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Segal M, Metanes I, O'Boyle CP, Sadeh O, Hassan S, Bryzgalin L, Lavi I, Franco E, Har-Shai Y. Safety of troclosene sodium solution in decontamination of wounds: A prospective clinical and laboratory study. Wound Repair Regen 2023; 31:635-640. [PMID: 37358433 DOI: 10.1111/wrr.13105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/15/2023] [Accepted: 06/14/2023] [Indexed: 06/27/2023]
Abstract
Debate persists regarding the safety of hypochlorite-containing solutions in the decontamination of infected wounds. In 2006, the Israeli Ministry of Health withdrew licensing approval for troclosene sodium as a wound irrigation solution. The aim of this prospective clinical and laboratory study was to investigate the safety of troclosene sodium solution for decontamination of infected wounds. Troclosene sodium solution was used to treat 30 patients with 35 infected skin wounds of various etiologies and body areas, over a treatment period of 8 days. Data were gathered according to a prospectively designed protocol including general findings, wound-specific observations on Day 1 and Day 8 and laboratory parameters on Day 1 and Day 8. Wound swabs and tissue biopsy for culture were taken on Day 1 and Day 8. Statistical analysis was executed. Tests were 2-sided and p values of <0.05 were considered statistically significant. Eighteen males and 12 females, with 35 infected skin wounds were enrolled. There were no adverse clinical events. No significant changes were observed in general clinical observations. Statistically significant improvements were observed in: pain (p < 0.0001); edema (p < 0.0001); area of wound covered by granulation tissue (p < 0.0001); exudate (p < 0.0001); and erythema (p = 0.002). Prior to treatment, bacteria were demonstrated on microscopy or on culture in 90% of wound samples. On Day 8, this frequency reduced to 40%. There were no abnormal laboratory tests. Serum sodium concentration increased significantly between Day 1 and Day 8, whilst serum concentration of urea and concentrations of thrombocytes, leucocytes and neutrophils showed statistically significant reductions, but all values remained within normal laboratory ranges throughout the study period. Troclosene sodium solution is clinically safe in the management of infected wounds. These findings were presented to the Israel Ministry of Health and as a result, troclosene sodium was re-approved and licensed for decontamination of infected wounds in Israel.
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Affiliation(s)
- Miriam Segal
- Department of Plastic Surgery, The Lady Davis Carmel Medical Center, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Issa Metanes
- Department of Plastic Surgery, The Lady Davis Carmel Medical Center, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Ciaran P O'Boyle
- Nottingham University Hospitals NUHS Trust, The University of Nottingham, Nottingham, UK
| | - Omer Sadeh
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Samer Hassan
- Department of Plastic Surgery, The Lady Davis Carmel Medical Center, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Leonid Bryzgalin
- Department of Plastic Surgery, The Lady Davis Carmel Medical Center, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Idit Lavi
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Department of Community Medicine and Epidemiology, The Lady Davis Carmel Medical Center, Haifa, Israel
| | - Eyal Franco
- Department of Plastic Surgery, The Lady Davis Carmel Medical Center, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Yaron Har-Shai
- Department of Plastic Surgery, The Lady Davis Carmel Medical Center, Haifa, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Bal A, Jain SK, Jagannath, Mohapatra KC, Rao S, Deshpande N, Munshi R, Mahey R, Chowdhury S, Bhaskar MM, Singh SO, Damle G, Damir A, Phal S, Zarapkar M. Efficacy and Safety of Topical Solution of Diperoxochloric Acid for Neuropathic Diabetic Foot Ulcer: Results from a Phase 3, Multicentre, Randomized, Active-controlled, Parallel-group Study. INT J LOW EXTR WOUND 2022:15347346221076625. [PMID: 35275009 DOI: 10.1177/15347346221076625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Diabetic foot ulcer (DFU), if untreated, accounts for lower-limb amputations affecting patients' quality-of-life. Diperoxochloric acid (DPOCL) is known to heal DFU by its antibacterial and fibroblast stimulating activity. This was a phase 3, multicentre, randomized, double-blind, active-controlled, parallel-group study conducted to evaluate the efficacy and safety of topic solution of DPOCL compared with isotonic sodium chloride solution (ISCL). Adult patients with type 1 or 2 diabetes with random blood glucose levels of <250 mg/dL, with ≤ than three full-thickness foot ulcers were enrolled. Primary efficacy endpoint was complete wound closure and secondary was wound surface area. Adverse events were analyzed as safety endpoint. Of 311 enrolled patients, 289 were randomized 1:1 to DPOCL (139) and ISCL (150) treatment (10-weeks [8-Visits]). Percentage of patients with complete wound closure at visit-8, were significantly higher (P = .0156) in DPOCL arm (76% [105/139]) compared to ISCL (62% [93/150]) arm. At end-of-study, mean wound surface area in DPOCL arm (0.639 cm2) was significantly lower (P = .0209) compared to ISCL (0.818 cm2) arm. One death was reported in control arm which was not considered as treatment-related. No important safety finding were observed. Results indicate that, DPOCL can be considered as effective and safe treatment option for DFU compared to ISCL, although future confirmatory studies are warranted.
