李孝建

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26 8月 2019

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Author : 伤口世界

专长：重症烧伤救治。广东省医学会烧伤科分会主任委员、广东省医疗行业协会伤口管理分会副主委。

广东红十字会医院烧伤整形科主任医师，博士研究生导师。烧伤科大主任、烧伤ICU主任。

Latest from 伤口世界

The Immediate and Delayed Post-Debridement Effects on Tissue Bacterial Wound Counts of Hypochlorous Acid Versus Saline Irrigation in Chronic Wounds
Sodium hypochlorite body wash in the management of Staphylococcus aureus–colonized moderate-to-severe atopic dermatitis in infants, children, and adolescents
Activity of a hypochlorous acid‐producing electrochemical bandage as assessed with a porcine explant biofilm model
次氯酸对骨科内固定物表面细菌生物膜的清除作用
Effects of Hypochlorous Acid and Hydrogen Peroxide Treatment on Bacterial Disinfection Treatments in Implantoplasty Procedures

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The Immediate and Delayed Post-Debridement Effects on Tissue Bacterial Wound Counts of Hypochlorous Acid Versus Saline Irrigation in Chronic Wounds 2026-10-19 00:00

John M. Hiebert, MD, FACN, FACS, and Martin C. Robson, MD, FACS, Hon. FRCS, Hon. FRACS

Truman Medical Center, University of Missouri–Kansas City; and Division of Plastic Surgery, University of South Florida, Tampa

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Keywords: ultrasonic debridement, bioburden, irrigation, hypochlorous acid, wound closure Published December 1, 2016

Introduction: Wound debridement is considered essential in chronic wound management. Hypochlorous acid has been shown to be an effective agent in reducing wound bacterial counts in open wounds. Ultrasound-enabled wound debridement is an effective and efficient method of debridement. This study compared ultrasound irrigation with hypochlorous acid versus saline irrigation for wound debridement on pre- and postoperative wounds and determined regrowth of bacteria over 1 week period of time. Finally, the outcome of definitive wound closure of the clinically clean-appearing wounds was

Methods: Seventeen consenting adult patients with chronic open wounds were randomly selected for study. The patients were randomly divided into the hypochlorous acid irrigation or saline irrigation group. All patients provided pre- and postoperative tissue samples for qualitative and quantitative bacteriology. For the time (7 days) between the debridement procedure and the definitive closure procedure, the wounds were dressed with a silver-impregnated dressing and a hydroconductive dressing. Results: Both types of irrigation in the ultrasonic system initially lowered the bacterial counts by 4 to 6 logs. However, by the time of definitive closure, the saline-irrigated wounds had bacterial counts back up to 105 whereas the hypochlorous acid–irrigated wounds remained at 102 or fewer. More than 80% of patients in the saline group had postoperative closure failure compared with 25% of patients in the hypochlorous acid group.

Conclusions: Hypochlorous acid irrigation with ultrasound debridement reduced bacterial growth in chronic open wounds more efficiently than saline alone. Postoperative wound closure outcomes suggest a remarkable reduction in wound complications after wound debridement using hypochlorous acid irrigation with ultrasound versus saline
Sodium hypochlorite body wash in the management of Staphylococcus aureus–colonized moderate-to-severe atopic dermatitis in infants, children, and adolescents 2026-10-17 00:00

Sara Majewski MS¹| Tanya Bhattacharya MD¹| Manuela Asztalos MD¹| Benjamin Bohaty MD²| Katherine C. Durham MD² | Dennis P. West PhD¹ | Adelaide A. Hebert MD²| Amy S. Paller MD¹

Abstract

Objectives: A cleansing body wash containing diluted sodium hypochlorite (0.006% NaOCl) was evaluated for management of moderate-to-severe Staphylococcus aureus–colonized, atopic dermatitis in children.

Methods: A 6-week, prospective, open-label study was conducted with 50 evaluable participants (ages 6 months to 17 years) who had moderate-to-severe atopic dermatitis with S aureus skin colonization documented by culture. Participants were instructed to continue using their current medications while using the study product, 0.006% NaOCl body wash, once daily to affected areas for 6 weeks. Primary outcome measures were Investigator's Global Assessment, Eczema Area and Severity Index, and Body Surface Area scores. Secondary outcome measures were the Visual Analog Scale for pruritus, Family Dermatology Life Quality Index, and Patient Satisfaction Questionnaire for Problem Areas. A subject daily diary and a six-item subject questionnaire that provided information on preferences for bleach bath vs body wash were secondary outcome measures.

Results: Daily use of the 0.006% NaOCl body wash led to improvement for all outcome measures comparing baseline to 2-week and to 6-week evaluations. Of the 50 skin S aureus-positive subjects, 32/50 (64%) were still positive at 2 weeks. A 36.5% decrease in subject's daily record of topical corticosteroid application at end of study compared to baseline was found. Participant surveys indicated preferences for the body wash over bleach baths.

Conclusions: Sodium hypochlorite (NaOCl) body wash improved all outcome measures for moderate-to-severe S aureus–colonized AD in infants, children, and adolescents. The limited reduction in S aureus further suggests that sodium hypochlorite has ameliorative effects other than antimicrobial actions.

KEYWORDS

atopic dermatitis, bleach, body wash, sodium hypochlorite
Activity of a hypochlorous acid‐producing electrochemical bandage as assessed with a porcine explant biofilm model 2026-10-16 00:00

Gretchen Tibbits¹ | Abdelrhman Mohamed¹ | Suzanne Gelston¹ | Laure Flurin² | Yash S. Raval² | Kerryl E. Greenwood‐Quaintance² | Robin Patel^2,3 | Haluk Beyenal¹

Abstract

The activity of a hypochlorous acid‐producing electrochemical bandage (e‐bandage) in preventing methicillin‐resistant Staphylococcus aureus infection (MRSA) infection and removing biofilms formed by MRSA was assessed using a porcine explant biofilm model. e‐Bandages inhibited S. aureus infection (p = 0.029) after 12 h (h) of exposure and reduced 3‐day biofilm viable cell counts after 6, 12, and 24 h exposures (p = 0.029). Needle‐type microelectrodes were used to assess HOCl concentrations in explant tissue as a result of e‐bandage treatment; toxicity associated with e‐bandage treatment was evaluated. HOCl concentrations in infected and uninfected explant tissue varied between 30 and 80 µM, decreasing with increasing distance from the e‐bandage. Eukaryotic cell viability was reduced by an average of 71% and 65% in fresh and day 3‐old explants, respectively, when compared to explants exposed to nonpolarized e‐bandages. HOCl e‐bandages are a promising technology that can be further developed as an antibiotic‐free treatment for wound biofilm infections.

KEYWORDS

biofilms, chronic wounds, electrochemical bandage, hypochlorous acid, MRSA, Staphylococcus aureus

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主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长

李孝建

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主任医师、教授、博导，南方医科大学第三附属医院（广东省骨科医院）院长

李孝建

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