Michał Krzysztof Kołodziejczyk, Michał Jakub Nachajski, Justyna Kołodziejska
Antimicrobial substances in wound treatment
2024-10-24
Introduction. European and Polish expert teams, including the Polish Wound Management Society, emphasize the importance of abandoning local use of antibiotics in favor of rational use of antimicrobial substances. They also provide detailed guidelines for treating wounds not at risk of infection, wounds at risk of infection, and infected wounds.
Objective. The aim of the study is to present current recommendations regarding wound antiseptic procedures and provide a review of antiseptic substances. The above may be useful in the daily work of pharmacists, as it will help them make the right decisions regarding the selection of a wound treatment product appropriate for the patient.
Methodology. Literature data was obtained by searching the PubMed and Science Direct databases using the following keywords: “antiseptic”, “wound infection”, “wound healing”, “antibiotic”, “lawaseptic”, “octenidine”, “polyhexamethylene biguanide”, “povidone iodine”, “hypochlorites”, and “silver compounds”.
Results and discussion. Antiseptics include medicinal products that destroy microorganisms and inhibit their growth and are applied topically to living tissues. They can be applied to mucous membranes and intact skin or damaged tissues, with particular emphasis on wounds and burns. The goal of antiseptic use is to completely remove microorganisms from tissue, reduce infection, or prevent infection or its transmission. Recommended active substances in pharmaceutical products include octenidine (octenidine dichloride, OCT), polyhexanidine (polyhexamethylene biguanide, PHMB), povidone iodine (povidone iodine, PVP-I), hypochlorites, and silver compounds. The importance of the wound cleansing and rinsing process using lavaseptics cannot be ignored. These are products based on surfactants such as betaine, poloxamer, and ethylhexylglycerin, which reduce the surface tension at the interface of the cleansing fluid and the wound surface. This contributes to the disorganization of the structure of the bacterial biofilm.
Conclusions. The choice of antiseptic preparation should be dictated, in addition to aspects related to the wound itself, i.e., wound type and its clinical condition, to the spectrum of target microorganisms and the side effect profile of the product. There is no perfect antiseptic. In particular cases, specific antiseptics are preferred, e.g., in the treatment of ulcers - lavaseptics, in the treatment of deep penetrating wounds – hypochlorites, in the treatment of abrasions and scratchesoctenidine.
Keywords: wound infection, wound healing, octenidine, antiseptic, povidone iodine, silver compounds, polyhexanidine, hypochlorites.
© Farm Pol, 2024, 80(5): 331–342