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Antiseptic Agents for Chronic Wounds: A Systematic Review
Koko Barrigah-Benissan1, Jérôme Ory1, Albert Sotto2
1Bacterial Virulence and Chronic Infections, INSERM U1047, Department of Microbiology and Hospital Hygiene, University of Montpellier, CHU Nîmes, 30029 Nîmes, France.
Antibiotics (Basel, Switzerland)
|March 25, 2022
Summary
Iodine antiseptics show promise for chronic wound healing compared to saline, offering a potential asset against antibiotic resistance. More research is needed for octenidine and polyhexanide efficacy.
Area of Science:
- Wound Care and Management
- Antimicrobial Agents
- Evidence-Based Medicine
Background:
- Antiseptic agents are underutilized in chronic wound care globally.
- Rising antibiotic resistance necessitates alternative infection prevention strategies.
- Newer antiseptic agents offer potential benefits in wound antisepsis.
Purpose of the Study:
- To systematically review the efficacy of common antiseptic agents in promoting complete healing of chronic wounds.
- To evaluate iodine, polyhexanide, and octenidine in adult chronic wound care.
Main Methods:
- Systematic review and meta-analysis adhering to Cochrane Handbook and PRISMA guidelines.
- Searched five databases and three registries from inception to June 2021.
- Included six randomized controlled trials (RCTs) involving 725 adult patients.
Main Results:
- Limited evidence from two RCTs (195 patients) suggests iodine (cadexomer or povidone iodine) improves wound healing completion compared to saline (pooled RR 1.85; moderate-quality evidence).
- Insufficient evidence exists to support differences in healing for octenidine or polyhexanide compared to saline.
- No significant difference in adverse events was observed for any tested antiseptic agent versus saline.
Conclusions:
- Iodine-based antiseptics demonstrate potential for enhancing chronic wound healing, particularly relevant given antibiotic resistance.
- Current evidence is insufficient to confirm the efficacy of octenidine or polyhexanide for chronic wound healing.
- Antiseptic use in chronic wound care warrants further investigation to optimize patient outcomes.
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