title: Efficacy and safety of neutral pH superoxidised solution in severe diabetic foot infections.
abstract: The use of antiseptics in wound care is often controversial and there is definitely a need for a non toxic, highly disinfective agent. This study assessed the efficacy of a neutral pH superoxidised aqueous solution (NpHSS) for infection control, odour reduction and surrounding skin and tissue damage on infected diabetic foot ulcerations. From November 2003 to March 2004, 45 patients with type 2 diabetes were randomised into a single-blind clinical trial comparing NpHSS (intervention group; n = 21) versus conventional disinfectant (control group; n = 16). All patients received comprehensive care including surgical debridement as appropriate, moist wound care, intensive glucose control and broad spectrum antibiotics. Treatment groups were matched in terms of sex, age (61.9 +/- 11.9 versus 67.8 +/- 11.6), years of diabetes duration (16.4 +/- 8.1 versus 17 +/- 10.2), obesity, HgAlc (7.1 +/- 2 versus 6.7 +/- 1.8), initial fasting glycaemia (163 +/- 59 versus 152 +/- 65.8 mg/dl), ulcer duration/week (13.7 +/- 24 versus 15.1 +/- 16.3), B/A Index (0.9 +/- 0.5 versus 1.14 +/- 0.7), depth and extent of infection/periwound cellulitis (groups B and C of the Tampico Hospital Classification) as well as aetiology (P = 0.647). Odour reduction was achieved in all NpHSS patients (100% versus 25%; P < 0.01) and surrounding cellulitis diminished (P < 0.001) in 17 patients (80.9% versus 43.7%). Nineteen patients in the NpHSS group showed advancement to granulating tissue stage (90.4% versus 62.5%; P = 0.05) with significantly less tissue toxicity (94% versus 31.2%; P < 0.01). A non toxic, NpHSS, as part of a comprehensive care regimen, may be more efficacious in infection control, odour and erythema reduction than conventional disinfectants in treatment of diabetic foot infections.
authors.affiliation: Diabetic Foot Salvage and Prevention Center San Elian, Veracruz, Ver, Academia Mexicana de Cirugía, International Working Group on the Diabetic Foot, México. ferminmdj@yahoo.com
authors.forename: Fermín R
authors.initials: FR
authors.lastname: Martínez-De Jesús
authors.forename: Antonio
authors.initials: A
authors.lastname: Ramos-De la Medina
authors.forename: José María
authors.initials: JM
authors.lastname: Remes-Troche
authors.forename: David G
authors.initials: DG
authors.lastname: Armstrong
authors.forename: Stephanie C
authors.initials: SC
authors.lastname: Wu
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Lázaro Martínez
authors.forename: Juan V
authors.initials: JV
authors.lastname: Beneit-Montesinos
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000704:Analysis of Variance; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D001424:Bacterial Infections / Q000175:diagnosis / Q000188:drug therapy*; D016009:Chi-Square Distribution; D003646:Debridement / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D017719:Diabetic Foot / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology*; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D011336:Probability; D018570:Risk Assessment; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013481:Superoxides / Q000627:therapeutic use*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D013481:Superoxides