Wound antisepsis has undergone a renaissance due to the introduction of highly effective wound-compatible antimicrobial agents and the spread of multidrug-resistant organisms (MDROs). However, a strict indication must be set for the application of these agents. An infected or critically colonized wound must be treated antiseptically. In addition, systemic antibiotic therapy is required in case the infection spreads. If applied preventively, the Wounds-at-Risk Score allows an assessment of the risk for infection and thus appropriateness of the indication. The content of this updated consensus recommendation still largely consists of discussing properties of octenidine dihydrochloride (OCT), polihexanide, and iodophores. The evaluations of hypochlorite, taurolidine, and silver ions have been updated. For critically colonized and infected chronic wounds as well as for burns, polihexanide is classified as the active agent of choice. The combination 0.1% OCT/phenoxyethanol (PE) solution is suitable for acute, contaminated, and traumatic wounds, including MRSA-colonized wounds due to its deep action. For chronic wounds, preparations with 0.05% OCT are preferable. For bite, stab/puncture, and gunshot wounds, polyvinylpyrrolidone (PVP)-iodine is the first choice, while polihexanide and hypochlorite are superior to PVP-iodine for the treatment of contaminated acute and chronic wounds. For the decolonization of wounds colonized or infected with MDROs, the combination of OCT/PE is preferred. For peritoneal rinsing or rinsing of other cavities with a lack of drainage potential as well as the risk of central nervous system exposure, hypochlorite is the superior active agent. Silver-sulfadiazine is classified as dispensable, while dyes, organic mercury compounds, and hydrogen peroxide alone are classified as obsolete. As promising prospects, acetic acid, the combination of negative pressure wound therapy with the instillation of antiseptics (NPWTi), and cold atmospheric plasma are also subjects of this assessment.

Keywords:
Wound antisepsis, Wounds-at-Risk Score, Antiseptics, Drug, Medical device, Octenidine, Polihexanide, Hypochlorite, Iodophors, Taurolidine
1.
Poole K: Efflux pumps as antimicrobial resistance mechanisms. Ann Med 2007;39:162-176.
2.
Costa SS: Multidrug efflux pumps in Staphylococcus aureus: an update. Open Microbiol J 2013;7:59-71.
3.
Silver S: Bacterial silver resistance: molecular biology and uses and misuses of silver compounds. FEMS Microbiol Rev 2003;27:341-353.
4.
Hetem DJ, Bonten MJ: Clinical relevance of mupirocin resistance in Staphylococcus aureus. J Hosp Infect 2013;85:249-256.
5.
Then RL, Kohl I, Burdeska A: Frequency and transferability of trimethoprim and sulfonamide resistance in methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis. J Chemother 1992;4:67-71.
6.
Heuer H, Smalla K: Manure and sulfadiazine synergistically increased bacterial antibiotic resistance in soil over at least two months. Environm Microbiol 2007;9:657-666.
7.
Kopmann C, Jechalke S, Rosendahl I, et al: Abundance and transferability of antibiotic resistance as related to the fate of sulfadiazine in maize rhizosphere and bulk soil. FEMS Microbiol Ecol 2013;83:125-134.
8.
Mayer KH: Review of epidemic aminoglycoside resistance worldwide. Am J Med 1986;80:56-64.
9.
Cookson BD: The emergence of mupirocin resistance: a challenge to infection control and antibiotic prescribing practice. J Antimicrob Chemother 1998;41:11-18.
10.
Upton A, Lang S, Heffernan H: Mupirocin and Staphylococcus aureus: a recent paradigm of emerging antibiotic resistance. J Antimicrob Chemother 2003;51:613-617.
11.
Simor AE, Stuart TL, Louie L, et al: Mupirocin-resistant, methicillin-resistant Staphylococcus aureus strains in Canadian Hospitals. Antimicrob Agents Chemother 2007;51:3880-3886.
12.
Tam VH, Kabbara S, Vo G, Schilling AN, Coyle EA: Comparative pharmacodynamics of gentamicin against Staphylococcus aureus and Pseudomonas aeruginosa. Antimicrob Agents Chemother 2006;50:2626-2631.
13.
Briedis DJ, Robson HG: Comparative activity of netilmicin, gentamicin, amikacin, and tobramycin against Pseudomonas aeruginosa and Enterobacteriaceae. Antimicrob Agents Chemother 1976;10:592-597.
14.
Boyd LB, Maynard MJ, Morgan-Linnell SK, et al: Relationships among ciprofloxacin, gatifloxacin, levofloxacin, and norfloxacin MICs for fluoroquinolone-resistant Escherichia coli clinical isolates. Antimicrob Agents Chemother 2009;53:229-234.
15.
Deutsche Gesellschaft für Wundheilung und Wundbehandlung: Lokaltherapie chronischer Wunden bei Patienten mit den Risiken periphere arterielle Verschlusskrankheit, Diabetes mellitus, chronisch venöse Insuffizienz. S3 Leitlinie Reg. No. 091-001. 2012.
16.
Acton C, Barrett S, Beldon P, et al: Best practice statement: the use of topical antiseptic/antimicrobial agents in wound management. Second edition, May 2011. http://www.wounds-uk.com/pdf/content_9969.pdf.
17.
World Health Organization: Prevention and management of wound infection: guidance from WHO's Department of Violence and Injury Prevention and Disability and the Department of Essential Health Technologies. 2008. http://www.who.int/hac/techguidance/tools/guidelines_prevention_and_management_wound_infection.pdf.
18.
Kramer A, Assadian O, Below H, Willy C: Wound antiseptics today - an overview; in Willy C (ed): Antiseptics in Surgery - Update 2013. Berlin, Lindqvist, 2013, pp 85-111.
19.
Schlüter B, Konig W: Microbial pathogenicity and host defense mechanisms: crucial parameters of posttraumatic infections. Thorac Cardiovasc Surg 1990:38:339-347.
20.
Thomson PD: Immunology, microbiology, and the recalcitrant wound. Ostomy Wound Manage 2000;46(suppl 1A):77S-82S.
21.
Roth B, Neuenschwander R, Brill F, et al: Effect of antiseptic irrigation on infection rates of traumatic soft tissue wounds: a longitudinal cohort study. J Wound Care 2017;26:1-6.
22.
Hessam S, Sand M, Georgas D, et al: Microbial profile and antimicrobial susceptibility of bacteria found in inflammatory hidradenitis suppurativa lesions. Skin Pharmacol Physiol 2016;29:161-167.
23.
Richter C, Trojahn C, Hillmann K, et al: Reduction of inflammatory and noninflammatory lesions with topical tyrothricin 0.1% in the treatment of mild to severe acne papulopustulosa: a randomized controlled clinical trial. Skin Pharmacol Physiol 2016;29:1-8.
24.
Wohlrab J, Jost G, Abeck D: Antiseptic efficacy of a low-dosed topical triclosan/chlorhexidine combination therapy in atopic dermatitis. Skin Pharmacol Appl Skin Physiol 2007;20:71-76.
25.
Stelzner A: Bakterielle Zytoadhärenz; in Krasilnikow AP, Kramer A, Gröschel D, Weuffen W (eds): Handbuch der Antiseptik, Bd. I/4, Faktoren der Mikrobiellen Kolonisation. Stuttgart, Fischer, 1984, pp 160-217.
26.
Hentzer M, Riedel K, Rasmussen TB, et al: Inhibition of quorum sensing in Pseudomonas aeruginosa biofilm bacteria by a halogenated furanone compound. Microbiol 2002;148:87-102.
27.
König B, Reimer K, Fleischer W, König W: Effects of Betaisodona on parameters of host defense. Dermatology 1997;195(suppl 2):42-48.
28.
Menke H, Pelzer M, Raff T, Siebert J, Germann G: Ein neues lokales Antiseptikum zur Oberflächenbehandlung bei Schwerstverbrannten. Akt Traumotol 2001;31:211-215.
29.
Medina-Tamayo J, Sánchez-Miranda E, Balleza-Tapia H, et al: Super-oxidized solution inhibits IgE-antigen-induced degranulation and cytokine release in mast cells. Int Immunopharmacol 2007;7:1013-1024.
30.
Reimer K, Vogt PM, Brögmann B, et al: An innovative topical drug formulation for wound healing and infectin treatment: in vitro and in vivo investigations of a povidone iodine liposome hydrogel. Dermatology 2000;201:235-241.
31.
Kramer A, Roth B, Müller G, Rudolph P, Klöcker N: Influence of the antiseptic agents polihexanide and octenidine on FL cells and on healing of experimental superficial aseptic wounds in piglets: a double-blind, randomised, stratified, controlled, parallel group study. Skin Pharmacol Physiol 2004;17:141-146.
32.
Roth C, Beule AG, Kramer A, Hosemann W, Kohlmann T, Scharf C: Response analysis of stimulating efficacy of polihexanide in an in vitro wound model with respiratory ciliary epithelial cells. Skin Pharmacol Physiol 2010;23(suppl 1):35-40.
33.
Kramer A, Kremer J, Assadian O, et al: The classification of antiseptic products to be administered to wounds - another borderline case between medicinal products and medical devices? Int J Clin Pharmacol Ther 2006;44:677-692.
