Zusammenfassung
Hintergrund
Antiseptika zur Behandlung chronischer und infizierter Wunden gehören zur Standardtherapie. Erkenntnisse über toxische Eigenschaften gegenüber dem Wund- und Hautgewebe sind jedoch kaum vorhanden. Diese Studie untersucht den Einfluss von Wundantiseptika auf die Vitalität und Proliferation humaner kutaner Zellen.
Material und Methoden
Die Antiseptika Lavasept (PHMB), Octenisept (Octenidin) und Betaisodona (PVP-Jod) wurden mittels MTT-Assay und BrDU-ELISA auf zytotoxische Effekte gegenüber der HaCaT-Zelllinie, primären humanen Keratinozyten und Fibroblasten untersucht.
Ergebnisse
Lavasept besaß nur geringen Einfluss auf Vitalität und Zellproliferation. Betaisodona und Octenisept induzierten eine signifikante Reduktion der Zellvitalität (p<0,05) bis zu 0% überlebender Fibroblasten bei 7,5% (Betaisodona) bzw. 10% (Octenisept) sowie der Zellproliferation auf 0% bei Keratinozyten durch Konzentrationen von 7,5% (Betaisodona und Octenisept).
Schlussfolgerung
Die Studie zeigt, dass herkömmlich verwendete Wundantiseptika deutlich toxische Effekte besitzen. Sowohl antimikrobielle Potenz als auch toxische Eigenschaften der einzelnen Antiseptika müssen bei der Wundbehandlung berücksichtigt werden. Insgesamt zeigte die PHMB-Lösung (Lavasept) die geringste toxische Wirkung.
Abstract
Purpose
Local skin antiseptics are the standard of care for chronic and non-healing wounds. However, little is known about their potential toxic properties. This study investigates the impact of three commercially available and widely used antiseptics on vitality and proliferation of human cutaneous cells.
Material and Methods
Three antiseptics, Lavasept (PHMB), Octenisept (octenidine) and Betaisodona (PVP-iodine) were tested for their cytotoxic effects towards HaCaT cells, primary human keratinocytes and fibroblasts using MTT assay and BrDU ELISA.
Results
Lavasept showed only slight to moderate toxic effects on cellular vitality and proliferation. Ocentisept and Betaisodona induced severe reduction of cell vitality (p<0.05) to 0% surviving fibroblasts at 7.5% (Betaisodona) and 12.5% Octenisept, respectively. Furthermore, poliferative activity was reduced to 0% in keratinocytes at 7.5% concentration of Betaisodona and Ocentisept.
Conclusion
This study shows that frequently used wound- and skin antiseptics show severe cytotoxic effects towards cutaneous cells. Furthermore, antimicrobial efficacy and toxic properties must be included in the clinical decision process for optimal therapy of chronic wounds. The PHMB solution Lavasept showed best results regarding toxicity in this study.
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Literatur
Apelqvist J, Larsson J (2000) What is the most effective way to reduce incidence of amputation in the diabetic foot? Diabetes Metab Res Rev 16 (Suppl 1):S75–S83
Birnie AJ, Bath-Hextall FJ, Ravenscroft JC et al (2008) Interventions to reduce Staphylococcus aureus in the management of atopic eczema. Cochrane Database Syst Rev CD003871
Brook I, Frazier EH (1998) Aerobic and anaerobic microbiology of infection after trauma. Am J Emerg Med 16:585–591
Cdc Cfdc (2007) National diabetes fact sheet 2007. In: CDC (ed) http://www.cdc.gov/diabetes/puls/pdf/ndfs_2007.pdf
Clark NC, Weigel LM, Patel JB et al (2005) Comparison of Tn1546-like elements in vancomycin-resistant Staphylococcus aureus isolates from Michigan and Pennsylvania. Antimicrob Agents Chemother 49:470–472
Diekema DJ, Pfaller MA, Schmitz FJ et al (2001) Survey of infections due to Staphylococcus species: frequency of occurrence and antimicrobial susceptibility of isolates collected in the United States, Canada, Latin America, Europe, and the Western Pacific region for the SENTRY Antimicrobial Surveillance Program, 1997–1999. Clin Infect Dis 32 (Suppl 2):S114–S132
Goldstein EJ, Citron DM, Nesbit CA (1996) Diabetic foot infections. Bacteriology and activity of 10 oral antimicrobial agents against bacteria isolated from consecutive cases. Diabetes Care 19:638–641
Harker J (2001) The effect of bacteria on leg ulcer healing. Br J Community Nurs 6:126–134
Hirsch T, Spielmann M, Zuhaili B et al (2008) Enhanced susceptibility to infections in a diabetic wound healing model. BMC Surg 8:5
Kalteis T, Luring C, Schaumburger J et al (2003) Tissue toxicity of antiseptics. Z Orthop Grenzgeb 141:233–238
Langer S, Sedigh Salakdeh M, Goertz O et al (2004) The impact of topical antiseptics on skin microcirculation. Eur J Med Res 9:449–454
Muller G, Kramer A (2008) Biocompatibility index of antiseptic agents by parallel assessment of antimicrobial activity and cellular cytotoxicity. J Antimicrob Chemother 61:1281–1287
O’meara S, Al-Kurdi D, Ovington LG (2008) Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst Rev CD003557
Steinstrasser L, Hasler R, Hirsch T et al (2008) Future treatment options for chronic wounds. Chirurg 79:555–559
Steinstrasser L, Hasler R, Hirsch T et al (2008) Future treatment options for chronic wounds. Chirurg 79:555–559
Steinstrasser L, Thies AH, Rabstein S et al (2007) Typical bacteria in an intensive care burn unit in severely burned patients and their importance with regard to mortality: retrospective study 1995–2004. Handchir Mikrochir Plast Chir 39:338–344
Webster J, Osborne S (2007) Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database Syst Rev CD004985
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Hirsch, T., Jacobsen, F., Rittig, A. et al. Vergleichende In-vitro-Studie zur Zytotoxizität klinisch eingesetzter Antiseptika. Hautarzt 60, 984–991 (2009). https://doi.org/10.1007/s00105-009-1842-x
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DOI: https://doi.org/10.1007/s00105-009-1842-x