title: The Effect of Polyhexanide, Octenidine Dihydrochloride, and Tea Tree Oil as Topical Antiseptic Agents on In Vivo Microcirculation of the Human Skin: A Noninvasive Quantitative Analysis.
abstract: BACKGROUND
  Antiseptics are indispensable for wound management and should focus not only on the efficacy in reducing the bacterial burden but also on how much they interfere in wound healing. In this study, the authors analyzed the direct effect of topical antiseptic agents on the microcirculation of intact human skin.
  
  
  METHODS
  The perfusion dynamics were assessed before, and 10 minutes after, the volunteers' fingers of the right hand (n = 20) were immersed in the following solutions - octenidine dihydrochloride, polyhexanide, tea tree oil, and saline solution. The authors used the Oxygen to See (LEA Medizintechnik GmbH, Giessen, Germany) diagnostic device for noninvasive determination of oxygen supply in microcirculation of blood perfused tissues, which combines a laser light to determine blood flow, as well as white light to determine hemoglobin oxygenation and the relative amount of hemoglobin.
  
  
  RESULTS
  Tea tree oil (&#247;19.0%) (B. Braun Melsungen AG, Melsungen, Germany) and polyhexanide (&#247;12.4%) (Lavanid, Serag Wiessner GmbH, Naila, Germany) caused a significant increase in blood flow compared to the negative control (-25.6%). Octenidine (Octenisept, Schülke & Mayr GmbH, Norderstedt, Germany) showed a nonsignificant trend towards an increase in blood flow (&#247;7.2%). There were alterations in the values of hemoglobin oxygenation and the relative amount of hemoglobin, but these were not significant.
  
  
  CONCLUSIONS
  Perfusion is an important factor for wound healing. Therefore, it might be advantageous if antiseptic agents would increase blood flow. Tea tree oil and polyhexanide have a positive effect on skin blood flow and can therefore be used especially in critically perfused wounds, provided the adverse reactions and the antimicrobial efficacy are comparable.
authors: Department of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University, Tübingen, Germany; and Department of Plastic, Reconstructive and Hand Surgery, University Hospital, University of Bern, Inselspital, Switzerland.
authors: Jens
authors: J
authors: Rothenberger
authors: Department of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University, Tübingen, Germany.
authors: Sabrina
authors: S
authors: Krauss
authors: Department of Plastic, Reconstructive and Hand Surgery, University Hospital, University of Bern, Inselspital, Switzerland.
authors: Christian
authors: C
authors: Tschumi
authors: Department of Plastic, Hand, Reconstructive and Aesthetic Surgery, Helios Klinikum Wuppertal, University Witten/ Herdecke, Witten, Germany.
authors: Afshin
authors: A
authors: Rahmanian-Schwarz
authors: Department of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University, Tübingen, Germany.
authors: Hans-Eberhard
authors: HE
authors: Schaller
authors: Department of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University, Tübingen, Germany.
authors: Manuel
authors: M
authors: Held
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000494:pharmacology*; D001645:Biguanides / Q000008:administration & dosage / Q000494:pharmacology*; D001783:Blood Flow Velocity / Q000187:drug effects; D005069:Evaluation Studies as Topic; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D007097:Imines; D008297:Male; D008833:Microcirculation / Q000187:drug effects*; D008856:Microscopy, Fluorescence; D011725:Pyridines / Q000008:administration & dosage / Q000494:pharmacology*; D012867:Skin / Q000098:blood supply* / Q000187:drug effects*; D020947:Tea Tree Oil / Q000008:administration & dosage / Q000494:pharmacology*; D014945:Wound Healing; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D001645:Biguanides; D007097:Imines; D011725:Pyridines; C031233:polihexanide; D020947:Tea Tree Oil; C034213:octenidine