34.
Kramer A, Jäkel C, Kremer J, Dähne H, Schwemmer J, Assadian O: Abgrenzung von Arzneimitteln und Medizinprodukten sowie Konsequenzen für den Verbraucherschutz; in Kramer A, Assadian O (eds): Wallhäussers Praxis der Sterilisation, Desinfektion, Antiseptik und Konservierung. Stuttgart, Thieme, 2008, pp 592-600.
35.
White RJ, Cutting KF: Critical colonization - the concept under scrutiny. Ostomy Wound Manage 2006;52:50-56.
36.
Eisenbeiss W, Siemers F, Amtsberg G, et al: Prospective, double-blinded, randomised controlled trial assessing the effect of an Octenidine-based hydrogel on bacterial colonisation and epithelialization of skin graft wounds in burn patients. Int J Burns Trauma 2012;2:71-79.
37.
Dissemond J, Assadian O, Gerber V, et al: Classification of wounds at risk and their antimicrobial treatment with polyhexanide: a practice-orientated expert recommendation. Skin Pharmacol Physiol 2011;24:245-255.
38.
Pitten FA, Werner HP, Kramer A: A standardized test to assess the impact of different organic challenges on the antimicrobial activity of antiseptics. J Hosp Inf 2003;55:108-115.
39.
Schedler K, Assadian O, Brautferger U, et al: Proposed phase 2/step 2 in-vitro test on basis of EN 14561 for standardised testing of the wound antiseptics PVP-iodine, chlorhexidine digluconate, polihexanide and octenidine dihydrochloride. BMC Infect Dis 2017;17:143.
40.
Hansmann F, Kramer A, Ohgke H, Strobel H, Geerling G: Polyhexamethylbiguanid (PHMB) as preoperative antiseptic for cataract surgery. Ophthalmol 2004;101:377-383.
41.
Hansmann F, Kramer A, Ohgke H, Strobel H, Muller M, Geerling G: Lavasept as an alternative to PVP-iodine as a preoperative antiseptic in ophthalmic surgery. Randomized, controlled, prospective double-blind trial. Ophthalmol 2005;102:1043-1050.
42.
Hoerauf H, Holz FG, Kramer A, Feltgen N, Krohne T, Behrens-Baumann W: Stellungnahme der Deutschen Ophthalmologischen Gesellschaft, der Retinologischen Gesellschaft und des Berufsverbandes der Augenärzte Deutschlands: Endophthalmitis-Prophylaxe bei intravitrealer operativer Medikamenteneingabe (IVOM). Klin Monatsbl Augenheilkd 2013;230:1157-1161.
43.
Crabtree TD, Pelletier SJ, Pruett TL: Surgical antisepsis; in Block SS (ed): Disinfection, Sterilization, and Preservation, ed 5. Philadelphia, Lippincott Williams & Wilkins 2001, pp 919-934.
44.
Wiegand C, Abel M, Ruth P, Hipler UC: HaCaT keratinocytes in co-culture with Staphylococcus aureus can be protected from bacterial damage by polihexanide. Wound Repair Regen 2009;17:730-738.
45.
Lineaweaver W, Howard R, Soucy D, et al: Topical antimicrobial toxicity. Arch Surg 1985;120:267-270.
46.
Cantoni O, Brandi G, Salvaggio L, Cattabeni F: Molecular mechanisms of hydrogen peroxide cytotoxicity. Ann Ist Super Sanita 1989; 5:69-73.
47.
Wilson JR, Mills JG, Prather ID, Dimitrijevich SD: A toxicity index of skin and wound cleansers used on in vitro fibroblasts and keratinocytes. Adv Skin Wound Care 2005;18:37-38.
48.
Kramer A, Hetmanek R, Weuffen W, et al: Wasserstoffperoxid; in Kramer A, Weuffen W, Krasilnikow AP, et al (eds): Antibakterielle, Antifungielle und Antivirale Antiseptik - ausgewählte Wirkstoffe. Handbuch der Antiseptik. Stuttgart, Fischer, 1987, vol II/3, pp 447-491.
49.
Brudzynksi K: Effect of hydrogen peroxide on antibacterial activities of Canadian honeys. Can J Microbiol 2006;52:1228-1237.
50.
Koburger T, Hübner NO, Braun M, Siebert J, Kramer A: Standardized comparison of antiseptic efficacy of triclosan, PVP-iodine, octenidine dihydrochloride, polyhexanide and chlorhexidine digluconate. J Antimicrob Chemother 2010;65:1712-1719.
51.
Müller G, Langer J, Siebert J, Kramer A: residual antimicrobial effect of chlorhexidine digluconate and octenidine dihydrochloride on reconstructed human epidermis. Skin Pharmacol Physiol 2014;27:1-8.
52.
Müller G, Kramer A: Biocompatibility index of antiseptic agents by parallel assessment of antimicrobial activity and cellular cytotoxicity. J Antimicr Chemother 2008;61:1281-1287.
53.
Marsch G, Mashaqi B, Burgwitz K, et al: Prevention of pacemaker infections with perioperative antimicrobial treatment: an in vitro study. Europace 2014;16:604-611.
54.
Forstner C, Leitgeb J, Schuster R, et al: Bacterial growth kinetics under a novel flexible methacrylate dressing serving as a drug delivery vehicle for antiseptics. Int J Mol Sci 2013;14:10582-10590.
55.
Junka A, Bartoszewicz M, Smutnicka D, Secewicz A, Szymczyk P: Efficacy of antiseptics containing povidone-iodine, octenidine dihydrochloride and ethacridine lactate against biofilm formed by Pseudomonas aeruginosa and Staphylococcus aureus measured with the novel biofilm-oriented antiseptics test. Int Wound J 2014;11:730-734.
56.
Cutting K, Westgate S: The use of cleansing solutions in chronic wounds. Wound UK 2012;8:130-133.
57.
Uygur F, Özyurt M, Evinç R, Hosbul T, Çeliköz B, Haznedaroglu T: Comparison of octenidine dihydrochloride (Octenisept®), polihexanide (Prontosan®) and povidone iodine (Betadine®) for topical antibacterial effects in Pseudomonas aeruginosa-contaminated, full-skin thickness burn wounds in rats. Cent Eur J Med 2008;3:417-421.
58.
Hübner NO, Assadian O, Sciermoch K, Kramer A: Interaction of antiseptics and antibiotics - principles and first in vitro results (in German). GMS Krankenhaushyg Interdiszip 2007;2:Doc59.
59.
Hübner NO, Siebert J, Kramer A: Octenidine dihydrochloride, a modern antiseptic for skin, mucous membranes and wounds. Skin Pharmacol Physiol 2010;23:244-258.
60.
Calow T, Oberle K, Bruckner-Tuderman L, Jakob T, Schumann H: Contact dermatitis due to use of Octenisept in wound care. J Dtsch Dermatol Ges 2009;7:759-765.
61.
Stahl J, Braun M, Siebert J, Kietzmann M: The percutaneous permeation of a combination of 0.1% octenidine dihydrochloride and 2% 2-phenoxyethanol (Octenisept®) through skin of different species in vitro. BMC Vet Re 2011;7:44.
62.
Chamanga ET, Hughes M, Hilston K, Sparke A, Jandrisits JM: Chronic wound bed preparation using a cleansing solution. Br J Nurs 2015;24:30-36.
63.
Braun M, McGrath A, Downie F: Octenilin range. Wounds UK 2013;9:1-4.
64.
Braun M, Price J, Ellis M: An evaluation of the efficacy and cost-effectiveness of Octenilin® for chronic wounds. Wounds UK 2014;10:89-96.
65.
Urbach M, Mügge G: Libysche und syrische Kriegsverletzte - Wundversorgung am Bundeswehrkrankenhaus Hamburg. WundManagement 2013;4:51.
66.
Klein D, Becker D, Urbach M, Mügge G: Versorgung lybischer Kriegsverletzter am Bundeswehrkrankenhaus Hamburg unter spezieller Berücksichtigung der Hygienemassnahmen. Wehrmed Wehrpharm 2013;1:52-54.
67.
Krasowski G, Wajda R, Olejniczak-Nowakowska M: Economic outcomes of a new chronic wound treatment system in Poland. EWMA J 2014;14:7-13.
68.
Mayr-Kanhäuser S, Kränke B, Aberer W: Efficacy of octenidine dihydrochloride and 2-phenoxyethanol in the topical treatment of inflammatory acne. Acta Dermatovenerol Alp Pannonica Adriat 2008;17:139-143.
69.
Höning HJ: Erfahrungen bei der Anwendung von Octenisept® zur Wundantisepsis. Hyg Med 2012;37:360-362.
70.
Octenisept®: Schwellungen und Gewebeschädigungen nach Spülung tiefer Wunden - weitere Massnahmen zur Risikominimierung. Bull Arzneimittelsicherheit, Issue 2, June 2016. http://www.pei.de/SharedDocs/Downloads/vigilanz/bulletin-zur-arzneimittelsicherheit/2016/2-2016.pdf?__blob=publicationFile&v=6.
