Rothenberger Jens, Krauss Sabrina, Tschumi Christian, Rahmanian-Schwarz Afshin, Schaller Hans-Eberhard, Held Manuel
Department of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University, Tübingen, Germany; and Department of Plastic, Reconstructive and Hand Surgery, University Hospital, University of Bern, Inselspital, Switzerland.
Department of Plastic, Reconstructive, Hand and Burn Surgery, BG-Trauma Center, Eberhard Karls University, Tübingen, Germany.
Wounds. 2016 Oct;28(10):341-346.
Antiseptics are indispensable for wound management and should focus not only on the efficacy in reducing the bacterial burden but also on how much they interfere in wound healing. In this study, the authors analyzed the direct effect of topical antiseptic agents on the microcirculation of intact human skin.
The perfusion dynamics were assessed before, and 10 minutes after, the volunteers' fingers of the right hand (n = 20) were immersed in the following solutions - octenidine dihydrochloride, polyhexanide, tea tree oil, and saline solution. The authors used the Oxygen to See (LEA Medizintechnik GmbH, Giessen, Germany) diagnostic device for noninvasive determination of oxygen supply in microcirculation of blood perfused tissues, which combines a laser light to determine blood flow, as well as white light to determine hemoglobin oxygenation and the relative amount of hemoglobin.
Tea tree oil (÷19.0%) (B. Braun Melsungen AG, Melsungen, Germany) and polyhexanide (÷12.4%) (Lavanid, Serag Wiessner GmbH, Naila, Germany) caused a significant increase in blood flow compared to the negative control (-25.6%). Octenidine (Octenisept, Schülke & Mayr GmbH, Norderstedt, Germany) showed a nonsignificant trend towards an increase in blood flow (÷7.2%). There were alterations in the values of hemoglobin oxygenation and the relative amount of hemoglobin, but these were not significant.
Perfusion is an important factor for wound healing. Therefore, it might be advantageous if antiseptic agents would increase blood flow. Tea tree oil and polyhexanide have a positive effect on skin blood flow and can therefore be used especially in critically perfused wounds, provided the adverse reactions and the antimicrobial efficacy are comparable.
防腐剂对于伤口处理至关重要，不仅应关注其降低细菌负荷的功效，还应关注其对伤口愈合的干扰程度。在本研究中，作者分析了局部抗菌剂对完整人体皮肤微循环的直接影响。
将20名志愿者右手手指浸入以下溶液——二盐酸奥替尼啶、聚己双胍、茶树油和盐溶液中，在浸入前及浸入10分钟后评估灌注动力学。作者使用“氧可视”（德国吉森市LEA Medizintechnik GmbH公司）诊断设备对血液灌注组织的微循环中的氧气供应进行无创测定，该设备结合激光光来测定血流，以及白光来测定血红蛋白氧合和血红蛋白的相对量。
与阴性对照（-25.6%）相比，茶树油（德国梅尔松根市贝朗医疗集团，降幅19.0%）和聚己双胍（德国奈拉市Serag Wiessner GmbH公司的Lavanid，降幅12.4%）导致血流显著增加。奥替尼啶（德国诺德施泰特市舒尔克&迈尔有限公司的Octenisept，增幅7.2%）显示出血流增加的趋势但不显著。血红蛋白氧合值和血红蛋白相对量有变化，但不显著。
灌注是伤口愈合的一个重要因素。因此，如果抗菌剂能增加血流可能会有好处。茶树油和聚己双胍对皮肤血流有积极作用，因此，只要不良反应和抗菌功效相当，尤其可用于灌注严重的伤口。
