Hypochlorous acid -the future of wound care?

Dear Editor, Wounds, especially chronic wounds and associated infections, impose a substantial burden on individuals and healthcare systems, leading to escalated morbidity rates and a significant ris in healthcare costs. Chronic wounds create ideal conditions for infection and the forma...

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Main Authors: Muhammad Roshan, Maryam Tariq, Muhammad Sulaman Akhtar
Format: Article
Language:English
Published: Pakistan Medical Association 2024-02-01
Series:Journal of the Pakistan Medical Association
Subjects:
Online Access:https://ojs.jpma.org.pk/index.php/public_html/article/view/10290
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author Muhammad Roshan
Maryam Tariq
Muhammad Sulaman Akhtar
author_facet Muhammad Roshan
Maryam Tariq
Muhammad Sulaman Akhtar
author_sort Muhammad Roshan
collection DOAJ
description Dear Editor, Wounds, especially chronic wounds and associated infections, impose a substantial burden on individuals and healthcare systems, leading to escalated morbidity rates and a significant ris in healthcare costs. Chronic wounds create ideal conditions for infection and the formation of biofilms, making it essential to implement comprehensive wound care techniques to promote wound healing1. Antiseptics are substances that impede or eradicate pathogens found within wounds or on the skin. Iodine-based agents such as povidone-iodine (PVP-I) have been used to treat wounds for decades. PVP-I is widely used and accepted due to its broad activity spectrum against gram-positive and negative bacteria, no development of cross-resistance upon use and its ability to penetrate biofilms. While being widely utilized worldwide, certain concerns have been raised regarding hypersensitivity, inadequate penetration, and potential cytotoxicity on host cells associated with its use. Reports have emerged documenting instances of both immediate and delayed allergic reactions to PVP-I. There have also been reports of iodine toxicity in patients when PVP-I was used as a constant wound irrigant2. Hypochlorous acid (HOCl) is a potent antimicrobial compound naturally synthesized by the immune system. It exhibits remarkable efficacy against a wide range of bacterial, viral, and fungal pathogens, effectively neutralizing their presence. A study conducted by Sakarya et al. concluded that stabilized HOCl solution is minimally allergenic as it’s produced naturally in the body and is also an ideal wound care solution3. A few comparative studies have been conducted between HOCl and PVP-I. In very recent research, it was concluded that in neonatal circumcision, the group of patients that used PVP-I had a greater occurrence of edema and delayed wound healing as compared to patients that used HOCl4. Moreover, PVP-I has been demonstrated to be cytotoxic to cellular components of wound healing while HOCl controls bacterial spread without disrupting the wound healing process as it is non-cytotoxic to cells at concentrations that achieve antimicrobial action. The amount of exudate also decreases when Hypochlorous acid is used instead of Povidone iodine5. To sum it up, Physicians and nurses face a formidable hurdle in identifying a topical antiseptic agent that is both safe and efficacious. PVP-I is being widely used as an antiseptic agent for wound healing but patients do experience some side effects. Research suggests that hypochlorous acid is also an effective option to treat lesions with less adverse effects, although more research should be conducted to reach absolute conclusive results.
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spelling doaj.art-c41fa5ec62a04171aa49c3c30410a9092024-02-24T05:33:34ZengPakistan Medical AssociationJournal of the Pakistan Medical Association0030-99822024-02-0174410.47391/JPMA.10290Hypochlorous acid -the future of wound care?Muhammad Roshan0Maryam Tariq1Muhammad Sulaman Akhtar22nd Year MBBS Student, Shifa College of Medicine, Shifa International Hospital, Islamabad, Pakistan3rd Year MBBS Student, Aziz Fatima Medical and Dental College, Faisalabad, Pakistan5th Year MBBS Student, Shifa College of Medicine, Shifa International Hospital, Islamabad, Pakistan Dear Editor, Wounds, especially chronic wounds and associated infections, impose a substantial burden on individuals and healthcare systems, leading to escalated morbidity rates and a significant ris in healthcare costs. Chronic wounds create ideal conditions for infection and the formation of biofilms, making it essential to implement comprehensive wound care techniques to promote wound healing1. Antiseptics are substances that impede or eradicate pathogens found within wounds or on the skin. Iodine-based agents such as povidone-iodine (PVP-I) have been used to treat wounds for decades. PVP-I is widely used and accepted due to its broad activity spectrum against gram-positive and negative bacteria, no development of cross-resistance upon use and its ability to penetrate biofilms. While being widely utilized worldwide, certain concerns have been raised regarding hypersensitivity, inadequate penetration, and potential cytotoxicity on host cells associated with its use. Reports have emerged documenting instances of both immediate and delayed allergic reactions to PVP-I. There have also been reports of iodine toxicity in patients when PVP-I was used as a constant wound irrigant2. Hypochlorous acid (HOCl) is a potent antimicrobial compound naturally synthesized by the immune system. It exhibits remarkable efficacy against a wide range of bacterial, viral, and fungal pathogens, effectively neutralizing their presence. A study conducted by Sakarya et al. concluded that stabilized HOCl solution is minimally allergenic as it’s produced naturally in the body and is also an ideal wound care solution3. A few comparative studies have been conducted between HOCl and PVP-I. In very recent research, it was concluded that in neonatal circumcision, the group of patients that used PVP-I had a greater occurrence of edema and delayed wound healing as compared to patients that used HOCl4. Moreover, PVP-I has been demonstrated to be cytotoxic to cellular components of wound healing while HOCl controls bacterial spread without disrupting the wound healing process as it is non-cytotoxic to cells at concentrations that achieve antimicrobial action. The amount of exudate also decreases when Hypochlorous acid is used instead of Povidone iodine5. To sum it up, Physicians and nurses face a formidable hurdle in identifying a topical antiseptic agent that is both safe and efficacious. PVP-I is being widely used as an antiseptic agent for wound healing but patients do experience some side effects. Research suggests that hypochlorous acid is also an effective option to treat lesions with less adverse effects, although more research should be conducted to reach absolute conclusive results. https://ojs.jpma.org.pk/index.php/public_html/article/view/10290woundscare
spellingShingle Muhammad Roshan
Maryam Tariq
Muhammad Sulaman Akhtar
Hypochlorous acid -the future of wound care?
Journal of the Pakistan Medical Association
wounds
care
title Hypochlorous acid -the future of wound care?
title_full Hypochlorous acid -the future of wound care?
title_fullStr Hypochlorous acid -the future of wound care?
title_full_unstemmed Hypochlorous acid -the future of wound care?
title_short Hypochlorous acid -the future of wound care?
title_sort hypochlorous acid the future of wound care
topic wounds
care
url https://ojs.jpma.org.pk/index.php/public_html/article/view/10290
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