71.
Siemers F, Stang FH, von Wild T, et al: Erfahrungen mit der lokalen Anwendung von Octenidin-Spüllösung bei der operativen Versorgung von Handinfektionen. Abstract 52. Congress DGH. http://www.egms.de/static/en/meetings/dgh2011/11dgh41.shtml.
72.
Good H: Charakterisierung der Desinfektionsmittel. Aktuelle Probleme der Chirurgie und Orthopädie. Bern, Huber, 1979, pp 87-96.
73.
Kramer A, Hübner NO, Assadian O, et al: Polihexanide - perspectives on clinical wound antisepsis. Skin Pharmacol Physiol 2010;23(suppl 1):1-3.
74.
Roth B, Brill FHH: Polihexanide for wound treatment - how it began. Skin Pharmacol Physiol 2010;23(suppl 1):4-6.
75.
Chhabra RS, Huff JE, Haseman JK, Elwell MR, Peters AC: Carcinogenicity of p-chloroaniline in rats and mice. Food Chem Toxicol 1991;29:119-124.
76.
Below H, Assadian O, Baguhl R, et al: Measurements of chlorhexidine, p-chloroaniline, and p-chloronitrobenzene in saliva after mouth wash before and after operation with 0.2% chlorhexidine digluconate in maxillofacial surgery: a randomised controlled trial. Br J Oral Maxillofac Surg 2017;55:150-155.
77.
Fabry W, Reimer C, Azem T, Aepinus C, Kock HJ, Vahlensieck W: Activity of the antiseptic polyhexanide against meticillin-susceptible and methicillin-resistant Staphylococcus aureus. J Glob Antimicrob Resist 2013;1:195-199.
78.
Dissemond J, Witthoff M, Brauns TC, et al: pH-Wert des Milieus chronischer Wunden. Hautarzt 2003;54:959-965.
79.
Wiegand C, Abel M, Ruth P, et al: pH influence on antibacterial efficacy of common antiseptic substances. Skin Pharmacol Physiol 2015;28:147-158.
80.
Müller G, Koburger T, Jethon FUW, Kramer A: Vergleich der bakterioziden Wirksamkeit und in-vitro-Zytotoxizität von Lavasept® und Prontosan®. GMS Krankenhaushyg Interdiszip 2007;2:Doc42.
81.
López-Rojasa R, Fernández-Cuenca F, Serrano-Rocha L, Pascual A: In vitro activity of a polyhexanide-betaine solution against high-risk clones of multidrug-resistant nosocomial pathogens. Enferm Infecc Microbiol Clin 2017;35:12-19.
82.
Kaehn K: An in-vitro model for comparing the efficiency of wound-rinsing solutions. J Wound Care 2009;18:229-234.
83.
Chindera K, Mahato M, Sharma AK, et al: The antimicrobial polymer PHMB enters cells and selectively condenses bacterial chromosomes. Sci Rep 2016;6:23121.
84.
Kamaruzzaman NF, Firdessa R, Good L: Bactericidal effects of polyhexamethylene biguanide against intracellular Staphylococcus aureus EMRSA-15 and USA 300. J Antimicrob Chemother 2016;71:1252-1259.
85.
Kramer A, Assadian O, Pleyer U: Antiinfektive Therapie bei Konjunktivitis und Keratitis; in Pleyer U (eds): Entzündliche Augenerkrankungen. Berlin, Springer, 2014, pp 23-33.
86.
Fabry WH, Kock HJ, Vahlensieck W: Activity of the antiseptic polyhexanide against Gram-negative bacteria. Microb Drug Resist 2014;20:138-143.
87.
Koburger T, Müller G, Eisenbeiss W, Assadian O, Kramer A: Microbicidal activity of polihexanide. GMS Krankenhaushyg Interdiszip 2007;2:Doc44.
88.
Werthén M, Davoudi M, Sonesson A, et al: Pseudomonas aeruginosa-induced infection and degradation of human wound fluid and skin proteins ex vivo are eradicated by a synthetic cationic polymer. J Antimicrob Chemother 2004;54:772-779.
89.
Carpenter S, Davis S, Fitzgerald R, et al: Expert recommendations for optimizing outcomes in the management of biofilm to promote healing of chronic wounds. Wounds 2016;28(suppl 6):1-20.
90.
Hübner NO, Matthes R, Koban I, et al: Efficacy of chlorhexidine, polihexanide and tissue-tolerable plasma against Pseudomonas aeruginosa biofilms grown on polystyrene and silicone materials. Skin Pharmacol Physiol 2010;34;23(suppl 1):28-34.
91.
Perez R, Davies SC, Kaehn K: Wirkung verschiedener Wundspüllösungen auf MRSA-Biofilme in Wunden im Tiermodell (Schwein). WundManagement 2010;4:44-48.
92.
Wiegand C, Moritz S, Hessler N, et al: Antimicrobial functionalization of bacterial nanocellulose by loading with polihexanide and povidone-iodine. J Mater Sci Mater Med 2015;26:245.
93.
Fabry W, Kock HJ: In-vitro activity of polyhexanide alone and in combination with antibiotics against Staphylococcus aureus. J Hosp Infect 2014;86:68-72.
94.
Hübner NO, Kramer A: Review on the efficacy, safety and clinical applications of polihexanide, a modern wound antiseptic. Skin Pharmacol Physiol 2010;23(suppl):17-27.
95.
Roth C, Beule A, Kramer A, Hosemann W, Kohlmann T, Scharf C: Response analysis of stimulating efficacy of polihexanide in an in vitro wound model with respiratory ciliary epithelial cells. Skin Pharmacol Physiol 2010;23(suppl 1):35-40.
96.
Wiegand C, Abel M, Kramer A, Müller G, Ruth P, Hipler UC: Proliferationsförderung und Biokompatibilität von Polihexanid. GMS Krankenhaushyg Interdiszip 2007;2:Doc43.
97.
Napavichayanun S, Yamdech R, Aramwit P: The safety and efficacy of bacterial nanocellulose wound dressing incorporating sericin and polyhexamethylene biguanide: in vitro, in vivo and clinical studies. Arch Dermatol Res 2016;308:123-132.
98.
Goertz O, Hirsch T, Ring A, et al: Influence of topically applied antimicrobial agents on muscular microcirculation. Ann Plast Surg 2011;67:407-412.
99.
Kramer A, Behrens-Baumann W: Prophylactic use of topical anti-infectives in ophthalmology. Ophthalmologica 1997;211:68-76.
100.
Creppy EE, Diallo A, Moukha S, Eklu-Gadegbeku C, Cros D: Study of epigenetic properties of poly(hexamethylene biguanide) hydrochloride (PHMB). Int J Environ Res Public Health 2014;11:8069-8092.
101.
Kramer A, Eberlein T, Assadian O: Erwiderung zum Beitrag “Polihexanid - Rechtsaspekte einer Risikoeinschätzung” von Volker Grosskopf und Michael Schanz. WundManagement 2017;11:32-38.
102.
Kramer A, Eberlein T, Müller G, Assadian A: Polihexanide - different aspects of a risk assessment. J Wound Care, in press.
103.
Olivieri J, Eigenmann PA, Hauser C: Severe anaphylaxis to a new disinfectant: polyhexanide, a chlorhexidine polymer. Schweiz Med Wschr 1998;128:1508-1511.
104.
Kautz O, Schumann H, Degerbeck F, Venemalm L, Jakob T: Severe anaphylaxis to the antiseptic polyhexanide. Allergy 2010;65:1068-1070.
105.
Creytens K, Goossens A, Faber M, Ebo D, Aerts O: Contact urticaria syndrome caused by polyaminopropyl biguanide in wipes for intimate hygiene. Contact Derm 2014;71:307-309.
106.
Schrøder MA, Kirketerp-Møller K, Winther L: Suspected anaphylaxis by wound treatment with polyhexanide derivate wound products (in Danish). Ugeskr Laeger 2014;176:V02120094.
107.
Schnuch A, Geier J, Uter W, Basketter DA, Jowsey IR: The biocide polyhexamethylene biguanide remains an uncommon contact allergen. Contact Dermatitis 2007;56:235-239.
108.
Eberlein T, Assadian O: Clinical use of polihexanide on acute and chronic wounds for antisepsis and decontamination. Skin Pharmacol Physiol 2010;23(suppl 1):45-51.
109.
Harati K, Kiefer J, Behr B, Kneser U, Daigeler A: The use of Prontosan® Wound Gel X in partial and full thickness burns requiring split thickness skin grafts - an interim analysis. Ann Burns Fire Disasters 2015;27:292-296.
110.
Shah C: Polyhexamethylene biguanide (PHMB) treated wound dressings and vancomycin-resistant enterococci (VRE). Managing Infect Control 2007;7:26-34.
111.
Kirker K, Fisher S, James G, McGhee D, Shah C: Efficacy of a ployhexamethylene biguanide-containing antimicrobial foam dressing against MRSA relative to standard foam dressing. Wounds 2009;21:229-233.
112.
