Do Commonly Used Antimicrobial Topicals Facilitate Venous Leg Ulcer Healing?

To survey which topical antimicrobials are most helpful in treating venous leg ulcers (VLUs).

In this narrative review, the authors searched the databases of Google Scholar, Cochrane Library, and Wiley Online Library.

Studies were eligible for inclusion if they studied the effects of antimicrobial agents on chronic VLU healing and were published after 1985. Exceptions to this were in vitro studies of manuka honey and Dakin solution (Century Pharmaceuticals). Search terms included "venous leg ulcer", "nonhealing ulcer", "antimicrobial resistance", and "biofilms".

Data extracted included design, setting, descriptions of intervention and control groups, outcomes, data collection tools, and potential harms.

A total of 19 articles encompassing 26 studies/trials met the inclusion criteria. Of the 26 studies, 17 were randomized controlled trials; the remaining 9 were a mix of lower-quality case series and comparative, nonrandomized, or retrospective studies.

Studies suggest that VLUs can be treated with multiple different topical antimicrobials. Depending on the extent of chronicity and bacterial colonization, some antimicrobials may be better suited than others.