Antiseptic with modern wound dressings in the treatment of venous leg ulcers: clinical and microbiological aspects.

OBJECTIVE: To assess the impact of a two-period treatment on the clinical condition, bacteriological changes and results of treatment of venous leg ulcers (VLU) using octenidine dihydrochloride. METHOD: Patients with a VLU were recruited and treated with octenidine dihydrochloride for one month, after which they were randomised and treated with hydrocolloids or foam dressings. The wounds were clinically assessed for the amount of necrotic tissue, granulation tissue, epithelialisation, amount of exudate and pain level. During the first period, bacterial colonisation and antimicrobial efficacy of octenidine dihydrochloride were also evaluated. In the second period the efficacy of treatment, time of treatment and healing rate were investigated. RESULTS: In the group of 50 VLU patients, all wounds (100%) improved after the first treatment period. No clinical signs of infection were observed. Statistically significant changes were observed in all the clinical parameters studied in the treated groups of VLU patients, including reduction of necrotic tissue, the amount of exudate and of pain, as well as increased granulation and epithelialisation. In the second period including treatment with the two dressings, no differences were observed in treatment efficacy, time of treatment or healing rate. CONCLUSION: As used in this study, octenidine dihydrochloride proved to be effective and useful, changing the clinical condition of VLU, preparing the wound for future treatment with modern dressings. High microbicidal activity of octenidine was observed, both against Gram-negative and Gram-positive bacteria isolated from the ulcers. Octenidine dihydrochloride caused an eradication of multiresistant strains (88%) as well as of bacteria qualified as alert-pathogens (100%) in the treated wounds after four weeks. However, no differences in the effects, time or rate of healing of VLU with two dressings were found in the second period. No side effects or significant local intolerance reactions used for treatment were observed.

Effect of Octenisept antiseptic on bioburden of neoplastic ulcers in patients with advanced cancer.

OBJECTIVE: To assess the effect of octenidine dihydrochloride (Octenisept, Schülke & Mayr) on the clinical condition and bacterial flora in neoplastic ulcers. METHOD: Twenty-one patients with advanced cancer and neoplastic ulcers were included in the study. Octenisept-moistened gauze dressings were applied to the ulcers three times daily. The clinical and bacteriological status of the wounds were assessed at baseline and after three weeks of treatment. RESULTS: Thirty-three bacterial strains were cultured at baseline. After three weeks of treatment, the tests were repeated on 16 patients. Clinical observations confirmed an improvement in the clinical condition of the ulcers, characterised by a reduction in necrosis, exudate levels, erythema and oedema. According to the bacteriological assessment, Staphylococcus aureus, Staphylococcus epidermidis and Proteus mirabilis were eradicated from the wounds. Enterococcus faecalis persisted in two patients, Escherichia coli in one patient and Pseudomonas aeruginosa in another patient. CONCLUSION: Octenispet was an effective antimicrobial: Staphylococcus aureus and Proteus mirabilis were eradicated in all ulcers. After three weeks of treatment, none of the ulcers developed an infection and there was an improvement in their clinical condition.

Effect of bacteriological status on pressure ulcer healing in patients with advanced cancer.

OBJECTIVES: This study aimed to identify the quantitative and qualitative bacteriological status of pressure ulcers in patients with advanced cancer, and the effects on the healing process. METHOD: We recruited 34 patients with advanced cancer who had 38 superficial grade II and III pressure ulcers. Patients were randomly allocated to treatment with Lyofoam/polyurethane foam dressing (Seton) or Aquagel/hydrogel dressing (Wytw.Opatrunków). Efficacy, treatment times and healing rates were noted. Qualitative studies were undertaken on 38 pressure ulcers and quantitative bacteriological studies on 19 ulcers. RESULTS: There was no statistical difference between the two treatment groups in efficacy, healing rates and treatment times. Bacteriological assessment identified 92 species. CONCLUSION: The bacteria did not cause any clinical signs of infection. Variations in the number and types of bacteria in individual wounds did not correlate to the grade of ulcer or the dressing used.