Reducing the pathogen burden and promoting healing with polyhexanide in non-healing wounds: a prospective study

Area of Science:

• Wound healing research
• Antimicrobial therapies
• Clinical trial analysis

Background:

• Polyhexamethylene biguanide (PHMB) is a novel antiseptic with broad-spectrum antimicrobial activity and wound healing properties.
• PHMB exhibits a favorable safety profile with minimal side effects, making it a promising agent for wound care.

Purpose of the Study:

• To evaluate the efficacy of PHMB compared to Ringer's lactate solution (RLS) in reducing bacterial burden, wound size, and promoting closure in non-healing wounds over 21 days.
• To investigate differences in C-reactive protein (CRP) and white blood cell (WBC) counts between PHMB and RLS treatment groups.

Main Methods:

• A prospective, open-cohort clinical study involving patients undergoing cardiac surgery.
• Patients were randomized into two groups: PHMB or RLS treatment.
• A dedicated wound care team monitored wound healing daily, infection parameters every third day, and collected wound tissue cultures weekly.

Main Results:

• Out of 31 patients analyzed, 17 (66.7% in PHMB group vs. 43.8% in RLS group) achieved successful wound closure or healing.
• Wound tissue cultures were negative in 47.4% of the PHMB group and 52.6% of the RLS group.
• While CRP levels decreased significantly in both groups, they were notably lower in the PHMB group after 12 days (p<0.05).

Conclusions:

• Successful treatment of chronic non-healing wounds necessitates a multidisciplinary team approach led by a wound care specialist.
• Treatment consistency appears to be a critical factor, potentially more so than the specific disinfectant used.
• Increased use of PHMB and adoption of a team-based approach may accelerate healing, particularly for chronic non-healing wounds.