Kramer A, Roth B, Müller G, Rudolph P, Klöcker N
Institute of Hygiene and Environmental Medicine, Ernst Moritz Arndt University, W.-Rathenau-Strasse 49a, DE-17489 Greifswald, Germany.
Skin Pharmacol Physiol. 2004 May-Jun;17(3):141-6. doi: 10.1159/000077241.
The main target of the combination of octenidine with phenoxyethanol (Octenisept) is the antisepsis of acute wounds, whereas polyhexanide combined with polyethylene glycol in Ringer solution (Lavasept) is the agent of choice for antisepsis of chronic wounds and burns. Because comparative data for both agents on the effects on wound healing are lacking, we investigated the influence of preparations based on polyhexanide and octenidine versus placebo (Ringer solution) in experimental superficial aseptic skin wounds (n = 108) of 20 mm diameter, using a double-blind, randomised, stratified, controlled, parallel-group design in piglets. Computerised planimetry and histopathological methods were used for the assessment of wound healing. Histologically, no significant differences could be verified at any time between the 3 groups. However, in the early phase (day 9 after wounding), the octenidine-based product retarded wound contraction to a significantly greater extent than placebo and polyhexanide, whereas in the later phase (days 18 and 28), polyhexanide promoted contraction significantly more than did placebo and octenidine. The consequence is complete wound closure after 22.9 days using polyhexanide, in comparison to the placebo after 24.1 days (p < 0.05) and octenidine after 28.3 days (no statistical difference to placebo). This may be explained by the better tolerance of polyhexanide in vitro, which was demonstrated with dose and time dependence in cytotoxicity tests on human amnion cells.
奥替尼啶与苯氧乙醇组合制剂（Octenisept）的主要目标是急性伤口的抗菌，而聚己缩胍与林格氏液中的聚乙二醇组合制剂（Lavasept）是慢性伤口和烧伤抗菌的首选药物。由于缺乏这两种制剂对伤口愈合影响的比较数据，我们采用双盲、随机、分层、对照、平行组设计，在直径20mm的实验性浅表无菌皮肤伤口（n = 108）的仔猪中，研究了基于聚己缩胍和奥替尼啶的制剂与安慰剂（林格氏液）的影响。采用计算机图像分析和组织病理学方法评估伤口愈合情况。组织学上，三组在任何时间均未发现显著差异。然而，在早期阶段（受伤后第9天），基于奥替尼啶的产品比安慰剂和聚己缩胍更显著地延缓伤口收缩，而在后期阶段（第18天和第28天），聚己缩胍比安慰剂和奥替尼啶更显著地促进收缩。结果是，使用聚己缩胍22.9天后伤口完全闭合，相比之下，安慰剂组为24.1天（p < 0.05），奥替尼啶组为28.3天（与安慰剂无统计学差异）。这可能是由于聚己缩胍在体外具有更好的耐受性，这在对人羊膜细胞的细胞毒性试验中得到剂量和时间依赖性的证明。
