Clinical Outcomes of Wide Postsurgical Lesions in the Infected Diabetic Foot Managed With 2 Different Local Treatment Regimes Compared Using a Quasi-Experimental Study Design: A Preliminary Communication

Abstract

The safety and efficacy of a novel superoxidized solution (Dermacyn Wound Care [DWC], Oculus Innovative Sciences, Petaluma, Calif) was evaluated for the treatment of wide postsurgical infected ulcers of the diabetic foot. A group (group A, n = 18) of patients with diabetes mellitus who had postsurgical lesions > 5 cm(2) without ischemia or infection were recruited consecutively and treated with DWC-saturated dressings. These dressings were renewed once daily and were compared with a group of patients that had been previously treated with diluted povidone iodine (group B, n = 15) using a quasi-experimental study design. Both sets of patients also received standard systemic antibiotic therapy, as per the practice in this center, and local surgical debridement. Patients had weekly assessments until wounds had re-epithelialized completely. Patients in group A had statistically significant shorter healing time and duration of antibiotic therapy and a higher healing rate at 6 months compared with those in group B (p < .01). Recurrence of infection, requirement for debridement procedures, and requirement for minor amputations were significantly less frequent during follow-up in group A patients (p < .05) when compared with those in group B. These preliminary data suggest that DWC used as a wound dressing together with other local and systemic therapies may have a role in reducing healing time as well as complications in patients with diabetes who have postsurgical lesions of the diabetic foot. These data propose the need for a robust controlled study of DWC-saturated dressings to explore its full potential.

Topical Antimicrobial Therapy for Treating Chronic Wounds

“…This pH-neutral sterilant with reactive species of chlorine and oxygen in a stable formulation is rapidly bactericidal, has broad-spectrum coverage, does not appear to facilitate bacterial resistance or damage host tissues, and may be active in the presence of biofilm [28]. It can be applied directly to wounds or be combined with dressings or other wound products, and several small, nonrandomized studies suggest it is effective in treating infected diabetic foot ulcers [29][30][31]. Antimicrobial peptides are another novel approach to topical therapy.…”

New developments in diagnosing and treating diabetic foot infections

“…Similarly, there are few studies of the efficacy (or safety) of topical iodides in treating DFIs [43]. Investigational topical agents for treating DFI include antimicrobial peptides, such as Pexiganan [44], and superoxidized water solutions, such as Dermacyn [45,46]. Studies to determine the usefulness of several of these new agents are currently being developed.…”

Zum Stellenwert der Unterdruck‐Instillationstherapie in der Dermatologie

“…Microcyn ® und Dermacyn ® stellen pH‐Wert‐neutrale Lösungen aus superoxidiertem Wasser und hypochloriger Säure dar. Die lokale Microcyn ® ‐Anwendung stellte sich dabei als genauso effektiv heraus wie eine orale Levofloxacin‐Gabe bei moderaten Wunden beim diabetischen Fußsyndrom , und die tägliche Applikation von Dermacyn ® bei postoperativen Fußwunden bei Patienten mit Diabetes mellitus hält dem Vergleich mit einer täglichen Anwendung von Polyvidon‐Jod stand .…”