Jahn B, Wassenaar TM, Stroh A: Integrated MRSA-Management (IMM) with prolonged decolonization treatment after hospital discharge is effective: a single centre, non-randomised open-label trial. Antimicrob Resist Infect Control 2016;5:25.
113.
Daeschlein G, Assadian O, Bruck JC, Meinl C, Kramer A, Koch S: Feasibility and clinical applicability of polihexanide for treatment of second-degree burn wounds. Skin Pharmacol Physiol 2007;20:292-296.
114.
Moore K, Gray D: Using PHMB antimicrobial to prevent wound infection. Wounds UK 2007;3:96-110.
115.
Butcher M: PHMB: an effective antimicrobial in wound bioburden management. Br J Nurs 2012;21:16-21.
116.
Gilliver S: PHMB: a well-tolerated antiseptic with no reported toxic effects. J Wound Care 2009;18(suppl):9-14.
117.
Cutting KF: Addressing the challenge of wound cleansing in the modern era. Br J Nurs 2010;19:1-5.
118.
Lenselink E, Andriessen A: A cohort study on the efficacy of a polyhexanide-containing biocellulose dressing in the treatment of biofilms in wounds. J Wound Care 2011;20:534-539.
119.
Swan J: Case report of a venous leg ulcer using Suprasorb® X +PHMB. Wounds UK 2011;7(suppl 2):17-18.
120.
Barrett S, Battacharyya M, Butcher M, et al: Consensus document: PHMB and its potential contribution to wound management. Wounds UK 2010;6:1-15.
121.
Mulder GD, Cavorsi JP, Lee DK: Polyhexamethylene biguanide (PHMB): an addendum to current topical antimicrobials. Wounds 2007;19:173-182.
122.
Roth B, Kramer A: Antiseptische Begleittherapie des Ulcus cruris mit Polihexanid. GMS Krankenhaushyg Interdiszip 2009;4:Doc16.
123.
Eberlein T, Kanis J: Use of a cellulose PHMB dressing in clinical practice. Int J Lower Extrem Wounds 2014;10(suppl 3):1-6.
124.
Hagelstein SM, Ivins N: Treating recalcitrant venous leg ulcers using a PHMB impregnated dressing: a case study evaluation. Wounds UK 2013;9:84-90.
125.
Reitsma AM, Rodeheaver GT: Effectiveness of a New Antimicrobial Gauze Dressing as a Bacterial Barrier. Mansfield, Tyco Healthcare Group LP, 2001, pp 1-4.
126.
Cazzaniga A, Serralta V, Davis S, Orr R, Eaglstein W, Mertz PM: The effect of an antimicrobial gauze dressing impregnated with 0.2-percent polyhexamethylene biguanide as a barrier to prevent Pseudomonas aeruginosa wound invasion. Wounds 2002;14:169-176.
127.
Davis S, Mertz PM, Cazzaniga A, Serralta V, Orr R, Eaglstein W: The use of new antimicrobial gauze dressings: effects on the rate of epithelialization of partial-thickness wounds. Wounds 2002;14:252-256.
128.
Hunt S: Case 14: Octenilin wound gel versus betaine/PHMB gel. J Wound Care 2016;25(suppl 3):22-23.
129.
Gentile A, Gerli S, Di Renzo GC: A new non-invasive approach based on polyhexamethylene biguanide increases the regression rate of HPV infection. BMC Clin Pathol 2012;12:17.
130.
Thorn RMS, Lee SWH, Robinson GM, Greenman J, Reynolds DM: Electrochemically activated solutions: evidence for antimicrobial efficacy and applications in healthcare environments. Eur J Clin Microbiol Infect Dis 2012;31:641-653.
131.
Wang L, Bassiri M, Najafi R, et al: Hypochlorous acid as a potential wound care agent. Part I. Stabilized hypochlorous acid: a component of the inorganic armamentarium of innate immunity. J Burn Wounds 2007;6:65-79.
132.
D'Atanasio N, Capezzone de Joannon A, Mangano G, et al: A new acid-oxidizing solution: assessment of its role on methicillin-resistant Staphylococcus aureus (MRSA) biofilm morphological changes. Wounds 2015;27:265-273.
133.
Tanaka H, Hirakata Y, Kaku M, Yashida R, Takemura H: Antimicrobial activity of super oxidized water. J Hosp Infect 1996;34:43-49.
134.
Middleton AM, Chadwick MV, Sanderson JL, Gaya H: Comparison of a solution of super oxidized water (sterilox) with glutaraldehyde for the disinfection of bronchoscopes, contaminated. J Hosp Infect 2000;45:278-282.
135.
Tanaka H, Hirakata Y, Kaku M, Yashida R, Takemura H: Antimicrobial activity of super oxidized water. J Hosp Infect 1996;34:43-49.
136.
Aggarwal R, Goel N, Chaudhary U, Kumar V, Ranjan KP: Evaluation of microbiocidal activity of superoxidized water on hospital isolates. Ind J Pathol Microbiol 2010;53:757-759.
137.
Velazquez-Meza ME, Hernández-Salgado M, Sánchez-Alemán MA: Evaluation of the antimicrobial activity of a super oxidized solution in clinical isolates. Microbial Drug Resistance 2015;21:367-372.
138.
Kubota A, Nose K, Yonekura T, Kosumi T, Yamauchi K, Oyanagi H: Effect of electrolyzed strong acid water on peritoneal irrigation of experimental perforated peritonitis. Surg Today 2009;39:514-517.
139.
Gutiérrez AA: The science behind stable, super-oxidized water. Wounds 2006;18(suppl): 7-10.
140.
Inagaki H, Shibata Y, Obata T, et al: Effects of slightly acidic electrolysed drinking water on mice. Lab Anim 2011;45:283-285.
141.
Hasegawa R, Takahashi M, Kokubo T, et al: Carcinogenicity study of sodium hypochlorite in F344 rats. Food Chem Toxicol 1986;24:1295-1302.
142.
Kurokawa Y, Takayama S, Konishi Y, et al: Long-term in vivo carcinogenicity tests of potassium bromate, sodium hypochlorite, and sodium chlorite conducted in Japan. Environ Health Perspect 1986;69:221-235.
143.
Ohno H, Higashidate M, Yokosuka T: Mediastinal irrigation with superoxidized water after open-heart surgery: the safety and pitfalls of cardiovascular surgical application. Surg Today 2000;30:1055-1056.
144.
Sekiya S, Ohmori K, Harii K: Treatment of infectious skin defects or ulcers with electrolyzed strong acid aqueous solution. Artif Organs 1997;21:32-38.
145.
Küster I, Kramer A, Bremert T, Langner S, Hosemann W, Beule AG: Eradication of MRSA skull base osteitis by combined treatment with antibiotics and sinonasal irrigation with sodium hypochlorite. Eur Arch Otorhinolaryngol 2016;273:1951-1956.
146.
Bongiovanni CM: Superoxidized water improves wound care outcomes in diabetic patients. Diabetic Microvasc Compl Today 2006;3:11-14.
147.
Tata MD, Kwan KC, Abdul-Razak MR, Paramalingam S, Yeen WC: Adjunctive use of superoxidized solution in chest wall necrotizing soft tissue infection. Ann Thor Surg 2009;87:1613-1614.
148.
Aragón-Sánchez J, Lázaro-Martínez JL, Quintana-Marrero Y, et al: Super-oxidized solution (Dermacyn Wound Care) as adjuvant treatment in the postoperative management of complicated diabetic foot osteomyelitis: preliminary experience in a specialized department. Int J Low Extrem Wounds 2013;12:130-137.
149.
Inouc Y, Endo S, Kondo K, Ito H, Onori H, Sarto K: Trail of electrolysed strong acid aqueous solution in the treatment of peritonitis and in abscesses. Artif Organs 1997;21:28-31.
150.
Garg PK, Kumar A, Sharda VK, Saini A, Garg A, Sandhu A: Evaluation of intraoperative peritoneal lavage with super-oxidized solution and normal saline in acute peritonitis. Arch Int Surg 2013;3:43-48.
151.
Allie DE: Super-oxidized microcyn technology in lower-extremity wounds. Wounds 2006;18(suppl):3-6.
152.
Wolvos TA: Advanced wound care with stable, super-oxidized water. Wounds 2006;18(suppl):11-13.
153.
Hierholzer G, Görtz G: PVP-Iod in der operativen Medizin. Berlin, Springer, 1984.
154.
Capriotti K, Capriotti JA: Topical iodophor preparations: chemistry, microbiology, and clinical utility. Dermatol Online J 2012;18:11.
155.
Noda Y, Fujii K, Fujii S: Critical evaluation of cadexomer-iodine ointment and povidone-iodine sugar ointment. Int J Pharm 2009;372:85-90.
156.
Kramer A, Reichwagen S, Heldt P, Widulle H, Nürnberg W: Oxidanzien; in Kramer A, Assadian O (eds): Wallhäussers Praxis der Sterilisation, Desinfektion, Antiseptik und Konservierung. Stuttgart, Thieme, 2008, pp 713-745.
157.
König B, König W, Reimer K: Jod - die Stellung eines alten Desinfektionsmittels in der modernen Infektiologie. Dtsch Med Wochenschr 1997;122:141.
