Gerit D. Mulder, DPM, MS; Joseph P. Cavorsi, MD; Daniel K. Lee, DPM


Wounds. 2007;19(7):173-182. 

In This Article

Abstract and Introduction


Antimicrobials are routinely used in the treatment of chronic and problematic wounds. Despite the on-going increase in numbers and types of products, well-designed clinical trials that support their efficacy are limited. Antimicrobial products are applied with understanding of their mechanisms of action and role in wound repair. This manuscript reviews the major categories of products on the market, providing the clinician with information on the different types of products and their purported effect on wounds. A new product containing polyhexamethylene biguanide is described in greater detail with relevant case presentations and cost data. This new product does not appear to have any known cytotoxicity in the dressing configuration and may be applied to a wide range of wounds.


Chronic wounds are often complex, difficult to heal, and may persist for months or years due to underlying disease processes or complications within the healing process.

Treating chronic wounds requires a multifaceted approach in order to address the underlying pathophysiology while promoting healing of the wound.[1,2,3,4] Before a wound can close, the wound bed status needs to be addressed to assist in creating an environment conducive to tissue repair. This may require 1) removal of nonviable tissue, 2) maintenance of a moisture balance, 3) resolution of any bacterial imbalance, and 4) removal of impediments to healing at the epidermal margins.[4] While each of these require attention, concern with bacterial imbalance in the wound bed has lead to the development and commercialization of a variety of antimicrobial products and therapies.


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