sodium-hypochlorite and Pressure-Ulcer

The aim of this study was to use a Cochrane systematic review process to explore the effect of wound cleansing solutions and techniques on pressure ulcer healing.. Pressure ulcers impose a significant financial burden on health care systems and negatively affect the quality of life. Wound cleansing is an important component of pressure ulcer care; however, there is uncertainty regarding best practice.. Systematic review.. The Specialised Trials Register of the Cochrane Wounds Group, the Cochrane Central Register of Controlled Trials and bibliographies of relevant publications were searched. Drug companies and experts in the field were also contacted. Randomized controlled trials (RCTs) comparing wound cleansing with no wound cleansing, or different wound cleansing solutions, or different cleansing techniques, were eligible for inclusion. For dichotomous outcomes, relative risk (RR) plus 95% confidence intervals (CI) were calculated; for continuous outcomes, weighted mean difference plus 95% CI were calculated. Meta analysis was not conducted because of the small number of diverse RCTs identified.. No studies compared cleansing with no cleansing. A statistically significant improvement in healing occurred for wounds cleansed with saline spray containing Aloe vera, silver chloride and decyl glucoside (Vulnopur) compared with isotonic saline (p = 0.025). No statistically significant change in healing was seen when water was compared with saline (RR 3.00, 95% CI 0.21, 41.89). No statistically significant change in healing was seen for ulcers cleansed with, or without, a whirlpool (RR 2.10, 95% CI 0.93-4.76).. There is little trial evidence to support the use of any particular wound cleansing solution or technique for pressure ulcers. Relevance to clinical practice. No firm recommendations for ways of cleansing pressure ulcers in clinical practice can be made, the lack of RCT evidence should be a concern for health care providers.

Topics: Aloe; Anti-Infective Agents, Local; Clinical Nursing Research; Data Collection; Data Interpretation, Statistical; Detergents; Evidence-Based Medicine; Glucosides; Humans; Hydrotherapy; Infection Control; Phytotherapy; Pressure Ulcer; Randomized Controlled Trials as Topic; Research Design; Silver Compounds; Skin Care; Sodium Chloride; Sodium Hypochlorite; Therapeutic Irrigation; Treatment Outcome; Wound Healing

Topics: Adult; Aged; Anti-Infective Agents; Bandages; Borates; Clinical Trials as Topic; Female; Humans; Male; Metronidazole; Middle Aged; Pressure Ulcer; Sodium Hypochlorite; Varicose Ulcer

An early-stage decision clinicians often make in the management of complex wounds is which method of wound preparation will be appropriate for the patient. This decision can be affected by numerous wound and patient risk factors that present challenges and may make surgical debridement difficult in patients with complex wounds. Recently, negative pressure wound therapy with instillation and dwell time (NPWTi-d) using a novel reticulated open-cell foam dressing with through holes (ROCF-CC) was shown to aid in the loosening and removal of thick exudate and nonviable tissue from wounds.. The authors present their experiences of using NPWTi-d with ROCF-CC, along with rationales for wound care decisions.. Patients received antibiotics and surgical debridement when appropriate. Therapy selection and parameters were based on a decision-tree model for wound care management that takes into consideration patient and wound information. Most patients received NPWTi-d with ROCF-CC for a duration of 5 to 8 days; however, 1 patient received NPWTi-d with ROCF-CC for more than 30 days due to the wound extent and severity. Therapy consisted of instilling saline or quarter-strength sodium hypochlorite solution with dwell times of 3 to 10 minutes, followed by 2 hours or 3.5 hours of NPWT either at -100 mm Hg or -125 mm Hg.. There were 6 patients (3 men, 3 women; average age, 58.5 years) treated. Wound types included 3 pressure ulcers, 1 necrotizing soft tissue infection, 1 perianal abscess, and 1 large abdominal wound. Patient comorbidities included obesity, type 2 diabetes, and radiation therapy. In all cases, progression of wound healing was observed with no complications. This method produced viable granulation tissue and wound bed preparation; however, patients were not followed to closure or grafting.. These cases help support the use of NPWTi-d with ROCF-CC as a viable option for wound care providers in the early-stage management of complex wounds.

Topics: Abdominal Abscess; Anus Diseases; Bandages; Critical Care; Critical Illness; Disinfectants; Female; Humans; Male; Middle Aged; Negative-Pressure Wound Therapy; Pilot Projects; Pressure Ulcer; Saline Solution; Sodium Hypochlorite; Soft Tissue Infections; Treatment Outcome; Wound Healing

Topics: Anti-Infective Agents, Local; Benzoates; Borates; Clinical Protocols; Critical Pathways; Debridement; Drug Combinations; Humans; Malates; Male; Middle Aged; Patient Care Team; Pressure Ulcer; Salicylates; Sodium Hypochlorite

Topics: Anti-Infective Agents, Local; Benzoates; Borates; Clinical Protocols; Drug Combinations; Humans; Malates; Pressure Ulcer; Salicylates; Sodium Hypochlorite

Topics: Anti-Infective Agents, Local; Benzoates; Borates; Clinical Protocols; Drug Combinations; Humans; Malates; Povidone-Iodine; Pressure Ulcer; Salicylates; Sodium Hypochlorite

A strain of Salmonella typhimurium isolated from a decubitus ulcer that was being treated topically with half-strength Dakin's solution became H2S negative, nitrate negative, and unable to produce gas from glucose. Experimental data suggested that these effects were associated with the development of chlorate resistance. Thirty-five other strains of Salmonella spp. that were made chlorate resistant also became negative for these three tests.

Topics: Chlorates; Drug Resistance; Glucose; Humans; Hydrogen Sulfide; Male; Nitrates; Oxidation-Reduction; Pressure Ulcer; Salmonella typhimurium; Sodium Hypochlorite

Topics: Humans; Ointments; Pressure Ulcer; Sodium Hypochlorite

Topics: Aged; Anti-Infective Agents; Bandages; Borates; Cost-Benefit Analysis; Detergents; Dextrans; Granulation Tissue; Humans; Middle Aged; Paraffin; Pressure Ulcer; Skin; Sodium Hypochlorite; Surface-Active Agents