158.
König B, Reimer K, Fleischer W, König W: Effects of Betaisodona on parameters of host defense. Dermatology 1997;195(suppl 2): 42-48.
159.
Fitzgerald DJ, Renick PJ, Forrest EC, et al: Cadexomer iodine provides superior efficacy against bacterial wound biofilms in vitro and in vivo. Wound Repair Regen 2016;25:13-24.
160.
Phillips PL, Yang Q, Davis S, et al: Antimicrobial dressing efficacy against mature Pseudomonas aeruginosa biofilm on porcine skin explants. Int Wound J 2015;12:469-483.
161.
Bolton L, Oleniacz W, Constantine B, et al: Repair and antibacterial effects of topical antiseptic agents in vivo; in Maibach H, Lowe I (eds): Models in Dermatology, vol 2. Basel, Karger, 1985 pp 145-158.
162.
Langer S, Botteck NM, Bosse B, et al: Effect of polyvinylpyrrolidone-iodine liposomal hydrogel on wound microcirculation in SKH1-hr hairless mice. Eur Surg Res 2006;38:27-34.
163.
Langer S, Sedigh Salakdeh M, Goertz O, Steinau HU, Steinstraesser L, Homann HH: The impact of topical antiseptics on skin microcirculation. Eur J Med Res 2004;9:449-454.
164.
Lamme EN, Gustafsson TO, Middelkoop E: Cadexomer iodine shows stimulation of epidermal regeneration in experimental full thickness wounds. Arch Dermatol Res 1998;290:18-24.
165.
Mertz PM, Davis SC, Brewer LD, Franzen L: Can antimicrobials be effective without impairing wound healing? The evaluation of a cadexomer iodine ointment. Wounds 1994;6:184-193.
166.
Robert LW: Cadexomer iodine: an effective palliative dressing in chronic critical limb ischemia. Wounds 2009;21:1.
167.
Zhou LH, Nahm WK, Badiavas E, Yufit T, Falanga V: Slow release iodine preparation and wound healing: in vitro effects consistent with lack of in vivo toxicity in human chronic wounds. Br J Dermatol 2002;146:365-374.
168.
Müller G, Hai DN, Kramer A: Lack of in vitro genotoxicity of povidone-iodine in solution, in ointment or in a liposomal formulation (Repithel®). Dermatology 2006(suppl 1):212:94-97.
169.
Freise J, Kohaus S, Körber A, et al: Contact sensitization in patients with chronic wounds: results of a prospective investigation. J Eur Acad Dermatol Venereol 2008;22:1203-1207.
170.
Below H, Brauer VFH, Kramer A: Iodresorption bei antiseptischer Anwendung von Iodophoren und Schlussfolgerungen zur Risikobewertung. GMS Krankenhaushyg Interdiszip 2007;2:Doc41.
171.
Angel DE, Morey P, Storer JG, Mwipatayi BP: The great debate over iodine in wound care continues: a review of the literature. Wound Pract Res 2008;16:6-21.
172.
Phillips H, Westerbos SJ, Ubbink DT: Benefit and harm of iodine in wound care: a systematic review. J Hosp Infect 2010;76:191-199.
173.
Müller G, Kramer A: Biocompatibility index of antiseptic agents by parallel assessment of antimicrobial activity and cellular cytotoxicity. J Antimicr Chemother 2008;61:1281-1287.
174.
Gulati S, Qureshi A, Srivastava A, Kataria K, Kumar P, Ji AB: A prospective randomized study to compare the effectiveness of honey dressing vs. povidone iodine dressing in chronic wound healing. Ind J Surg 2014;76:193-198.
175.
Campbell N, Campbell D: Evaluation of a non-adherent, povidone-iodine dressing in a case series of chronic wounds. J Wound Care 2013;22:401-406.
176.
Oliveira AS, Santos VL: Topical iodophor use in chronic wounds: a literature review. Rev Latino Enfermagem 2007;15:671-676.
177.
Skripitz R, Werner HP: Bakterizide Langzeit-Wirkung ausgewählter Antiseptika. Hyg Med 1994;17:19.
178.
Bedrosian I, Sofia RD, Wolff SM, Dinarello CA: Taurolidine, an analogue of the amino acid taurine, suppresses interleukin 1 and tumor necrosis factor synthesis in human peripheral blood mononuclear cells. Cytokine 1991;3:568.
179.
Rosman C, Westerveld GJ, van Oeveren W, Kooi K, Bleichrodt RP: Effect of intraperitoneal antimicrobials on the concentration of bacteria, endotoxin, and tumor necrosis factor in abdominal fluid and plasma in rats. Eur Surg Res 1996;28:351.
180.
Akkuş A, Gülmen M, Cevik A, et al: Effect of peritoneal lavage with taurolidine on primary colonic anastomosis in a rat model of secondary peritonitis. Surg Today 2006;36:436-440.
181.
Kramer A, Halle W, Adrian V, et al: Antimikrobielle Wirkung, Zytotoxizität und Phytotoxizität als Basisinformation zur Verträglichkeitsprüfung von Desinfektionsmitteln bzw. Antiseptika. Z Ges Hyg 1987;33:610-615.
182.
Kramer A, Adrian V, Rudolph P, Wurster S, Lippert H: Explantationstest mit Haut und Peritoneum der neonaltalen Ratte als Voraussagetest zur Verträglichkeit lokaler Antiinfektiva für Wunden und Körperhöhlen. Chirurgie 1998;69:840-845.
183.
Simpson JM, Séguin B, Gitelman A: Effects of topical application of taurolidine on second intention healing of experimentally induced wounds in rats. Am J Vet Res 2008;69:1210-1216.
184.
Baker M, Jones JA, Nguyen-Van-Tam JS, et al: Taurolidine peritoneal lavage as prophylaxis against infection after elective colorectal surgery. Br J Surg 1994;1:1054-1056.
185.
Willatts SM, Radford S, Leitermann M: Effect of the antiendotoxic agent, taurolidine, in the treatment of sepsis syndrome: a placebo-controlled, double-blind trial. Crit Care Med 1995;23:1033-1039.
186.
Gallieni M, Chiarelli G, Olivi L, Cozzolino M, Cusi D: Unsuccessful application of taurolidine in the treatment of fungal peritonitis in peritoneal dialysis. Clin Nephrol 2011;75:70-73.
187.
Schneider A, Sack U, Rothe K, Bennek J: Peritoneal taurolidine lavage in children with localised peritonitis due to appendicitis. Pediatr Surg Int 2005;21:445-448.
188.
Baker DM, Jones JA, Nguyen-Van-Tam JS, et al: Taurolidine peritoneal lavage as prophylaxis against infection after elective colorectal surgery. Br J Surg 1994;81:1054-1056.
189.
Hübner-Müller C, Peter RU: Taurolin in der Lokalbehandlung septischer Ulcera. Z Wundbehandl 2000;12:7-9.
190.
Dissemond J, Böttrich JG, Braunwarth H, Hilt J, Wilken P, Münter KC: Evidenz von Silber in der Wundbehandlung - Meta-Analyse der klinischen Studien von 2000-2015. J Dtsch Dermatol Ges 2017;15:524-536.
191.
Vermeulen H, van Hattem JM, Storm-Versloot MN, Ubbink DT: Topical silver for treating infected wounds. Cochrane Database Syst Rev 2007;24:CD005486.
192.
Storm-Versloot MN, Vos CG, Ubbink DT, Vermeulen H: Topical silver for preventing wound infection. Cochrane Database Syst Rev 2010;17:CD006478.
193.
FDA Drug Safety Communication: FDA warns about rare but serious allergic reactions with the skin antiseptic chlorhexidine gluconate. 2017. https://www.fda.gov/Drugs/DrugSafety/ucm530975.htm.
194.
Kramer A, Daeschlein G, Kammerlander G, et al: Konsensusempfehlung zur Auswahl von Wirkstoffen für die Wundantiseptik. Z Wundheilung 2004;3:110-120.
195.
Kramer A, Reichwagen S, Widulle H, Heldt P: 8-Chinolinole; in Kramer A, Assadian O (eds): Wallhäussers Praxis der Sterilisation, Desinfektion, Antiseptik und Konservierung. Stuttgart, Thieme, 2008 pp 823-826.
196.
Kramer A, Reichwagen S, Widulle H, Heldt P: Nitrofurane; in Kramer A, Assadian O (eds): Wallhäussers Praxis der Sterilisation, Desinfektion, Antiseptik und Konservierung. Stuttgart, Thieme, 2008, pp 836-838.
197.
Wound Healing and Management Node Group: Evidence summary: polyhexamethylene biguanide (PHMB) wound dressings. Wound Pract Res 2013;21:82-85.
198.
Vogt PM, Hauser J, Rossbach O, et al: Polyvinyl pyrrolidone-iodine liposome hydrogel improves epithelialization by combining moisture and antisepsis: a new concept in wound therapy. Wound Repair Regen 2001;9:116-122.
199.
Kramer A, Assadian O, Frank M, Bender C, Hinz P: Prevention of post-operative infections after surgical treatment of bite wounds. GMS Krankenhaushyg Interdiszip 2010;5: Doc12.
