sodium-hypochlorite and Diabetes-Mellitus

Diabetic foot ulcers (DFUs) are the main cause of hospitalizations and amputations in diabetic patients. Failure of standard foot care is the most important cause of impaired DFU healing. Dakin's solution (DS) is a promising broad-spectrum bactericidal antiseptic for management of DFUs. Studies investigating the efficacy of using DS on the healing process of DFUs are scarce. Accordingly, this is the first evidence-based, randomized, controlled trial conducted to evaluate the effect of using diluted DS compared with the standard care in the management of infected DFUs.. A randomized controlled trial was conducted to assess the efficacy of DS in the management of infected DFUs. Patients were distributed randomly to the control group (DFUs irrigated with normal saline) or the intervention group (DFUs irrigated with 0.1% DS). Patients were followed for at least 24 weeks for healing, reinfection, or amputations. In vitro antimicrobial testing on DS was performed, including determination of its minimum inhibitory concentration, minimum bactericidal concentration, minimum biofilm inhibitory concentration, minimum biofilm eradication concentration, and suspension test.. Replacing normal saline irrigation in DFU standard care with 0.1% DS followed by soaking the ulcer with commercial sodium hypochlorite (0.08%) after patient discharge significantly improved ulcer healing (P < .001) and decreased the number of amputations and hospitalizations (P < .001). The endpoint of death from any cause (risk ratio, 0.13; P = .029) and the amputation rate (risk ratio, 0.27; P < .001) were also significantly reduced. The effect on ulcer closure (OR, 11.9; P < .001) was significantly enhanced in comparison with the control group. Moreover, DS irrigation for inpatients significantly decreased bacterial load (P < .001). The highest values for the in-vitro analysis of DS were as follows: minimum inhibitory concentration (MIC), 1.44%; minimum bactericidal concentration (MBC), 1.44%; minimum biofilm inhibitory concentration (MBIC), 2.16%; and minimum biofilm eradication concentration (MBEC), 2.87%.. Compared with standard care, diluted DS (0.1%) was more effective in the management of infected DFUs. Dakin's solution (0.1%) irrigation with debridement followed by standard care is a promising method in the management of infected DFUs.

Topics: Amputation, Surgical; Anti-Bacterial Agents; Diabetes Mellitus; Diabetic Foot; Humans; Saline Solution; Sodium Hypochlorite; Wound Healing

In diabetic foot ulcers (DFUs), biofilm formation is a major challenge that promotes wound chronicity and delays healing. Antiseptics have been proposed to combat biofilms in the management of DFUs. However, there is limited evidence on the activity of these agents against biofilms, and there are questions as to which agents have the best efficiency. Here, we evaluated the antibiofilm activity of sodium hypochlorite, polyvinylpyrrolidoneIodine (PVPI), polyhexamethylenebiguanide (PHMB) and octenidine against

Topics: Anti-Bacterial Agents; Anti-Infective Agents, Local; Biofilms; Diabetes Mellitus; Diabetic Foot; Humans; Pseudomonas aeruginosa; Sodium Hypochlorite

Topics: Aged; Diabetes Mellitus; Diabetic Foot; Foot Ulcer; Humans; Hypochlorous Acid; Male; Sodium Hypochlorite; Treatment Outcome

Topics: Amputation, Surgical; Anti-Bacterial Agents; Debridement; Diabetes Mellitus; Diabetic Foot; Diabetic Neuropathies; Foot Ulcer; Humans; Hypochlorous Acid; Male; Middle Aged; Sodium Hypochlorite; Treatment Outcome

Topics: Aged; Amputation, Surgical; Diabetes Mellitus; Diabetic Foot; Humans; Hypochlorous Acid; Male; Negative-Pressure Wound Therapy; Sodium Hypochlorite; Treatment Outcome