart from that, polihexanide does not inhibit the re-epithelialization process at second-degree burns treatment and exhibits good antiseptic effect [19]. In our studies PHMG salts have affected growing of the primary culture of fibroblasts of the chicken embryo and interweaved culture of the trachea cells of calf [20].…”