Topical stabilized hypochlorous acid: The future gold standard for wound care and scar management in dermatologic and plastic surgery procedures

Gold, Michael H.; Andriessen, Anneke; Bhatia, Ashish C.; Bitter, Patrick; Chilukuri, Suneel; Cohen, Joel L.; Robb, Chris W.

doi:10.1111/jocd.13280

Cited by 51 publications

(58 citation statements)

References 31 publications

(106 reference statements)

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“…Irrigation solutions such as sterile normal saline or sterile water are the simplest wound cleansing methods. Antiseptic agents, such as octenidine dihydrochloride (OCT), polyhexamethylene biguanide (PHMB), povidone-iodine, and super oxidized hypochlorous acid (HOCl) and sodium hypochlorite (NaOCl) are widely used in topical wound therapy in solution form or as functionalized dressings due to their high microbicidal and antibiofilm properties (193)(194)(195)(196)(197). OCT and PHMB have surfactant properties to help break apart biofilms and PHMB is particularly useful due to its low toxicity (198).…”

Section: Antisepticsmentioning

confidence: 99%

Biofilm-Innate Immune Interface: Contribution to Chronic Wound Formation

et al. 2021

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Delayed wound healing can cause significant issues for immobile and ageing individuals as well as those living with co-morbid conditions such as diabetes, cardiovascular disease, and cancer. These delays increase a patient’s risk for infection and, in severe cases, can result in the formation of chronic, non-healing ulcers (e.g., diabetic foot ulcers, surgical site infections, pressure ulcers and venous leg ulcers). Chronic wounds are very difficult and expensive to treat and there is an urgent need to develop more effective therapeutics that restore healing processes. Sustained innate immune activation and inflammation are common features observed across most chronic wound types. However, the factors driving this activation remain incompletely understood. Emerging evidence suggests that the composition and structure of the wound microbiome may play a central role in driving this dysregulated activation but the cellular and molecular mechanisms underlying these processes require further investigation. In this review, we will discuss the current literature on: 1) how bacterial populations and biofilms contribute to chronic wound formation, 2) the role of bacteria and biofilms in driving dysfunctional innate immune responses in chronic wounds, and 3) therapeutics currently available (or underdevelopment) that target bacteria-innate immune interactions to improve healing. We will also discuss potential issues in studying the complexity of immune-biofilm interactions in chronic wounds and explore future areas of investigation for the field.

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Section: Antisepticsmentioning

confidence: 99%

Biofilm-Innate Immune Interface: Contribution to Chronic Wound Formation

et al. 2021

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“…Moreover, the dramatic increase in the use of disinfectants, including NaOCl and HOCl, due to the current pandemic, suggests an increase in resistance of bacteria present in the everyday human environment to these disinfectants. In addition to its use as disinfectant, HOCl can also be applied as a topical antiseptic agent for wound healing [ 43 , 44 , 45 ].…”

Section: Hypochlorous Acid a Widely Used Disinfectantmentioning

confidence: 99%

Surviving Reactive Chlorine Stress: Responses of Gram-Negative Bacteria to Hypochlorous Acid

2020

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Sodium hypochlorite (NaOCl) and its active ingredient, hypochlorous acid (HOCl), are the most commonly used chlorine-based disinfectants. HOCl is a fast-acting and potent antimicrobial agent that interacts with several biomolecules, such as sulfur-containing amino acids, lipids, nucleic acids, and membrane components, causing severe cellular damage. It is also produced by the immune system as a first-line of defense against invading pathogens. In this review, we summarize the adaptive responses of Gram-negative bacteria to HOCl-induced stress and highlight the role of chaperone holdases (Hsp33, RidA, Cnox, and polyP) as an immediate response to HOCl stress. We also describe the three identified transcriptional regulators (HypT, RclR, and NemR) that specifically respond to HOCl. Besides the activation of chaperones and transcriptional regulators, the formation of biofilms has been described as an important adaptive response to several stressors, including HOCl. Although the knowledge on the molecular mechanisms involved in HOCl biofilm stimulation is limited, studies have shown that HOCl induces the formation of biofilms by causing conformational changes in membrane properties, overproducing the extracellular polymeric substance (EPS) matrix, and increasing the intracellular concentration of cyclic-di-GMP. In addition, acquisition and expression of antibiotic resistance genes, secretion of virulence factors and induction of the viable but nonculturable (VBNC) state has also been described as an adaptive response to HOCl. In general, the knowledge of how bacteria respond to HOCl stress has increased over time; however, the molecular mechanisms involved in this stress response is still in its infancy. A better understanding of these mechanisms could help understand host-pathogen interactions and target specific genes and molecules to control bacterial spread and colonization.

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“…The risk factors have been introduced in specific scores by some working groups (6). The guidelines of diagnosis and treatment vary (6,8). Topical solutions seem the most reasonable approach as therapy (8).…”

Section: Discussionmentioning

confidence: 99%

“…The guidelines of diagnosis and treatment vary (6,8). Topical solutions seem the most reasonable approach as therapy (8).…”

Section: Discussionmentioning

confidence: 99%

Hypertrofic scar – associated ultrasound aspects after thyroidectomy

Şandru¹,

Valea²,

Albu³

et al. 2020

Ro J Med Pract.

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Scar is part of wound healing and hypertrophic aspects as well as keloids are pathological formation of a scar. Their appearance is seen post-operatory, post-trauma and the consequences are more than cosmetic depending on location, for instance at joins functional impotence is associated. A scar formation involves activation of matrix enzymes, matrix response, local inflammation and fibroblast intervention as well as local cytokines and growth factors action. Our purpose is to introduce to cases of females who developed hypertrophic scars after thyroidectomy in addition to local swelling as revealed by neck ultrasound. The paper is two cases series report. The hormonal assays and ultrasound aspects are provided. A 30-year female with Basedow disease had one month after thyroidectmy TRAb of 2.4 U/l while TSH was 1 of under daily 100 µg of levothyroxine. The subject presented a post-operatory hypertrophic scar in addition to the following ultrasound aspect: right area with an inhomogeneous structure of 1/1.2/4 cm, left area of 1.4/1.7/4 cm, with multiple images with posterior echo and intense local edema. This is a 44-year female referred for total thyroidectomy (for large goiter). The subject did not develop any peri-operatory complication. The histological report showed chronic autoimmune thyoiditis background of focal type in addition to nodules of colloidal and cystic adenomatosis with hyperplasic epithelium. One month later TSH was normal under levothyroxine. The subject presented a post-operatory hypertrophic scar in addition to ultrasound aspect of edema in association with inflammatory lymph nodes at lateral cervical level of 0.6/0.2 cm maximum diameter. It is still a matter of debate to classify the high risk patients for developing post-thyroidectomy scars.

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Topical stabilized hypochlorous acid: The future gold standard for wound care and scar management in dermatologic and plastic surgery procedures

Cited by 51 publications

References 31 publications

Biofilm-Innate Immune Interface: Contribution to Chronic Wound Formation

Biofilm-Innate Immune Interface: Contribution to Chronic Wound Formation

Surviving Reactive Chlorine Stress: Responses of Gram-Negative Bacteria to Hypochlorous Acid

Hypertrofic scar – associated ultrasound aspects after thyroidectomy

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