200.
Hinz P, Boenigk I, Ekkernkamp A, Wolf A, Kramer A: Prinzipien der chirurgischen Wundbehandlung. Gynäkol Prax 2011;35:711-719.
201.
Gerber V: Phasengerechte, problemorientierte Wundversorgung. GMS Krankenhaushyg Interdiszip 2006;1:Doc29.
202.
AWMF: Anforderungen der Hygiene bei chronischen und sekundär heilenden Wunden. AWMF Leitlinien Register No. 029/ 042. 2014. http://www.awmf.org/uploads/tx_szleitlinien/029-042l_S1_Chronische_Wunden_Hygieneanforderungen_2014-01.pdf.
203.
Rothe K, Tsokos M, Handrick W: Tier- und Menschenbissverletzungen. Dtsch Arztebl Int 2015;112:433-443.
204.
Eisenbeiss W: Therapie der infizierten Verbrennungswunde. GMS Krankenhaushyg Interdiszip 2006;1:Doc26.
205.
Habild G, Bruck JC: Primärversorgung von Verbrennungswunden. GMS Krankenhaushyg Interdiszip 2006;1:Doc25.
206.
Blangy H, Simon D, Levy-Cloez A, et al: Topic silver sulfadiazine bicytopenia: first case. Therapie 2002;57:307-309.
207.
Fisher NM, Marsh E, Lazova R: Scar-localized argyria secondary to silver sulfadiazine cream. J Am Acad Dermatol 2003;49:730-732.
208.
Mueller TC, Loos M, Haller B, et al: Intra-operative wound irrigation to reduce surgical site infections after abdominal surgery: a systematic review and meta-analysis. Langenbecks Arch Surg 2015;400:167-181.
209.
Hübner NO, Wander K, Ryll S, Kramer A: Successful decolonisation of MRSA-positive patients. Med Monatsschr Pharm 2009;32:87-94.
210.
Rode H, Hanslo D, de Wet PM, Millar AJ, Cywes S: Efficacy of mupirocin in methicillin-resistant Staphylococcus aureus burn wound infection. Antimicrob Agents Chemother 1989;33:1358-1361.
211.
Kauffman CA, Terpenning MS, He X, et al: Attempts to eradicate methicillin-resistant Staphylococcus aureus from a long-term care facility with the use of mupirocin ointment. Am J Med 1993;94:371-378.
212.
Kampf G, Kramer A: Eradication of methicillin-resistant Staphylococcus aureus with an antiseptic soap and nasal mupirocin among colonized patients - an open uncontrolled clinical trial. Ann Clin Microbiol Antimicrob 2004;3:9.
213.
Kim PJ, Attinger CE, Olawoye O, et al: Negative-pressure wound therapy with instillation: international consensus guidelines. Plast Reconstr Surg 2013;132:1569-1579.
214.
Wolvos T: The evolution of negative pressure wound therapy: negative pressure wound therapy with instillation. J Wound Care 2015;24(suppl 4):15-20.
215.
Huang C, Leavitt T, Bayer LR, Orgill DP: Effect of negative pressure wound therapy on wound healing. Curr Probl Surg 2014;51:301-331.
216.
Fleischmann W: Die V.A.C.-Instill zur Behandlung der akuten Wundinfektion. GMS Krankenhaushyg Interdiszip 2006;1:Doc28.
217.
Fleischmann W, Russ M, Westhauser A, Stampehl M: Vacuum sealing as carrier system for controlled local drug administration in wound infection. Unfallchir 1998;101:649-654.
218.
Kim PJ, Attinger CE, Olawoye O, et al: Negative pressure wound therapy with instillation: review of evidence and recommendations. Wounds 2015;27:2-19.
219.
Timmers MS, Le Cessie S, Banwell P, Jukema GN: The effects of varying degrees of pressure delivered by negative-pressure wound therapy on skin perfusion. Ann Plast Surg 2005;55:665-671.
220.
Davis K, Bills J, Barker J, Kim P, Lavery L: Simultaneous irrigation and negative pressure wound therapy enhances wound healing and reduces wound bioburden in a porcine model. Wound Repair Regen 2013;21:869-875.
221.
Kim PJ, Attinger CE, Steinberg JS, et al: The impact of negative-pressure wound therapy with instillation compared with standard negative-pressure wound therapy: a retrospective, historical, cohort, controlled study. Plast Reconstr Surg 2014;133:709-716.
222.
Matiasek J, Diomig K, Assadian O: Comparison of the effect of negative pressure wound therapy with different antiseptic dressings on Gr+ and Gr- bacteria in experimental in-vitro wounds. Ger Med Sci 2015, DOI: 10.3205/15dgpraec048.
223.
Matiasek J, Djedovic G, Unger L, et al: Outcomes for split-thickness skin transplantation in high-risk patients using octenidine. J Wound Care 2015;24(suppl 6):8-12.
224.
Matiasek J, Djedovic G, Mattesich M, et al: The combined use of NPWT and instillation using an octenidine based wound rinsing solution: a case study. J Wound Care 2014;23:590-596.
225.
Willy C, Scheuermann-Poley C, Stichling M, Stein von T, Kramer A: Importance of wound irrigation solutions and fluids with antiseptic effects in therapy and prophylaxis. Update 2017 (in German). Unfallchirurg 2017;120:549-560.
226.
Nagoba BS, Selkar SP, Wadher BJ, et al: Acidic environment and wound healing: a review. Wounds 2015;27:5-11.
227.
Taylor K: Treatment of Bacillus pyocyaneus infection. J Am Med Assoc 1916;67:1598-1599.
228.
Juma IM, Yass HS, Al-Jaberi FH: Comparison between the effect of acetic acid and salicylic acid in different concentrations on Pseudomonas aeruginosa isolated from burn wound infection. Al Taqani 2007;20:73-78.
229.
Kramer A, Reichwagen S, Widulle H, Nürnberg W, Heldt P: Organische Carbonsäuren; in Kramer A, Assadian O (eds): Wallhäussers Praxis der Sterilisation. Stuttgart, Thieme, 2008.
230.
Madhusudhan VL: Efficacy of 1% acetic acid in the treatment of chronic wounds infected with Pseudomonas aeruginosa: prospective randomised controlled clinical trial. Int Wound J 2016;13:1129-1136.
231.
Halstead FD, Rauf M, Moiemen NS, et al: The antibacterial activity of acetic acid against biofilm-producing pathogens of relevance to burns patients. PLoS One 2015;10:0136190.
232.
McKenna PJ, Lehr GS, Leist P, Welling RE: Antiseptic effectiveness with fibroblast preservation. Ann Plast Surg 1991;27:265-268.
233.
Ryssel H, Kloeters O, Germann G, Schafer T, Wiedemann G, Oehlbauer M: The antimicrobial effect of acetic acid-an alternative to common local antiseptics? Burns 2009;35:695-700.
234.
Gruber RP, Vistnes L, Pardoe R: The effect of commonly used antiseptics on wound healing. Plast Reconstr Surg 1975;55:472-476.
235.
Sloss JM, Cumberland N, Milner SM: Acetic acid used for the elimination of Pseudomonas aeruginosa from burn and soft tissue wounds. J R Army Med Corp 1993;139:49-51.
236.
Nagoba B, Wadher B, Kulkarni P, Kolhe S: Acetic acid treatment of pseudomonal wound infections. Eur J Gen Med 2008;5:104-106.
237.
Milner SM: Acetic acid to treat Pseudomonas aeruginosa in superficial wounds and burns. Lancet 1992;340:61.
238.
Phillips I, Lobo AZ, Fernandes R, Gundara NS: Acetic acid in the treatment of superficial wounds infected by Pseudomonas aeruginosa. Lancet 1968;1:11-14.
239.
Salati S, Rather A: Management of pseudomonal wound infection. Internet J Surg 2008;20:1-4.
240.
Jeong HS, Lee BH, Lee HK, Kim HS, Moon MS, Suh IS: Negative pressure wound therapy of chronically infected wounds using 1% acetic acid irrigation. Arch Plast Surg 2015;42:59-67.
241.
Hammann A, Huebner NO, Bender C, et al: Antiseptic efficacy and tolerance of tissue-tolerable plasma compared with two wound antiseptics on artificially bacterially contaminated eyes from commercially slaughtered pigs. Skin Pharmacol Physiol 2010;23:328-332.
242.
Hübner NO, Matthes R, Koban I, et al: Efficacy of chlorhexidine, polihexanide and tissue-tolerable plasma against Pseudomonas aeruginosa biofilms grown on polystyrene and silicone materials. Skin Pharmacol Physiol 2010;23(suppl):28-34.
243.
Lademann J, Richter H, Schanzer S, et al: Comparison of the antiseptic efficacy of tissue-tolerable plasma and an octenidine hydrochloride-based wound antiseptic on human skin. Skin Pharmacol Physiol 2012;25:100-106.
244.
Shimizu T, Zimmermann JL, Morfill GE: The bactericidal effect of surface microdischarge plasma under different ambient conditions. New J Phys 2011;13:023026.
