Yong Enming, Zhu Xiaoli, Weng Jiayi, Ng Marcus Jia Ming, Khoo Yuqing Michal, Lo Zhiwen Joseph
Consultant, Vascular Surgery Service, Department of General Surgery, Tan Tock Seng Hospital, Singapore.
Senior Nurse Clinician, Nursing Services, National Healthcare Group Polyclinics, Singapore.
J Wound Care. 2025 Apr 1;34(Sup4c):S4-S13. doi: 10.12968/jowc.2025.34.Sup4c.S4.
Diabetic foot ulcers (DFUs) are a prevalent and severe complication of diabetes, leading to significant morbidity, impaired health-related quality of life (HRQoL) and economic burden on healthcare systems. The complexity of DFUs often results in prolonged healing and high recurrence rates. Effective management strategies are crucial for improving outcomes and reducing complications.
This study aimed to review the efficacy of antiseptic solutions in the treatment and care of DFUs.
A literature analysis was conducted to review clinical studies and guidelines on the use and efficacy of antiseptic solutions, particularly Octenisept (0.1% octenidine dihydrochloride and 2% 2-phenoxyethanol). The review focused on the antimicrobial properties, biofilm-disruption capabilities and wound healing outcomes associated with the use of antiseptic solutions in DFU management.
Antiseptic solutions have potential to reduce bioburden, disrupt biofilm and modulate healing. There is a need to balance antimicrobial clinical efficacy with tolerability and cytotoxicity. The use and choice of adjunctive antiseptic solutions must be tailored to the patient, as antimicrobial efficacy can vary for antiseptic solutions, particularly for hypochlorous solutions. It is important to use products according to their instructions, with consideration of minimum contact time to maximise clinical efficacy. Low-pressure irrigation is adjunctive, and concurrent wound-bed preparation, including debridement, frequent inspection, infection and moisture control, remain important.
The therapeutic application of antiseptic solutions in DFU care presents a promising approach to enhancing wound healing and reducing infection risks. Integrating these solutions into standard wound care protocols could lower the incidence of complications, improve HRQoL and decrease the economic burden associated with diabetic foot disease. Further large-scale studies are recommended to validate these findings and refine guidelines for antiseptic use in DFU management.
糖尿病足溃疡（DFU）是糖尿病常见且严重的并发症，会导致严重发病、健康相关生活质量（HRQoL）受损以及给医疗系统带来经济负担。DFU的复杂性常常导致愈合时间延长和复发率高。有效的管理策略对于改善治疗效果和减少并发症至关重要。
本研究旨在综述抗菌溶液在DFU治疗和护理中的疗效。
进行文献分析以综述关于抗菌溶液（特别是奥替尼啶（0.1%二盐酸奥替尼啶和2%苯氧乙醇））使用和疗效的临床研究及指南。该综述聚焦于与抗菌溶液在DFU管理中的使用相关的抗菌特性、生物膜破坏能力和伤口愈合结果。
抗菌溶液有潜力减少生物负荷、破坏生物膜并调节愈合。需要在抗菌临床疗效与耐受性和细胞毒性之间取得平衡。辅助抗菌溶液的使用和选择必须根据患者情况量身定制，因为不同抗菌溶液的抗菌效果可能不同，尤其是次氯酸溶液。按照产品说明使用产品很重要，要考虑最短接触时间以最大化临床疗效。低压冲洗是辅助手段，同时进行伤口床准备，包括清创、频繁检查、感染和湿度控制仍然很重要。
抗菌溶液在DFU护理中的治疗应用是一种有前景的方法，可促进伤口愈合并降低感染风险。将这些溶液纳入标准伤口护理方案可降低并发症发生率、改善HRQoL并减轻与糖尿病足疾病相关的经济负担。建议进一步开展大规模研究以验证这些发现并完善DFU管理中抗菌剂使用的指南。
