Antiseptics on Wounds: An Area of Controversy

Anna Drosou, MD, Anna Falabella, MD, Robert S. Kirsner, MD

Disclosures

Wounds. 2003;15(5) 

In This Article

Chlorhexidine

Chlorhexidine has been commonly used in disinfectant and antiseptic solutions. Chlorhexidine antiseptic solutions are used mainly in urology, gynecology, dentistry, and in the treatment of wounds. It is highly bactericidal.

Several animal studies have tested the efficacy and safety of chlorhexidine on wounds ( Table 5 ). It has been found to have mild inhibitory effects on wound healing in guinea pigs.[87] Chlorhexidine diacetate was found to accelerate wound healing in full-thickness wounds in beagles.[88] Chlorhexidine was also found to be relatively safe for use as a surgical wound irrigation solution, since only the higher concentrations tested (0.05%) caused slight tissue toxicity in rats.[89] Lower concentrations (0.02%) are recommended for wound irrigation. In other studies, it was found to cause inhibition of granulation tissue in guinea pigs[57] and decreased tensile strength of wounds in rats.[90] However, Brennan, et al., found no decrease in collagen production in a rat model,[91] and Shahan, et al., also in a rat model, found decreased tensile strength 48 hours after the treatment and significantly increased strength at 96 hours, since chlorhexidine decreased the healing time.[92]

In human studies, chlorhexidine rinses were shown effective in reducing microbial complications when used perioperatively in patients that received dental implants.[93] Conversely, in another study, it was found to be ineffective to reduce wound sepsis rate and length of hospital stay in patients that had undergone appendicectomy.[94] The authors speculate that reinfection from within as an explanation for the lack of chlorhexidine efficiency.

Chlorhexidine appears to be relatively safe with little effect on the wound healing process, and its use may favor healing of open wounds in risk for infection. However, the results from studies to date are insufficient to draw conclusions about the use of chlorhexidine on open wounds. More human trials need be performed to assess its efficacy and safety.

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