Wundverschluss nach Wundspülung mit Octenisept® ohne Abflussmöglichkeit

Abstract

A 39-year-old patient suffered a stab wound of the right thenar prominence after an accident with a screwdriver. In the first hospital the deep wound was irrigated with octenidine dihydrochloride/2-phenoxyethanol and closed by suture. During the further course pressure pain and numbness of the right thenar and swelling of the right hand occurred. Three weeks after the accident an operative revision of the wound in a second hospital was performed. The intraoperative findings showed inflammation and necrosis of the right m. abductor pollicis brevis, but no infection with pus.The patient accused the first hospital of irrigating the tissue of his right hand with Octenisept®. The expert option of the Arbitration Board identified improper care in the first hospital with insufficient excision of the wound and incorrect use of the Octenisept® solution. Against the explicit advice of the manufacturing company the wound had been sutured without the possibility of drainage for the Octenisept® solution.

Eradication of MRSA skull base osteitis by combined treatment with antibiotics and sinonasal irrigation with sodium hypochlorite

“…As a consequence, irrigation of penetrating wounds using Octenisept Ò resulted in aseptic tissue necrosis [19][20][21]. Besides, in vitro results indicate significantly reduced cell viability after octenidine treatment [11].…”

Effect of Commercially Available Wound Irrigation Solutions on Uninfected Host Tissue in a Murine Model

“…But, in addition to evidence that supports their anti-infective capabilities, these solutions have also demonstrated toxicity to host cells in vitro [ [11] , [12] , [13] , [14] , [15] ]. This toxicity could be detrimental to wound healing and even increase the rate of wound complications [ 16 , 17 ]. Meurs et.…”

A prospective study to analyse the concentration of octenidine in hand wounds after disinfection by LC–MS/MS

“…Toxic reactions after the application of OCT such as chemical serositis, persistent subcutaneous oedema and aseptic necrosis are described in the literature 4,5 . They predominantly occur when OCT is injected (pressurised application) into the soft tissue or when rinsing wound pockets without sufficient drainage 3,6,7 . The toxicity is explained by the interaction between the antiseptic and polysaccharides of the cell membrane, which induces cell death after destruction of the cytoplasmic membrane 2 .…”

“… 4 , 5 They predominantly occur when OCT is injected (pressurised application) into the soft tissue or when rinsing wound pockets without sufficient drainage. 3 , 6 , 7 The toxicity is explained by the interaction between the antiseptic and polysaccharides of the cell membrane, which induces cell death after destruction of the cytoplasmic membrane. 2 Histologically, cytotoxic effects were detected in keratinocytes, fibroblasts and in endothelial cells of blood vessels.…”