Antiseptic versus non-antiseptic solutions for preventing infection in acute traumatic wounds: a systematic review

Abstract

Objective: To compare the effectiveness of antiseptic solutions to that of non-antiseptic solutions in reducing wound infection rate, reducing bacterial load and improving wound healing. Method: We searched PubMed MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), ProQuest Medical Database and medRxiv for randomised controlled trials (RCTs) comparing antiseptic solutions with non-antiseptic solutions in simple, uncomplicated acute traumatic wounds. Qualitative data synthesis was employed. Risk of bias was assessed and GRADE assessment was used to evaluate quality of evidence. Results: In this systematic review, four studies with a total of 875 participants were included, of which two studies showed a significant reduction of wound infection rate using povidone-iodine (p=0.001 and p=0.03). The use of non-antiseptic solutions significantly increased bacterial load on acute traumatic wounds (p=0.0001). The quality of evidence was very low. No studies reported on wound healing outcome. Conclusion: No robust conclusions can be implemented in clinical practice. Future studies are needed to compare the use of antiseptic and non-antiseptic solutions in acute traumatic wounds.

An objective comparative study of non‐surgical cleansing techniques and cleanser types in bacterial burden management

“…We observed that cleansers with antiseptic properties, including povidone‐iodine, led to a significantly greater reduction in bacterial FL area than non‐antiseptics and surfactants (saline, soap). This aligns with the findings from a 2022 systematic review focussed on antiseptic versus non‐antiseptic effectiveness in acute wounds, 26 however, that review only identified two RCTs that directly compared bacterial load reduction. We were unable to find any comparable reviews focused on chronic wounds, demonstrating the scarcity of rigorous, clinical evidence in this regard.…”