Dita Mutiara Irawan 1 , Ronny Lesmana2–4 , Edhyana Sahiratmadja 4
1Graduate School of Master Program in Anti Aging and Aesthetic Medicine, Faculty of Medicine, Universitas Padjadjaran,Jatinangor, 45363, Indonesia;2Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, 45363, Indonesia; 3Division of Biological Activity, Central Laboratory, Universitas Padjadjaran, Sumedang, 45363, Indonesia; 4Department of Biomedical Science, Faculty of Medicine, Universitas Padjadjaran, Sumedang, 45363, Indonesia
Correspondence: Dita Mutiara Irawan, Email 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。
Background: People who suffered type 2 diabetes have impaired healing of wounds due to the large number of circulating inflammatory cells resulting from high blood sugar levels. The wound healing process involves various complex processes including
the degradation of extracellular matrix, a process characterized by an increase in matrix metalloproteinase-9 (MMP-9). Conventional management of diabetic wounds usually involves systemic blood sugar control and topical antimicrobial treatment, including hydrogen peroxide and povidone-iodine, which are known to be cytotoxic to the cells involved in the wound healing cascade. Finding a safe, non-toxic, and effecting wound cleansing still poses a challenge, and hypochlorous acid (HOCl) could act as a potential candidate.
Purpose: Unveiling an HOCl ion as an agent for diabetic wound management and MMP-9 as a marker for delayed diabetic wound
Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Flow Diagram is used to find and select related, eligible literatures for the review. The authors used several databases such as Pro Quest, Scopus, Springer link and
Science Direct. In addition, and to expand the data, the database on Google Scholar was also opened. Then, the compiled data are analyzed to form results and discussions to the research question.
Results: Five eligible articles passed the inclusion criteria and reviewed for data synthesis. From 5 pieces of literature, it was found that the use of HOCl ions can be a good choice of topical agent in the management of diabetic wounds and decrease the activity of
MMP-9, which act as a marker for delayed healing of diabetic wounds.
Conclusion: Topical agent, in this case HOCl ion, shows good results and can be used as an option in the management of diabetic wounds and MMP-9 can be used as a predictive marker in the management of diabetic wounds.
Keywords: diabetic wound, HOCl ion, hypochlorite acid, MMP-9, wound healing
Julian-Dario Rembe1*†, Lioba Huelsboemer2†, Isabell Plattfaut2, Manuela Besser2 and Ewa K. Stuermer3
1Department of Vascular and Endovascular Surgery, University Hospital Düsseldorf, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany,2Chair for Translational Wound Research, Centre for Biomedical Education and Research, Witten/Herdecke University, Witten, Germany, 3Department of Vascular Medicine, University Heart and Vascular Center Hamburg, Translational Wound Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
Biofilms pose a relevant factor for wound healing impairment in chronic wounds.With 78% of all chronic wounds being affected by biofilms, research in this area is of high priority, especially since data for evidence-based selection of appropriate antimicrobials and antiseptics is scarce.Therefore,the objective of this study was to evaluate the anti-biofilm efficacy of commercially available hypochlorous wound irrigation solutions compared to established antimicrobials.Using an innovative complex in-vitro human plasma biofilm model(hpBIOM),quantitative reduction of Pseudomonas aeruginosa,Staphylococcus aureus,and Methicillin-resistant S. aureus (MRSA) biofilms by three hypochlorous irrigation solutions[two polyhexanide (PHMB)irrigation solution and 0.1%octenidine-dihydrochloride/phenoxyethanol(OCT/PE).Efficacy was compared to a non-challenged planktonic approach,as well as with increased substance volume over a prolonged exposure (up to 72 h).Qualitative visualization of biofilms was performed by scanning electron microscopy (SEM). Both reference agents(OCT/PE and PHMB)induced significant biofilm reductions within 72 h,whereby high volume OCT/PE even managed complete eradication of P. aeruginosa and MRSA biofilms after72 h.The tested hypochlorous wound irrigation solutions achieved no relevant penetration and eradication of biofilms despite increased volume and exposure. Only 0.2% NaClO managed a low reduction under prolonged exposure.The results demonstrate that low-dosed hypochlorous wound irrigation solutions are significantly less effective than PHMB-based irrigation solution and OCT/PE, thus unsuitable for biofilm eradication on their own. The used complex hpBIOM thereby mimics the highly challenging clinical wound microenvironment, providing a more profound base for future clinical translation.
Keywords: wound infection, biofilm, antimicrobial, antiseptic, hypochlorous acid, human plasma bioflm model, wound irrigation, chronic wound
长期从事影像诊断和介入放射学诊疗工作，擅长肿瘤和血管病的介入治疗。
佛山市禅城区中心医院慢性伤口造口专科主任。
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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