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Published on: April 7, 2017
Activated chlorine dioxide solution can be used as a biocompatible antiseptic wound irrigant
Jonathan H Valente1, Gregory D Jay, Christopher P Zabbo
1Jonathan H. Valente, MD, is an Associate Professor in the Department of Emergency Medicine at The Alpert Medical School of Brown University and Rhode Island Hospital, and Hasbro Children's Hospital, Providence, Rhode Island. Gregory D. Jay, MD, PhD, is a Professor in the Department of Emergency Medicine at The Alpert Medical School of Brown University and Rhode Island Hospital in Providence, Rhode Island. He has received grant/research funding from the NIH and AHRQ in the past and is receiving funding from those same organizations currently. He is a consultant/advisor to Covidien (Mansfield, Massachusetts). Christopher P. Zabbo, DO, is the Program Director of the Emergency Medicine Residency at Kent Hospital in Warwick, Rhode Island, and a Clinical Assistant Professor at the University of New England College of Osteopathic Medicine in the Department of Emergency Medicine at Kent Hospital in Warwick, Rhode Island. Steven E. Reinert, MS, is a Research Analyst at Lifespan Information Services in Providence, Rhode Island. Karina Bertsch, MSW, is the Clinical Research Program Administrator at Rhode Island Hospital in Providence.
Objective:
The purpose of this study was to compare cosmesis at 3 to 4 months and infection in simple lacerations irrigated with normal saline (NS) versus activated chlorine dioxide (CD).
Design:
This was a prospective, randomized trial of a convenience sample of patients. This study was approved by the institutional review board and Food and Drug Administration as a physician-sponsored trial (FDA investigational new drug no. 68762).
Setting:
The study was conducted in a large urban, academic emergency department.
Patients:
Patients aged 18 to 100 with simple, uncomplicated lacerations requiring repair that were less than 8 hours old were enrolled.
Interventions:
Patients were randomized to receive either NS or CD wound irrigation.
Main Outcome Measures:
Demographics, infection, and cosmesis were analyzed and assessed. Cosmetic outcome was assessed at 3 to 4 months using a visual analog scale (VAS), wound evaluation score (WES), patient VAS (VASPt), and digital imaging VAS by 2 plastic surgeons (VASPlast).
Main Results:
One hundred ninety-three patients were enrolled. Data analysis was available for 175 cases (86 NS and 89 CD). Wound infection follow-up was obtained in 74.9% of the patients. The 3- to 4-month cosmesis follow-up was 37.7% for VAS/WES, 40.0% for VASPt, and 37.7% for VASPlast. There were no significant differences in demographics, key wound characteristics, infection, adverse reactions, and cosmesis.
Conclusion:
The authors report the use of a novel antimicrobial irrigation solution. Chlorine dioxide appears to be a safe biologically acceptable antiseptic wound irrigant that does not appear to interfere with cosmetic outcomes.
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