245.
Bender C, Hübner NO, Weltmann KD, Scharf C, Kramer A: Tissue tolerable plasma and polihexanide: are synergistic effects possible to promote healing of chronic wounds? In vivo and in vitro results; in Machala Z, Hendsel K, Akishev Y (eds): Plasma for Bio-Decontamination, Medicine and Food Security. NATO Science for Peace and Security Series A: Chemistry and Biology. Dordrecht, Springer, 2012, pp 312-314.
246.
Isbary G, Morfill G, Schmidt HU, et al: A first prospective randomized controlled trial to decrease bacterial load using cold atmospheric argon plasma on chronic wounds in patients. Br J Dermatol 2010;163:78-82.
247.
Kramer A, Lademann J, Bender C, et al: Suitability of tissue tolerable plasmas (TTP) for the management of chronic wounds. Clin Plasma Med 2013;1:11-18.
248.
Kramer A, Bekeschus S, Matthes R, et al: Cold physical plasmas in the field of hygiene - relevance, significance, and future applications. Plasma Proc Polym 2015;12:1410-1422.
249.
Ulrich C, Kluschke F, Patzelt A, et al: Clinical use of cold atmospheric pressure argon plasma in chronic leg ulcers: a pilot study. J Wound Care 2015;24:196-203.
250.
Partecke LI, Evert K, Haugk J, et al: Tissue tolerable plasma (TTP) induce apoptosis in the human pancreatic cancer cell line Colo-357 in vitro and in vivo. BMC Cancer 2012;12:473.
251.
Fricke K, Koban I, Tresp H, et al: Atmospheric pressure plasma: a high-performance tool for the efficient removal of biofilms. PLoS One 2012;7:42539.
252.
Koban I, Holtfreter B, Hübner NO, et al: Antimicrobial efficacy of non-thermal plasma in comparison to chlorhexidine against dental biofilms on titanium discs in vitro - proof of principle experiment. J Clin Periodontol 2011;38:956-965.
253.
Laroussi M, Kong MG, Morfill G: Plasma Medicine. Applications of Low-Temperature Gas Plasmas in Medicine and Biology. Cambridge, Cambridge University Press, 2012.
254.
Kramer A, Hübner NO, Weltmann KD, et al: Polypragmasia in the therapy of infected wounds - conclusions drawn from the perspectives of low temperature plasma technology for plasma wound therapy. GMS Krankenhaushyg Interdiszip 2008;3:Doc13.
255.
Kramer A, Hübner NO, Assadian O, et al: Chancen und Perspektiven der Plasmamedizin durch Anwendung von gewebekompatiblen Atmosphärendruckplasmen (Tissue Tolerable Plasmas, TTP). GMS Krankenhaushyg Interdiszip 2009;4:Doc10.
256.
Wiegand C, Fink S, Beier O, et al: Dose- and time-dependent cellular effects of cold atmospheric pressure plasma evaluated in 3D skin models. Skin Pharmacol Physiol 2016;29:257-265.
257.
Matthes R, Lührman A, Holtfreter S, et al: Antibacterial activity of cold atmospheric pressure argon plasma against 78 genetically different (meca, luk-p, agr or capsular polysaccharide type) Staphylococcus aureus strains. Skin Pharmacol Physiol 2016;29:83-91.
258.
Kramer A, Schauer F, Papke R, et al: Plasma application for hygienic purposes in medicine, industry, and biotechnology - update 2017; in Metelmann HR, Woedtke von T, Weltmann KD (eds): Comprehensive Clinical Plasma Medicine -Cold Physical Plasma for Medical Application. Berlin, Springer, 2018.
259.
Wiegand C, Beier O, Horn K, et al: Antimicrobial impact of cold atmospheric pressure plasma on medical critical yeasts and bacteria cultures. Skin Pharmacol Physiol 2014;27:25-35.
260.
Lademann O, Kramer A, Richter H, et al: Skin disinfection by plasma-tissue interaction: comparison of the effectivity of tissue-tolerable plasma and a standard antiseptic. Skin Pharmacol Physiol 2011;24:284-288.
261.
Wiegand C, Fink S, Hipler UC, Beier O, Horn K, Pfuch A, Schimanski A, Grünler B: Cold atmospheric pressure plasmas exhibit antimicrobial properties against critical bacteria and yeast species. J Wound Care 2017;26:462-468.
262.
Bender C, Partecke LI, Kindel E, et al: The modified HET-CAM as a model for the assessment of the inflammatory response to tissue tolerable plasma. Toxicol In Vitro 2011;25:530-537.
263.
Bender C, Pavlovic D, Wegner A, et al: Intravital fluorescence microscopy for the assessment of microcirculation and leucoyte-endothel interaction after application of tissue tolerable plasma in the HET-CAM; in Mikikian M, Rabat H, Robert E, Pouvesle JM (eds): Book of Abstracts: 4th International Conference on Plasma Medicine. Greifswald, ISPM, 2012.
264.
Kluge S, Bekeschus S, Bender C, et al: Investigating the in vivo mutagenicity of a cold atmospheric pressure argon plasma jet in an HET-MN model. PLoS One 2016;11:0160667.
265.
Bender C, Kramer A: Behandlung von Wundheilungsstörungen beim Haustier mit kaltem Atmosphärendruckplasma. Tierärztl Umschau 2016;71:262-268.
266.
Assadian O, Ousey K, Daeschlein G, et al: Effects and safety of atmospheric low temperature plasma on bacterial reduction in chronic wounds and wound size reduction - a systematic review and meta-analysis. Br J Derm, in press.
267.
Horton JW: Free radicals and lipid peroxidation mediated injury in burn trauma: the role of antioxidant therapy. Toxicology 2003;189:75-88.
268.
Beldame J, Lagrave B, Lievain L, Lefebvre B, Frebourg N, Dujardin F: Surgical glove bacterial contamination and perforation during total hip arthroplasty implantation: when gloves should be changed. Orthop Traumatol Surg Res 2012;98:432-440.
269.
Neu HC, Fu KP: Cefuroxime, a beta-lactamase-resistant cephalosporin with a broad spectrum of gram-positive and -negative activity. Antimicrob Agents Chemother 1978;13:657-664.
270.
Andrews JM: Determination of minimum inhibitory concentrations. J Antimicrob Chemother 2001;48(suppl 1):5-16.
271.
Bowler PG, Duerden BI, Armstrong DG: Wound microbiology and associated approaches to wound management. Clin Microbiol Rev 2001;14:244-269.
272.
Ebert M, Assadian O, Hübner NO, Koburger T, Kramer A: Antimicrobial efficacy of the silver wound dressing Biatain Ag in a disc carrier test simulating wound secretion. Skin Pharmacol Physiol 2011;24:337-341.
273.
Maitre S, Jaber K, Perrot JL, Guy C, Cambazard F: Increased serum and urinary levels of silver during treatment with topical silver sulfadiazine. Ann Dermatol Venereol 2002;129:217-219.
274.
Drosou A, Falabella A, Kirsner RS: Antiseptics on wounds: an area of controversy. Wounds 2003;15:49-166.
275.
Nagoba BS, Selkar SP, Wadher BJ, Gandhi RC: Acetic acid treatment of pseudomonal wound infections - a review. J Infect Public Health 2013;6:410-415.
276.
Bolton L, Oleniacz W, Constantine B, et al: Repair and antibacterial effects of topical antiseptic agents in vivo; in Maibach H, Lowe I (eds): Models in Dermatology, vol 2. Basel, Karger, 1985, pp 145-158.
277.
Landa-Solis C, González-Espinosa D, Guzmán-Soriano B, et al: Microcyn: a novel super-oxidized water with neutral pH and disinfectant activity. J Hosp Infect 2005;61:291-299.
278.
Hadi SF, Khaliq T, Bilal N, et al: Treating infected diabetic wounds with superoxidized water as antiseptic agent: a preliminary experience. J Coll Physicians Surg Pak 2007;17:740-743.
279.
Müller G, Kramer A: Effect of selected wound antiseptics on adult articular cartilage (bovine sesamoid bone) in the presence of Escherichia coli and Staphylococcus aureus. J Orthop Res 2005;23:127-133.
280.
Hämmerle G, Strohal R: Efficacy and cost-effectiveness of octenidine wound gel in the treatment of chronic venous leg ulcers in comparison to modern wound dressings. Int Wound J 2016;13:182-188.
281.
Krasowski G, Jawień A, Tukiendorf A, et al: A comparison of an antibacterial sandwich dressing vs dressing containing silver. Wound Repair Regen 2015;23:525-530.
282.
Sopata M, Tomaszewska E, Muszyński Z, Ciupińska M, Kotlińska-Lemieszek A: The pilot study assessing efficacy and versatility of novel therapy for neoplastic ulceration: clinical and microbiological aspects. Postepy Dermatol Alergo 2013;30:237-245.
283.
Vanscheidt W, Harding K, Téot L, Siebert J: Effectiveness and tissue compatibility of a 12-week treatment of chronic venous leg ulcers with an octenidine based antiseptic - a randomized, double-blind controlled study. Int Wound J 2012;9:316-323.
