Articals
Pure Hypochlorous Acid: A Primer on pH and Wound Solutions
The treatment of complex wounds is challenging both for our patients and for those of us who have the privilege of participating in their care. As physicians, nurses, and all those who engage in this field, it is incumbent upon us to understand “the what, the why, and the how” of the tools in our medical armamentarium. The biochemistry, potential for cellular toxicity, and wound pathophysiology are important factors that should be considered in the selection of any wound cleansing agent.
Hypochlorous Acid as a Potential Wound Care Agent
Hypochlorous acid (HOCl), a major inorganic bactericidal compound of innate immunity, is effective against a broad range of microorganisms. Owing to its chemical nature, HOCl has never been used as a pharmaceutical drug for treating infection. In this article, we describe the chemical production, stabilization, and biological activity of a pharmaceutically useful formulation of HOCl.
Hypochlorous Acid: An Ideal Wound Care Agent With Powerful Microbicidal, Antibiofilm, and Wound Healing Potency
The aim of this study was to investigate the effect of stabilized hypochlorous acid solution (HOCl) on killing rate, biofilm formation, antimicrobial activity within biofilm against frequently isolated microorganisms and migration rate of wounded fibroblasts and keratinocytes.
The stabilized HOCl solution had dose-dependent favorable effects on fibroblast and keratinocyte migration compared to povidone iodine and media alone. These features lead to a stabilized HOCl solution as an ideal wound care agent.
EXPERT RECOMMENDATIONS
FOR THE USE OF HYPOCHLOROUS SOLUTION:
SCIENCE AND CLINICAL APPLICATION
Wound complications such as infection continue to inflict enormous financial and patient quality-of-life burdens. The
traditional practice of using antiseptics and antibiotics to prevent and/or treat infections has been questioned with increasing
concerns about the cytoxitity of antiseptics and proliferation of antibiotic resistant bacteria. Solutions of sodium
hypochlorite (NaOCl), commonly known as Dakin’s solution, have been used in wound care for 100 years. In the last 15
years, more advanced hypochlorous acid (HOCl) solutions, based on electrochemistry, have emerged as safe and viable
wound-cleansing agents and infection treatment adjunct therapies
Diagnosing and managing infection in acute and chronic wounds
The International Wound Infection Institute has recently updated its guidance and now recommends using the term ‘microbial’, rather than ‘bacterial’, when discussing wound infection. It has also adopted a new way of categorising wound infection as stages in a continuum. These updated definitions and recommendations should help health professionals recognise the presence of infection in a wound and choose the appropriate management.