Impact of human wound exudate on the bactericidal efficacy of commercial antiseptic products

TY - JOUR

T1 - Impact of human wound exudate on the bactericidal efficacy of commercial antiseptic products

AU - Augustin, Matthias

AU - Herberger, Katharina

AU - Wille, Andreas

AU - Twarock, Sören

PY - 2023/7/2

Y1 - 2023/7/2

N2 - OBJECTIVE: By default, the antimicrobial efficacy of antiseptics used in wound management is tested in vitro under standardised conditions according to European standard DIN EN 13727, with albumin and sheep erythrocytes used as organic challenge. However, it is not clear whether these testing conditions adequately reflect the wound bed environment and its interaction with antiseptic products intended to be used in wounds in humans.METHOD: This study compared the efficacy of different commercial antiseptic products based on octenidine dihydrochloride (OCT), polyhexamethylene biguanide (PHMB) and povidone-iodine under challenge with human wound exudate collected from the hard-to-heal wounds of patients, compared to the standardised organic load, in an in vitro setting according to DIN EN 13727.RESULTS: The bactericidal efficacy of the tested products was reduced to a different extent when challenged with human wound exudate, compared to the standardised conditions. Overall, OCT-based products showed the necessary germ count reductions at the shortest exposure times (e.g., 15 seconds for Octenisept (Schülke & Mayr GmbH, Germany)). PHMB-based products were the least efficient. In addition to the protein content, other components of wound exudate, such as the microbiota, seem to influence the efficacy of antiseptics.CONCLUSION: This study demonstrated that the standardised in vitro test conditions may only partially reflect actual wound bed conditions in humans.

AB - OBJECTIVE: By default, the antimicrobial efficacy of antiseptics used in wound management is tested in vitro under standardised conditions according to European standard DIN EN 13727, with albumin and sheep erythrocytes used as organic challenge. However, it is not clear whether these testing conditions adequately reflect the wound bed environment and its interaction with antiseptic products intended to be used in wounds in humans.METHOD: This study compared the efficacy of different commercial antiseptic products based on octenidine dihydrochloride (OCT), polyhexamethylene biguanide (PHMB) and povidone-iodine under challenge with human wound exudate collected from the hard-to-heal wounds of patients, compared to the standardised organic load, in an in vitro setting according to DIN EN 13727.RESULTS: The bactericidal efficacy of the tested products was reduced to a different extent when challenged with human wound exudate, compared to the standardised conditions. Overall, OCT-based products showed the necessary germ count reductions at the shortest exposure times (e.g., 15 seconds for Octenisept (Schülke & Mayr GmbH, Germany)). PHMB-based products were the least efficient. In addition to the protein content, other components of wound exudate, such as the microbiota, seem to influence the efficacy of antiseptics.CONCLUSION: This study demonstrated that the standardised in vitro test conditions may only partially reflect actual wound bed conditions in humans.

KW - Humans

KW - Anti-Bacterial Agents/pharmacology

KW - Anti-Infective Agents

KW - Anti-Infective Agents, Local/pharmacology

KW - Exudates and Transudates

KW - Povidone-Iodine/pharmacology

U2 - 10.12968/jowc.2023.32.7.422

DO - 10.12968/jowc.2023.32.7.422

M3 - SCORING: Journal article

C2 - 37405941

VL - 32

SP - 422

EP - 427

JO - J WOUND CARE

JF - J WOUND CARE

SN - 0969-0700

IS - 7

ER -