Stephanie M. Mueller ^1,2 , LaYow C. Yu ² , Michael Drake Pike ² , Hannah D. Shi ² and Dennis P. Orgill ^1,2,*

1 Division of Plastic and Reconstructive Surgery, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115, USA; 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。

2 Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; 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。 (L.C.Y.); 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。 (M.D.P.); 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。 (H.D.S.)

* Correspondence: 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。

Abstract

Background: Irrigation is a key strategy in reducing bioburden, disrupting biofilms, and supporting wound healing. While saline is the standard for its safety and availability, antiseptic and antibiotic solutions are often used in clinical scenarios that require infection control. However, the rise in antibiotic stewardship and concerns regarding cytotoxicity are reshaping current practices. This review identifies recent trends, current controversies, and persistent gaps in knowledge that warrant further investigation and regulatory attention. Methods: A literature review identified irrigation solutions commonly used in plastic surgery; labeling and concentrations were obtained from Devices@FDA, Drugs@FDA, and DailyMed, and PubMed, Cochrane Central, and Embase were searched (January 2022–July 2025) for human studies on acute wounds, chronic wounds, and implant-based breast surgery. Results: In acute wounds, saline and potable tap water effectively prevent infection. In chronic wounds, such as diabetic foot ulcers and pressure injuries, antiseptic agents, including hypochlorous acid, sodium hypochlorite, polyhexanide, and citrate-based solutions, have shown promise in improving healing and reducing infection. In implant-based breast reconstruction and augmentation, data on antiseptics, such as chlorhexidine, and changes in FDA guidance for povidone–iodine and bacitracin have prompted a reevaluation of intraoperative irrigation practices. Conclusion: Despite widespread use, many antiseptics remain off-label, and high-quality clinical studies comparing efficacy and safety are lacking.

Keywords: wound irrigation; saline irrigation; antiseptic irrigation; surgical site infection/prevention and control; breast pocket irrigation; Povidone–Iodine (PVI); Polyhexamethylene Biguanide/polyhexanide (PHMB); Hypochlorous Acid (HOCl); Sodium Hypochlorite (NaOCl); Triple antibiotic solution (TAS)

Warren W. Burggren*

Developmental Integrative Biology, Department of Biological Sciences, University of North Texas, Denton, TX, United States

Akash Patel , Monica Patel , Joseph Glowacki

1.Internal Medicine, St. Mary Medical Center, Langhorne , USA 2. Internal Medicine, Temple University Hospital, Philadelphia, USA 3. Internal Medicine, Rowan University School of Medicine, Stratford, USA

Corresponding author: Akash Patel, 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。

Abstract

Fusobacterium nucleatum is a strict anaerobe that is indigenous to the human oral cavity, where it coexists with more than 500 other species. It is associated with paranasal sinus, odontogenic, and pulmonary infections. In literature, cases of Fusobacterium nucleatum are rare. Here we report a case of a patient with multiple brain abscesses caused by Fusobacterium nucleatum. This case report looks to assist clinicians in determining the true etiology of this organism, which can change patient management based on the current literature review and similar case studies.

Categories: Internal Medicine, Infectious Disease, Neurosurgery

Keywords: anaerobes of clinical importance, colon cancer surveillance, periodontal disease, brain abscess, fusobacterium nucelatum

Kento Tazawa^1,2, Rutuja Jadhav¹ , Mariane Maffei Azuma¹ , J. Christopher Fenno³ , Neville J. McDonald1 and Hajime Sasaki^1*

Abstract

Background Droplets and aerosols produced during dental procedures are a risk factor for microbial and viral transmission. Unlike sodium hypochlorite, hypochlorous acid (HOCl) is nontoxic to tissues but still exhibits broad microbicidal effect. HOCl solution may be applicable as a supplement to water and/or mouthwash. This study aims to evaluate the effectiveness of HOCl solution on common human oral pathogens and a SARS-CoV-2 surrogate MHVA59 virus, considering the dental practice environment.

Methods HOCl was generated by electrolysis of 3% hydrochloric acid. The effect of HOCl on human oral pathogens, Fusobacterium nucleatum, Prevotella intermedia, Streptococcus intermedius, Parvimonas micra, and MHV A59 virus was studied from four perspectives: concentration; volume; presence of saliva; and storage. HOCl solution in different conditions was utilized in bactericidal and virucidal assays, and the minimum inhibitory volume ratio that is required to completely inhibit the pathogens was determined.

Results In the absence of saliva, the minimum inhibitory volume ratio of freshly prepared HOCl solution (45–60 ppm) was 4:1 for bacterial suspensions and 6:1 for viral suspensions. The presence of saliva increased the minimum inhibitory volume ratio to 8:1 and 7:1 for bacteria and viruses, respectively. Applying a higher concentration of HOCl solution (220 or 330 ppm) did not lead to a significant decrease in the minimum inhibitory volume ratio against S. inter-medius and P. micra. The minimum inhibitory volume ratio increases in applications of HOCl solution via the dentalunit water line. One week of storage of HOCl solution degraded HOCl and increased the minimum growth inhibition volume ratio.

Conclusions HOCl solution (45–60 ppm) is still effective against oral pathogens and SAR-CoV-2 surrogate viruses even in the presence of saliva and after passing through the dental unit water line. This study indicates that the HOCl solution can be used as therapeutic water or mouthwash and may ultimately reduce the risk of airborne infection in dental practice.

Keywords Hypochlorous acid (HOCl), Dental practice, Airborne infection, Oral pathogens, SARS-CoV-2, Disinfectant, Mouthwash, Minimum inhibitory volume ratio