title: Antiseptic with modern wound dressings in the treatment of venous leg ulcers: clinical and microbiological aspects.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors: Ass Prof, Chair, Department of Palliative Medicine, Hospice Palium, University of Medical Sciences, Poznan, Poland.
authors: M
authors: M
authors: Sopata
authors: Chair, School of Medicine with the Division of Dentistry in Zabrze, Department of Descriptive and Topographic Anatomy, Medical University of Silesia.|Outpatient Surgery Center no. 2, Specialist Hospital no. 2, Bytom, Poland.
authors: M
authors: M
authors: Kucharzewski
authors: Ass Prof, Chair, Department of Palliative Medicine, Hospice Palium, University of Medical Sciences, Poznan, Poland.
authors: E
authors: E
authors: Tomaszewska
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007097:Imines; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D010146:Pain / Q000188:drug therapy; D011725:Pyridines / Q000627:therapeutic use*; D014647:Varicose Ulcer / Q000382:microbiology* / Q000628:therapy*; D014945:Wound Healing / Q000502:physiology*
chemical_list: D000891:Anti-Infective Agents, Local; D007097:Imines; D011725:Pyridines; C034213:octenidine
keywords: hydrocolloids; microbiology; octenidine dihydrochloride; poliurethane foam; topical antiseptics; venous leg ulcers