Antiseptics in surgery

Abstract

Background: Wound healing is a complex process, with many potential factors that can delay or complicate healing. Bacterial infection is one of the most dangerous complications once the skin barrier is destroyed. The search for optimal treatment of chronic and infected wounds is an ongoing challenge for healthcare professionals.

Methods: This article discusses recent findings in the field of wound antiseptics, its antibacterial efficacy, cell toxicity, and compatibility with wound dressings.

Results: Skin antiseptics are daily used for wound cleansing to reduce the bacterial burden. However, there is little evidence concerning the antimicrobial efficacy, cytotoxicity of host cells, and compatibility with commonly used wound dressings. Recent findings show high toxicity and significant incompatibilities with wound dressings for some antiseptics.

Conclusion: Antiseptics are widely used in hospitals worldwide to reduce, inactivate, or eliminate potentially pathogenic microorganisms. Current studies show that widely used wound antiseptics show relevant cytotoxicity and cross-reactivity with certain wound dressings. Future research should particularly focus on cytotoxicity, mechanisms of bacterial resistance toward skin antiseptics and wound irrigants, as well as compatibility and cross-reactivity with wound dressings.

Figure 1

Cytotoxicity of antiseptics in skin cells. (a) In HaCaT cells, Lavasept and Prontosan show little toxicity. Betaisodona-treated cells show no vitality at a concentration of 12.5%, followed by Octenisept at 15% and Braunol at 20%. (b) Human keratinocytes are barely affected by Lavasept and Prontosan. Braunol and Octenisept show low cytotoxicity up to concentrations of 12.5%, followed by a marked decrease in cytotoxicity. Betaisodona is the most toxic agent. (c) In fibroblast, Lavasept showed the best result. Prontosan showed low toxicity. Braunol has low toxicity within low concentrations, followed by a linear decrease of 0% in cell viability. At 10%, Octenisept shows a decrease of 0%, followed by Betaisodona (0% cell viability at 7.5%).