Total amount: € 0,00
Official Journal of the Italian Association for Cutaneous Ulcers
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Online ISSN 1827-1774
Unità Operativa Complessa di Geriatria “Bentivoglio”, Dipartimento Medico AUSL di Bologna, Ospedale di Bentivoglio Bentivoglio, Bologna, Italia
Controversy exists among wound care experts regarding how to control the bacterial load in chronic wounds and the use of topical antiseptics. A traditional approach depends on application of topical substances containing antimicrobial agents at each dressing change copying the model of surgical field preparation. Those products generally derive from disinfectants (hypochlorite, iodine, chlorexidine, etc.). Despite the broad range of activity and the low microbial resistances, some of these products showed both local and systemic toxic effects, directly connected with concentration and time of contact. More recently antimicrobial products containing silver and iodine were added into modern dressings with high absorption capacity (like alginates, hydrofiber, foams, etc.). Slow release allows both low local and systemic toxicity and a prolonged antimicrobial action. Those dressing are usually expensive but single cost is balanced by delayed dressing changes of up to a week. In infected wounds an aggressive approach can reduce healing time and costs too. Recently, international consensus stressed the effectiveness of a sequential approach in which the use of an antiseptic product at dressing change is followed by the application a modern high-absorbent slow-release dressing. The author presents a review of literature about the usage of topical based products such as hypochlorite, that for long time represented one of best choices of local treatment of wound infections at a generally low cost. Conclusions suggest that in infected wounds with necrosis, it is possible to pair the application of a modern slow release and long permanence dressings with the use at dressing changes of specific hypochlorite solutions (e.g. 0.057%), that balance local toxicity with high activity and low microbial resistances.