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Bitte verwenden Sie diesen Link, wenn Sie dieses Dokument zitieren oder verlinken wollen: https://nbn-resolving.org/urn:nbn:de:gbv:9-opus-30768

Consensus on Wound Antisepsis: Update 2018

  • Wound antisepsis has undergone a renaissance due to the introduction of highly effective wound-compatible antimicrobial agents and the spread of multidrug-resistant organisms (MDROs). However, a strict indication must be set for the application of these agents. An infected or critically colonized wound must be treated antiseptically. In addition, systemic antibiotic therapy is required in case the infection spreads. If applied preventively, the Wounds-at-Risk Score allows an assessment of the risk for infection and thus appropriateness of the indication. The content of this updated consensus recommendation still largely consists of discussing properties of octenidine dihydrochloride (OCT), polihexanide, and iodophores. The evaluations of hypochlorite, taurolidine, and silver ions have been updated. For critically colonized and infected chronic wounds as well as for burns, polihexanide is classified as the active agent of choice. The combination 0.1% OCT/phenoxyethanol (PE) solution is suitable for acute, contaminated, and traumatic wounds, including MRSA-colonized wounds due to its deep action. For chronic wounds, preparations with 0.05% OCT are preferable. For bite, stab/puncture, and gunshot wounds, polyvinylpyrrolidone (PVP)-iodine is the first choice, while polihexanide and hypochlorite are superior to PVP-iodine for the treatment of contaminated acute and chronic wounds. For the decolonization of wounds colonized or infected with MDROs, the combination of OCT/PE is preferred. For peritoneal rinsing or rinsing of other cavities with a lack of drainage potential as well as the risk of central nervous system exposure, hypochlorite is the superior active agent. Silver-sulfadiazine is classified as dispensable, while dyes, organic mercury compounds, and hydrogen peroxide alone are classified as obsolete. As promising prospects, acetic acid, the combination of negative pressure wound therapy with the instillation of antiseptics (NPWTi), and cold atmospheric plasma are also subjects of this assessment.

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Metadaten
Author: Axel Kramer, Joachim Dissemond, Simon Kim, Christian Willy, Dieter Mayer, Roald Papke, Felix Tuchmann, Ojan Assadian
URN:urn:nbn:de:gbv:9-opus-30768
DOI:https://doi.org/10.1159/000481545
ISSN:1660-5527
ISSN:1660-5535
Pubmed Id:https://pubmed.ncbi.nlm.nih.gov/29262416
Parent Title (English):Skin Pharmacology and Physiology
Publisher:S. Karger AG
Place of publication:Basel, Switzerland
Document Type:Article
Language:English
Date of first Publication:2017/12/21
Release Date:2020/09/29
Tag:Acetic acid; Antiseptics; Drug; Dyes; Hydrogen peroxide; Hypochlorite; Iodophors; Medical device; Mercury compounds; Negative pressure wound therapy with the instillation of antiseptics; Octenidine; Physical body warm atmospheric plasma; Polihexanide; Silver ions; Silver sulfadiazine; Taurolidine; Wound antisepsis; Wounds-at-Risk Score
GND Keyword:-
Volume:31
Issue:1
First Page:28
Last Page:58
Faculties:Universitätsmedizin / Klinik und Poliklinik für Chirurgie Abt. für Unfall- und Wiederherstellungschirurgie
Licence (German):License LogoUrheberrechtlich geschützt