Evaluation of angiogenesis, epithelialisation and microcirculation after application of polyhexanide, chitosan and sodium chloride in rodents

Abstract

The purpose of this study was to investigate the effect of polyhexanide and a new developed chitin-based wound dressing on skin microcirculation, epithelialisation and angiogenesis. A full-thickness dermal layer extending to the underlying cartilage was excised on the dorsal side of hairless mice (n = 27; 2·3 ± 0·3 mm ). A polyhexanide ointment, a chitosan solution and a sodium chloride group as control were analysed using intravital fluorescence microscopy. Angiogenesis, epithelialisation and microcirculatory standard parameters were measured over a time period of 20 days. The non-perfused area is regarded as a parameter for angiogenesis and showed the following results: on days 12, 16 and 20, the sodium chloride group was significantly superior to chitosan solution (P < 0·05) and, on days 8, 12, 16 and 20, the polyhexanide group was superior to chitosan solution (P < 0·05). The epithelialisation was measured significantly faster in the polyhexanide and control group on day 8 versus chitosan solution. Whereas polyhexanide and sodium chloride were nearly completely epithelialised, treatment with chitosan solution showed still an open wound of 11% of the initial wound size. Altogether, we could demonstrate the advantageous effects of a polyhexanide ointment on microcirculation, angiogenesis and epithelialisation. Chitosan solution appears to inhibit angiogenesis and delays epithelialisation. Further studies in different models would be worthwhile to confirm these results.

Update on the role of antiseptics in the management of chronic wounds with critical colonisation and/or biofilm

“…In a recent systematic review, it was concluded that PHMB may promote the healing of chronic wounds, reduce the bacterial load, eradicate MRSA, and lessen wound‐related pain 151 . A preclinical study using a mouse wound model demonstrated that PHMB had more beneficial effects on the microcirculation, angiogenesis, and epithelialisation compared with chitosan 152 . In a further study, PHMB had a more positive effect upon the blood flow of intact human skin in vivo than octenidine, suggesting value in the treatment of critically perfused wounds, such as burns 142 .…”

“…151 A preclinical study using a mouse wound model demonstrated that PHMB had more beneficial effects on the microcirculation, angiogenesis, and epithelialisation compared with chitosan. 152 In a further study, PHMB had a more positive effect upon the blood flow of intact human skin in vivo than octenidine, suggesting value in the treatment of critically perfused wounds, such as burns. 142 Comparison of a PHMB-containing dressing with a silver-based dressing in patients with critically colonised and locally infected wounds demonstrated that the PHMBcontaining dressing was significantly faster and more effective at removing the critical bacterial load over a 28-day period.…”