Rapid degradation and non-selectivity of Dakin’s solution prevents effectiveness in contaminated musculoskeletal wound models

Mangum, Lee C.; Franklin, Nathan A; Garcia, Gerardo R.; Akers, Kevin S.; Wenke, Joseph C.

doi:10.1016/j.injury.2018.08.004

Cited by 14 publications

(7 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Both H 2 O 2 and HOCl are produced by neutrophils to break down pathogenic and foreign substances and have been used to treat wound infections (Wang et al 2007). Dilute sodium hypochlorite (Dakin's solution) has also been used for wound debridement (Degnim et al 2013;Mangum et al 2018). We previously investigated infections postbreast and axillary operations and found that including Dakin's solution in postoperative care reduced bacterial colonization of drainage tubes (Degnim et al 2013).…”

Section: Introductionmentioning

confidence: 99%

Hypochlorous acid-generating electrochemical scaffold eliminates Candida albicans biofilms

Zmuda

Mohamed

Raval

et al. 2020

Journal of Applied Microbiology

View full text Add to dashboard Cite

Aims Wound infections involving Candida albicans can be challenging to treat because of the fungus’ ability to penetrate wound tissue and form biofilms. The goal of this study was to assess the activity of a hypochlorous acid (HOCl)‐generating electrochemical scaffold (e‐scaffold) against C. albicans biofilms in vitro and on porcine dermal explants (ex vivo). Methods and Results C. albicans biofilms were grown either on acrylic‐bottom six‐well plates (in vitro) or on skin tissue excised from porcine ears (ex vivo), and the polarized e‐scaffold was used to generate a continuous supply of low concentration HOCl near biofilm surfaces. C. albicans biofilms grown in vitro were reduced to undetectable amounts within 24 h of e‐scaffold exposure, unlike control biofilms (5·28 ± 0·034 log10 (CFU cm‐2); P < 0·0001). C. albicans biofilms grown on porcine dermal explants were also reduced to undetectable amounts in 24 h, unlike control explant biofilms (4·29 ± 0·057 log10 (CFU cm‐2); P < 0·0001). There was a decrease in the number of viable mammalian cells (35·6 ± 6·4%) in uninfected porcine dermal explants exposed to continuous HOCl‐generating e‐scaffolds for 24 h compared to explants exposed to nonpolarized e‐scaffolds (not generating HOCl) (P < 0·05). Conclusions Our HOCl‐generating e‐scaffold is a potential antifungal‐free strategy to treat C. albicans biofilms in chronic wounds. Significance and Impact of the Study Wound infections caused by C. albicans are difficult to treat due to presence of biofilms in wound beds. Our HOCl producing e‐scaffold provides a promising novel approach to treat wound infections caused by C. albicans.

show abstract

Section: Introductionmentioning

confidence: 99%

Hypochlorous acid-generating electrochemical scaffold eliminates Candida albicans biofilms

Zmuda

Mohamed

Raval

et al. 2020

Journal of Applied Microbiology

View full text Add to dashboard Cite

show abstract

“…Introduced more than 100 years ago, NaOCl solutions remain a standard of care in the disinfection of external soft tissue wounds [54]. Irrigants containing one or multiple antibiotics have also been discussed, as they selectively kill the invading microorganisms and obviously cause less collateral damage than non-specific biocides such as NaOCl [55]. There is also a history of glutaraldehyde usage in antiseptic solutions [56] and despite the fact that it is still contained in some dentine bonding agents [57], the high toxicity and mutagenic potential of this chemical would preclude it from the application proposed by Waly (1995) [47].…”

Section: Discussionmentioning

confidence: 99%

Wound Lavage in Studies on Vital Pulp Therapy of Permanent Teeth with Carious Exposures: A Qualitative Systematic Review

Munir

Zehnder

Rechenberg

2020

JCM

View full text Add to dashboard Cite

The aim of this study was to systematically review pulp wound lavage in vital pulp therapy (VPT). A search was conducted in six life science databases to identify clinical trials carried out on permanent teeth with a carious pulp exposure and a recall interval of at least six months. Twenty-seven trials of low to moderate risk of bias (RoB-2 and ROBINS-I) were included. Data was extracted and analyzed regarding study characteristics and methods used for pulp wound lavage. The agent used for pulp wound lavage was specified in all included trials. Most of the identified trials (23/27) randomized the pulp capping material. Many (14/27) reported the use of sodium hypochlorite (NaOCl); ten used only saline or water. One trial was identified that compared pulp wound lavage with 2.5% (NaOCl) to saline, another compared 5% glutaraldehyde to water, both in immature molar pulpotomies. Both studies were underpowered. Neither showed a significant difference between treatments. The use of NaOCl was positively correlated to recent year of publication and use of hydraulic calcium silicate cements for pulp capping (p < 0.05). In conclusion, despite a lack of well-designed trials on pulp wound lavage in VPT, a trend towards using NaOCl for this purpose was observed.

show abstract

“…Our institution utilised a 0.125% (quarter‐strength) Dakin's solution in accordance with this principle. It should be noted, however, that recent studies have suggested that Dakin's cytotoxic effects may remain at much lower concentrations, although this is an area of on‐going research …”

Section: Discussionmentioning

confidence: 99%

“…It should be noted, however, that recent studies have suggested that Dakin's cytotoxic effects may remain at much lower concentrations, although this is an area of on-going research. [32][33][34] In our study, Dakin's and Prontosan were utilised as the initial or only instillation solutions in all the cases. Early in our series, Prontosan was used exclusively when we were presented with an open wound with exposed hardware due to institutional policy regarding Dakin's solution instillation.…”

Section: Discussionmentioning

confidence: 99%

Instillation negative pressure wound therapy: An effective approach for hardware salvage

Hehr

Hodson

West

et al. 2019

International Wound Journal

View full text Add to dashboard Cite

Wound infection involving hardware can be notoriously difficult to treat, often requiring the removal of the infected implant. The goal of this study was to determine the utility of instillation negative pressure wound therapy to help eradicate infection and allow for definitive wound closure in patients without removing the infected hardware. A retrospective review was performed on the outcomes of 28 patients who presented with open wounds with exposed or infected hardware and who were treated with a combination of surgical debridement and negative pressure wound therapy with instillation (NPWTi). Eleven patients were treated for infected spinal hardware, 12 for extremity, and 5 for sternal hardware. Twenty‐five of 28 (89%) patients had successful retention or replacement of hardware, with clearance of infection and healed wounds. Original hardware was maintained in 17 of 28 (61%) patients. In 11 patients, original hardware was removed, with subsequent replacement in eight of those patients after a clean wound was achieved. Average time to definitive closure was 12.6 days. Average follow‐up was 135 days. This series supports NPWTi as an effective adjunct therapy to help expeditiously eradicate hardware infection, allowing for hardware retention.

show abstract

Rapid degradation and non-selectivity of Dakin’s solution prevents effectiveness in contaminated musculoskeletal wound models

Cited by 14 publications

References 45 publications

Hypochlorous acid-generating electrochemical scaffold eliminates Candida albicans biofilms

Hypochlorous acid-generating electrochemical scaffold eliminates Candida albicans biofilms

Wound Lavage in Studies on Vital Pulp Therapy of Permanent Teeth with Carious Exposures: A Qualitative Systematic Review

Instillation negative pressure wound therapy: An effective approach for hardware salvage

Contact Info

Product

Resources

About