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Affiliation(s)
- Arun Bal
- Dhanvantari Hospital, Dadar, Mumbai, Maharashtra, India
| | | | - Jagannath
- 72929Sri Siddhartha Medical College, Tumkur, Karnataka, India
| | | | - Shilpa Rao
- 29549Seth. G. S. Medical College and K.E.M. Hospital, Parel, Mumbai, India
| | | | - Renuka Munshi
- 29566T. N. M. C. and B. Y. L. Nair Ch. Hospital, Mumbai, India
| | | | - Subhankar Chowdhury
- Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, India
| | - M M Bhaskar
- Harsha Hospital, K.R. Nagar, Mysore, Karnataka, India
| | | | - Gauri Damle
- Madhunayni Diabetes care and Eye laser center, Sadashiv Peth, Pune, India
| | - Ashok Damir
- Fortis C-Doc Healthcare Ltd, New Delhi, India
| | - Smita Phal
- Centaur Pharmaceuticals Pvt. Ltd, Mumbai, Maharashtra, India
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Biswas A, Bharara M, Hurst C, Gruessner R, Armstrong D, Rilo H. Use of sugar on the healing of diabetic ulcers: a review. J Diabetes Sci Technol 2010; 4:1139-45. [PMID: 20920433 PMCID: PMC2956799 DOI: 10.1177/193229681000400512] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
With the advent of several innovative wound care management tools, the choice of products and treatment modalities available to clinicians continues to expand. High costs associated with wound care, especially diabetic foot wounds, make it important for clinician scientists to research alternative therapies and optimally incorporate them into wound care protocols appropriately. This article reviews using sugar as a treatment option in diabetic foot care and provides a guide to its appropriate use in healing foot ulcers. In addition to a clinical case study, the physiological significance and advantages of sugar are discussed.
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Affiliation(s)
- Atanu Biswas
- Department of Surgery, Center for Cellular Transplantation, University of Arizona College of MedicineTucson, Arizona
| | - Manish Bharara
- Department of Surgery, Southern Arizona Limb Salvage Alliance, University of Arizona College of MedicineTucson, Arizona
| | - Craig Hurst
- Department of Surgery, Division of Plastic and Reconstructive Surgery, University of Arizona College of MedicineTucson, Arizona
| | - Rainer Gruessner
- Department of Surgery, Center for Cellular Transplantation, University of Arizona College of MedicineTucson, Arizona
- Department of Surgery, Division of Abdominal Transplant Surgery, University of Arizona College of MedicineTucson, Arizona
| | - David Armstrong
- Department of Surgery, Southern Arizona Limb Salvage Alliance, University of Arizona College of MedicineTucson, Arizona
| | - Horacio Rilo
- Department of Surgery, Center for Cellular Transplantation, University of Arizona College of MedicineTucson, Arizona
- Department of Surgery, Southern Arizona Limb Salvage Alliance, University of Arizona College of MedicineTucson, Arizona
- Department of Surgery, Division of Abdominal Transplant Surgery, University of Arizona College of MedicineTucson, Arizona
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