Selection of the ideal antiseptic or antimicrobial treatment for contaminated wounds remains a controversial decision. Clinical decisions are often made on the basis of in vitro studies and personal preference. Although topical solutions are widely used, their comparative in vivo effects on wound healing are largely unreported.
A porcine wound model was used to compare five commonly used topical agents—5% mafenide acetate (Sulfamylon solution), 10% povidone with 1% free iodine (Betadine), 0.25% sodium hypochlorite (“half-strength” Dakin), 3% hydrogen peroxide, and 0.25% acetic acid— with a control group. Reepithelialization, angiogenesis, neodermal regeneration, fibroblast proliferation, collagen production, and bacterial colony counts were analyzed at 4 and 7 days after wounding (n = 4).
Reepithelialization was not significantly influenced among the various treatment modalities tested. Sulfamylon and Dakin solutions significantly increased neodermal thickness (p < 0.05), whereas hydrogen peroxide and acetic acid significantly inhibited neodermal formation (p < 0.001). All treatments except hydrogen peroxide significantly increased fibroblast proliferation. Sulfamylon and Betadine significantly enhanced angiogenesis (p < 0.05). Sulfamylon proved most effective in maintaining an aseptic environment while concomitantly increasing angiogenesis, fibroblast proliferation, and dermal thickness compared with control.
These data show that selection of a particular topical treatment can affect various aspects of wound repair in an animal model. These results suggest that the selection of topical treatments in the clinical setting should be carefully tailored to match unique wound situations and therapeutic endpoints. (Plast. Reconstr. Surg. 108: 675, 2001.)
From the Department of Plastic Surgery, the Department of Pathology, and the Department of Cell Biology, Vanderbilt University School of Medicine, and the Department of Veterans Affairs. Received for publication May 4, 2000; revised October 17, 2000.
Presented at the Annual Meeting of the Southeastern Society of Plastic and Reconstructive Surgeons, in Southampton, Bermuda, June 4 through 8, 2000, and at the 69th Annual Meeting of the American Society of Plastic Surgeons, in Los Angeles, California, in October of 2000.
Lillian B. Nanney, Ph.D. Department of Plastic Surgery Vanderbilt University School of Medicine S-2221, Medical Center North Nashville, Tenn. 37232-2631 email@example.com