284.
Radu CA, Gazyakan E, Germann G, Riedel K, Reichenberger M, Ryssel H: Optimizing Suprathel®-therapy by the use of Octenidine-Gel®. Burns 2011;37:294-298.
285.
Krzeminski M, Bartoszewicz M, Czarniak E, Gregorowicz-Warpas D, Mączyńska B, Junka A: The use of octenidine dihydrochloride in the treatment of musculoskeletal infections. Adv Clin Exp Med 2010;19:631-636.
286.
Sopata M, Ciupinska M, Glowacka A, Muszyński Z, Tomaszewska E: Effect of octenisept antiseptic on bioburden of neoplastic ulcers in patients with advanced cancer. J Wound Care 2008;17:24-27.
287.
Bellingeri A, Falciani F, Traspedini P, et al: Effect of a wound cleansing solution on wound bed preparation and inflammation in chronic wounds: a single-blind RCT. J Wound Care 2016;25:160-168.
288.
Ceviker K, Canikoğlu M, Tatlıoğlu S, Bağdatlı Y: Reducing the pathogen burden and promoting healing with polyhexanide in non-healing wounds: a prospective study. J Wound Care 2015;24:582-586.
289.
Durante CM, Greco A, Sidoli O, Maino C, Gallarini A, Ciprandi G: Evaluation of the effectiveness of a polyhexanide and propyl betaine-based gel in the treatment of chronic wounds. Minerva Chir 2014;69:283-292.
290.
Mendes J, Martinho A: An observational study about the performance of a wound gel for the treatment of burn wounds. EWMA 2014, poster EP436. http://de.slideshare.net/EWMA/ewma-2014-ep436-an-observational-study-about-the-performance-of-a-wound-gel-for-the-treatment-of-burn-wounds.
291.
Marquardt C, Koppes P, Krohs U, Mares A, Paglinawan R, Höfer D, Schiedeck T: Vakuumtherapie mit PHMB Gaze zur Behandlung postoperativer subkutaner Bauchdeckeninfektionen. Coloproctology 2014;36:364-369.
292.
Gaspard F, Brassard P, Alamet T, et al: Impact of an antimicrobial dressing in reducing surgical site infections in cardiac surgery patients. Wounds 2013;25:178-185.
293.
Eberlein T, Haemmerle G, Signer M, et al: Comparison of PHMB-containing dressing and silver dressings in patients with critically colonised or locally infected wounds. J Wound Care 2012;21:12-20.
294.
Lee CK, Chua YP, Saw A: Antimicrobial gauze as a dressing reduces pin site infection: a randomized controlled trial. Clin Orthop Relat Res 2012;470:610-615.
295.
Sibbald RG, Coutts P, Woo KY: Reduction of bacterial burden and pain in chronic wounds using a new polyhexamethylene biguanide antimicrobial foam dressing: clinical trial results. Adv Skin Wound Care 2011;24:78-84.
296.
Piatkowski A, Drummer N, Andriessen A, Ulrich D, Pallua N: Randomized controlled single center study comparing a polyhexanide containing biocellulose dressing with silver sulfadiazine cream in partial-thickness dermal burns. Burns 2011;37:800-804.
297.
Muangman P, Nitimonton S, Aramwit P: Comparative clinical study of bactigras and Telfa AMD for skin graft donor-site dressing. Int J Mol Sci 2011;12:5031-5038.
298.
Lehner B, Fleischmann W, Becker R, Jukema GN: First experiences with negative pressure wound therapy and instillation in the treatment of infected orthopaedic implants: a clinical observational study. Int Orthop 2011;35:1415-1420.
299.
Romanelli M, Dini V, Barbanera S, Bertone MS: Evaluation of the efficacy and tolerability of a solution containing propyl betaine and polihexanide for wound irrigation. Skin Pharmacol Physiol 2010;23(suppl 1):41-44.
300.
Mueller SW, Krebsbach LE: Impact of an antimicrobial-impregnated gauze dressing on surgical site infections including methicillin-resistant Staphylococcus aureus infections. Am J Infect Control 2008;36:651-655.
301.
Valenzuela A, Perucho N: The effectiveness of a 0.1% polihexanide gel. Rev Endferm 2008;31:7-12.
302.
Fabry W, Trampenau C, Bettag C, et al: Bacterial decontamination of surgical wounds treated with Lavasept. Int J Hyg Environ Health 2006;209:567-573.
303.
Motta GJ, Milne CT, Corbett LQ: Impact of antimicrobial gauze on bacterial colonies in wounds that require packing. Ostomy Wound Manage 2004;50:48-62.
304.
Kapur V, Marwaha AK: Evaluation of effect and comparison of superoxidised solution (Oxum) v/s povidone iodine (Betadine). Indian J Surg 2011;73:48-53.
305.
Pandey PK, Koushariya M, Shukla S, Das S: Outcomes of superoxide solution dressings in surgical wounds: a randomized case control trial. Int J Biol Med Res 2011;2:965-968.
306.
Piaggesi A, Goretti C, Mazzurco S, et al: A randomized controlled trial to examine the efficacy and safety of a new super-oxidized solution for the management of wide postsurgical lesions of the diabetic foot. Int J Lower Extr Wounds 2010;9:10-15.
307.
Abhyankar SV, Venkatesh V, Karnad S, et al: Efficacy and safety of oxum in treatment of chronic wounds. J Indian Med Assoc 2009;107:904-906.
308.
Martınez-De Jesu´s FR, Ramos-De la Medina A, Remes-Troche JM, et al: Efficacy and safety of neutral pH superoxidised solution in severe diabetic foot infections. Int Wound J 2007;4:353-362.
309.
Dalla Paola L, Brocco E, Senesi A, Ninkovic S, Merico M, De Vido D: Use of Dermacyn, a new antiseptic agent for the local treatment of diabetic foot ulcers. J Wound Heal 2005;2:201.
310.
Altamirano MA, Preciado MD, Chavez Velarde TJ: Treatment of 2nd and 3rd degree burns in 64 pediatric patients without routine antibiotics using new “super-oxidized solution technology.” Texas Surgical Society Congress, San Antonio, April 1-3, 2005, and European Burns Association Meeting, Estoril, 2005.
311.
Nanashimah A, Yamaguchit H, Sawai T, et al: Treatment of surgical site infection with aqua oxidation water: comparison with povidone iodine. Acta Medica Nnagasakiensia 2001;46:33-37.
312.
Nherera LM, Woodmansey E, Trueman P, Gibbons GW: Estimating the clinical outcomes and cost differences between standard care with and without cadexomer iodine in the management of chronic venous leg ulcers using a Markov model. Ostomy Wound Manage 2016;62:26-40.
313.
Norman G, Dumville JC, Moore ZEH, Tanner J, Christie J, Goto S: Antibiotics and antiseptics for pressure ulcers. Cochrane Database Syst Rev 2016;4:CD011586.
314.
O'Meara S, Al-Kurdi D, Ologun Y, Ovington LG, Martyn-St JM, Richardson R: Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst Rev 2014;1: CD003557.
315.
Singh S, Apte A: Comparative study of silver foam dressing over povidone iodine dressing in infected wounds. J Evol Med Dental Sci 2014;3:6233-6242.
316.
Li SH, Wang Y, Gao HB, Zhao K, Hou YC, Sun W: Experimental study on the toxicity of povidone-iodine solution in brain tissues of rabbits. Int J Clin Exp Med 2015;8:14863-14870.
317.
Kim PJ, Attinger CE, Oliver N, et al: Comparison of outcomes for normal saline and an antiseptic solution for negative-pressure wound therapy with instillation. Plast Reconstr Surg 2015;136:657-664.
318.
Tuncel U, Erkormaz Ü, Turan A: Clinical evaluation of gauze-based negative pressure wound therapy in challenging wounds. Int Wound J 2013;10:152-158.
319.
Goss SG, Schwartz JA, Facchin F, Avdagic E, Gendics C, Lantis JC: Negative pressure wound therapy with instillation (NPTWi) better reduces post-debridement bioburden in chronically infected lower extremity wounds than NPWT alone. Am Coll Clin Wound Spec 2012;4:74-80.
320.
Timmers MS, Graafland N, Bernards AT, Nelissen RG, van Dissel JT, Jukema GN: Negative pressure wound treatment with polyvinyl alcohol foam and polyhexanide antiseptic solution instillation in posttraumatic osteomyelitis. Wound Repair Regen 2009;17:278-286.
321.
Hansson C, Faergemann J: The effect of antiseptic solutions on microorganisms in venous leg ulcers. Acta Derm Venereol 1995;75:31-33.
322.
Klasinc R, Augustin LA, Below H, et al: Evaluation of three experimental in vitro models for the assessment of the mechanical cleansing efficacy of wound irrigation solutions. Int Wound J 2017, Epub ahead of print.
323.
Harnoss JC, Elrub QMH, Koburger T, et al: Irritative potency of selected wound antiseptics in the hen's egg test on chorioallantoic membrane (het cam) to predict their compatibility to wounds. Wound Repair Regen, in press.
© 2017 S. Karger AG, Basel
2017
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.