PHMB: an effective antimicrobial in wound bioburden management

Butcher, Martyn

doi:10.12968/bjon.2012.21.sup12.s16

Cited by 34 publications

(17 citation statements)

References 55 publications

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“…It is well tolerated [109], antiseptically effective against MRSA and VRE (vancomycin-resistant Enterococcus ) [110,111,112], can be used for wound irrigation, is suitable as an antiseptic for critically colonized and infected chronic wounds, including burns [37,94,113,114,115,116,117,118,119,120,121,122,123,124], and, in combination with NPWT, can be used for instillation (NPWTi). It is superior to Ag + and PVP-I regarding wound healing [123] (Table 7).…”

Section: Polihexanidementioning

confidence: 99%

Consensus on Wound Antisepsis: Update 2018

Krämer

Dissemond²,

Kim³

et al. 2017

Skin Pharmacol Physiol

243

215

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Wound antisepsis has undergone a renaissance due to the introduction of highly effective wound-compatible antimicrobial agents and the spread of multidrug-resistant organisms (MDROs). However, a strict indication must be set for the application of these agents. An infected or critically colonized wound must be treated antiseptically. In addition, systemic antibiotic therapy is required in case the infection spreads. If applied preventively, the Wounds-at-Risk Score allows an assessment of the risk for infection and thus appropriateness of the indication. The content of this updated consensus recommendation still largely consists of discussing properties of octenidine dihydrochloride (OCT), polihexanide, and iodophores. The evaluations of hypochlorite, taurolidine, and silver ions have been updated. For critically colonized and infected chronic wounds as well as for burns, polihexanide is classified as the active agent of choice. The combination 0.1% OCT/phenoxyethanol (PE) solution is suitable for acute, contaminated, and traumatic wounds, including MRSA-colonized wounds due to its deep action. For chronic wounds, preparations with 0.05% OCT are preferable. For bite, stab/puncture, and gunshot wounds, polyvinylpyrrolidone (PVP)-iodine is the first choice, while polihexanide and hypochlorite are superior to PVP-iodine for the treatment of contaminated acute and chronic wounds. For the decolonization of wounds colonized or infected with MDROs, the combination of OCT/PE is preferred. For peritoneal rinsing or rinsing of other cavities with a lack of drainage potential as well as the risk of central nervous system exposure, hypochlorite is the superior active agent. Silver-sulfadiazine is classified as dispensable, while dyes, organic mercury compounds, and hydrogen peroxide alone are classified as obsolete. As promising prospects, acetic acid, the combination of negative pressure wound therapy with the instillation of antiseptics (NPWTi), and cold atmospheric plasma are also subjects of this assessment.

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Section: Polihexanidementioning

confidence: 99%

Consensus on Wound Antisepsis: Update 2018

Krämer

Dissemond²,

Kim³

et al. 2017

Skin Pharmacol Physiol

243

215

View full text Add to dashboard Cite

show abstract

“…The ideal antimicrobial should be inexpensive, non-toxic, noncarcinogenic, and fast acting and should not interfere with the wound healing process (Butcher, 2012). Antiseptics are more preferable than antibiotics as they are less likely to lose their effectiveness due to bacterial resistance (Lipsky and Hoey, 2009).…”

Section: Impregnation Of Bacterial Cellulose With Antimicrobial Agentsmentioning

confidence: 99%

Bacterial cellulose as a material for wound treatment: Properties and modifications. A review

Sulaeva

Henniges

Rosenau

et al. 2015

Biotechnology Advances

365

275

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“…It used in eye drops, mouthwashes, contact lens disinfectants and other fields. Some dressings with antibacterial ability also incorporate PHMB as the main antibacterial ingredient 19‐21 . To impart antibacterial ability to wound scaffold dressing, researchers have previously directly added antibacterial ingredients to collagen prior to formation of the collagen layer 18 .…”

Section: Discussionmentioning

confidence: 99%

Development of a PHMB hydrogel‐modified wound scaffold dressing with antibacterial activity

Jianhui

Chen

Xiang

et al. 2020

Wound Repair Regeneration

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Current wound scaffold dressing constructs can facilitate wound healing but do not exhibit antibacterial activity, resulting in high infection rates. We aimed to endow wound scaffold dressing with anti‐infective ability by polyhexamethylenebiguanide (PHMB). We prepared PHMB hydrogel at varying concentrations (0.25%, 0.5%, 1%, 2%) and assessed release and cytotoxicity. PHMB hydrogel was added to the wound scaffold dressing to generate a PHMB hydrogel‐modified wound scaffold dressing. Wound healing and infection prevention were evaluated using a full‐thickness skin defect model in rats. In vitro, the hydrogel PHMB release time positively correlated with PHMB concentration, with 1% allowing sufficiently long release time to encompass the high‐incidence period (3‐5 days) of infection following wound scaffold dressing implantation. Implantation of 1% PHMB hydrogel into the skin did not cause adverse responses. in vitro cytotoxicity assays showed the PHMB hydrogel‐modified wound scaffold dressing did not significantly affect proliferation of fibroblasts or vascular endothelial cells, 99.90% vs 99.84% for fibroblasts and 100.21% vs 99.28% for vascular endothelial cells at 21 days. Transplantation of PHMB hydrogel‐modified wound scaffold dressing/unmodified wound scaffold dressing on the non‐infected wounds of rats yielded no significant difference in relative vascularization rate, 47.40 vs 50.87 per view at 21 days, whereas bacterial content of the wound tissue in the PHMB hydrogel‐modified wound scaffold dressing group was significantly lower than the unmodified wound scaffold dressing group, (1.80 ± 0.35) × 103 vs (9.34 ± 0.45) × 103 at 14 days. Prevalence of persistent wound infection in the rats receiving PHMB hydrogel‐modified wound scaffold dressing transplantation onto infected wounds was significantly lower than the unmodified wound scaffold dressing group, 30% vs 100%. PHMB hydrogel‐modified wound scaffold dressing exhibited suitable antibacterial ability, and its biological activity did not significantly differ from that of the unmodified wound scaffold dressing, thereby allowing it to effectively prevent infection following wound scaffold dressing implantation.

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PHMB: an effective antimicrobial in wound bioburden management

Cited by 34 publications

References 55 publications

Consensus on Wound Antisepsis: Update 2018

Consensus on Wound Antisepsis: Update 2018

Bacterial cellulose as a material for wound treatment: Properties and modifications. A review

Development of a PHMB hydrogel‐modified wound scaffold dressing with antibacterial activity

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