The management of chronic ulcers with an acidoxidising solution

Chronic ulcers are an intractable problem in many patients and are associated with impaired quality of life and high health-care costs. In an attempt to improve outcome, our centre began cleansing wounds with a novel spray acidoxidising solution (Nexodyn) with unique physicochemical features, pH <3.0; oxidation reduction potential >1000mV; and free chlorine content (>95% HClO).

A retrospective analysis was conducted in patients with numerous comorbidities and an unsatisfactory response to standard therapy. The solution was administered for six weeks and the patients' clinical course evaluated using standard measures of wound healing, pain and bioburden.

We assessed 20 patients with a mean time since ulcer onset of 23.7 months. Complete resolution of the lesion was achieved in 25% of cases (p=0.005). In the group as a whole, wound size decreased significantly (11% mean reduction versus baseline; p=0.039). In the relatively short six-week observation period, significant reductions versus baseline were also observed in control of wound bioburden (p=0.005) and ulcer-related pain score (p<0.001). Furthermore, the wound bed preparation score suggests an improved wound microenvironment with better wound bed cleansing and the presence of granulation tissue. There were no adverse systemic effects of treatment nor adverse local effects in the wound bed or on healthy periwound skin.

Encouraging initial results in a population refractory to standard management provide evidence that this new product may make a helpful contribution to the care of chronic ulcers. The integration of this cleansing solution into standard care contributes to the modulation of local microenvironmental responses that inhibit physiological healing processes while also contributing to the reduction of bacterial load.