Randomized Comparison of Hypochlorous Acid With 5% Sulfamylon Solution as Topical Therapy Following Skin Grafting

Kevin N. Foster, MD, MBA, FACS; K. J. Richey, BSN, RN; J. S. Champagne, MA, RN; M. R. Matthews, MD, FACS


ePlasty. 2019;19(e16) 

In This Article


This study demonstrated that HOCl used as a topical antimicrobial solution over excised and autografted burn wounds was safe and effective compared with 5% Sulfamylon solution. Specifically, there was no difference in healing at day 14 postgrafting or in adverse events or serious adverse events.

An interesting finding was the significantly increased LOS in the HOCl group compared with the control group. The burns in the HOCl group were larger than those in the control group. No other obvious differences were noted. Also, since graft take and reepithelialization were the same in both groups, it is unlikely that the increased LOS was caused by grafting-related factors.

While the median level of pain was the same for both groups during the study, the pain at baseline was higher in the HOCl group. Thus, pain reduction in the HOCl group was better than that in the control group.

The most compelling finding in this study was the significant decrease in cost in the HOCl group compared with the control group. When size of burn and amount of solution were accounted for, the cost savings were over $406 per patient.

This was a small pilot study and was not adequately powered to provide definitive conclusions regarding safety and efficacy. A larger trial might be necessary to confirm the positive trends—equivalent efficacy and safety, better pain control, and lower costs—shown in this study.

HOCl demonstrated equivalent efficacy and safety compared with 5% Sulfamylon when used as the postoperative topical dressing for skin grafts. HOCl was more cost-effective.