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Clinical Research
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Evaluation of hypochlorous acid* in the treatment of chronic venous leg ulcers Joe B. Selkon, George W. Cherry, D Phil (Oxford), Jasmine M. Wilson, Margaret A. Hughes Hypochlorous acid* is a microbiocidal agent active against bacteria, viruses and fungi. It is not antigenic or irritant in animal tests, not mutagenic and not toxic to fibroblasts and keratinocytes in culture at concentrations equivalent to those achieved in man when applied topically. Used widely to disinfect endoscopes, it is not yet available for routine clinical use. In preliminary studies on patients we showed, using quantitative microbiology, it appreciably reduced the bacterial burden of chronic venous leg ulcers. The aim of the present study was to determine whether hypochlorous acid might serve as an additional treatment for chronic venous ulcers which had failed to heal with conventional treatment. On the basis of reports by both Phillips and Margolis in which they showed that patients who failed to achieve a 44% reduction of their ulcer size in their initial three weeks of compression bandaging standard treatment would not be likely to heal in more than 22% of cases, we designed a study with patients as their own controls. Of 30 patients admitted to the study, 10 did achieve a 44% reduction of the ulcer after three weeks standard treatment, and nine of these proceeded to heal by 12 weeks. The remaining 20 patients were given, in addition to standard compression treatment, washes with hypochlorous acid for twelve weeks. Of the 20 patients 9(45%) healed and 5(25%) achieved a >60% reduction in ulcer size. All patients became free of pain. The statistical evaluation of these results is reported and confirms the clinical efficacy of this treatment with hypochlorous washes. We conclude that the use of hypochlorous acid washes as an adjunctive therapy for recalcitrant venous leg ulcers appreciably increases healing of these ulcers and rapidly relieves pain. *STERILOX¨, Sterilox Technologies International Ltd, Stafford, UK Selkon JB, Babb JR, Morris R. Evaluation of the antimicrobial activity of a new super oxidised water (STERILOX¨) for the disinfection of endoscopes. J Hosp Infect. 1999;41:59Ð70. Selkon JB. Development of a new antiseptic for treating wound infection. In: The Oxford European Wound Healing Course Handbook. Wound Healing Institute. 2002;159Ð164 Selkon JB, Cameron. Development of a new antiseptic for preparing wound beds. International Congress and Symposium Series 250. Wound Bed Preparation. Royal Soc Med. 2001;53Ð57. Duby T, Hoffman D, Cameron J, et al. A randomized trial in the treatment of venous leg ulcers comparing short stretch bandages, four layer bandage system, and a long stretchÐpaste bandage system. WOUNDS. 1993;5:276Ð279 McGuckin M, Waterman R, Brooks J, et al. Validation of venous leg ulcer guidelines in the United States and United Kingdom. Am J Surg. 2002;183:132Ð137 Moffatt C, Franks P. The problem of recurrence in patients with leg ulceration. J Tissue Viability. 1995;5:65Ð67 Phillips TJ, Machado F, Trout R, et al. Prognostic indicators in venous ulcers. J Am Acad Dermatol. 2000;43:627Ð630. Margolis DJ, Berlin JA, Strom BL. Which venous leg ulcers will heal with limb compression bandages? Am J Med. 2000;109:15Ð19 Melzack R. The McGill Pain Questionnaire: major properties and scoring methods. Pain. 1975;1:277Ð99. Adderley UJ, Nelson ER. Can a pragmatic model predict which venous ulcers will fail to heal in 6 months? Presented at the 11th conference of the European Wound Management Association, held May 17Ð19, 2--1, Dublin, Ireland. |
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