ArticleThe Journal of antimicrobial chemotherapy2018
Evaluation of short exposure times of antimicrobial wound solutions against microbial biofilms: from in vitro to in vivo.
Article in The Journal of antimicrobial chemotherapy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 74 citations in OpenAlex.
- Effect on total microbial load and community composition with two vs six-week topical Cadexomer Iodine for treating chronic biofilm infections in diabetic foot ulcers.International wound journal · 2019Trial
- From Natural Product to Topical Antimicrobial Candidate: EvaluatingPharmaceuticals (Basel, Switzerland) · 2026Article
- Intraoperative Wound Irrigation in Orthopaedic Surgery: A Survey of Current Understanding and Practice Across the United States.Arthroplasty today · 2026Article
- Beyond susceptibility testing: traditional Chinese medicine-associated compounds as candidate antibiotic adjuncts in chronic-wound biofilms.Frontiers in cellular and infection microbiology · 2026Review
- Efficacy of 0.2% povidone-iodine and 0.1% polyhexamethylene biguanide as preoperative antiseptics in equine ophthalmic procedures.Veterinary ophthalmology · 2025Article
- Unravelling the Microbiome's Role in Healing Diabetic Wounds.Current pharmaceutical biotechnology · 2025Review
- Synthesis, physicochemical properties and antimicrobial activity of a di-aminopropionic acid hydrogen tri-iodide coordination compound.BMC research notes · 2024Article
- Impact of Interfering Substances on the Bactericidal Efficacy of Different Commercially Available Hypochlorous Acid-Based Wound Irrigation Solutions Commonly Found in South-East Asia.Antibiotics (Basel, Switzerland) · 2024Article
- Insights into the mechanisms of diabetic wounds: pathophysiology, molecular targets, and treatment strategies through conventional and alternative therapies.Inflammopharmacology · 2024Review
- Host-microbe interactions in chronic rhinosinusitis biofilms and models for investigation.Biofilm · 2023Review
- The effect and mechanism of iodophors on the adhesion and virulence of Staphylococcus aureus biofilms attached to artificial joint materials.Journal of orthopaedic surgery and research · 2023Article
- What's old is new again: Insights into diabetic foot microbiome.World journal of diabetes · 2023Review
- Evaluation of the role of povidone‑iodine in the prevention of surgical site infections.Surgery open science · 2023Review
- Anti-biofilm Activity of Povidone-Iodine and Polyhexamethylene Biguanide: Evidence from In Vitro Tests.Current microbiology · 2023Article
- Biofilm-Associated Infections in Chronic Wounds and Their Management.Advances in experimental medicine and biology · 2023Article
- Robbing Peter to Pay Paul: Chlorhexidine gluconate demonstrates short-term efficacy and long-term cytotoxicity.Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society · 2022Article
- Efficacy of Surgical/Wound Washes against Bacteria: Effect of Different In Vitro Models.Materials (Basel, Switzerland) · 2022Article
- Topical Antibiofilm Agents With Potential Utility in the Treatment of Chronic Rhinosinusitis: A Narrative Review.Frontiers in pharmacology · 2022Review
- Article
- Wound Antiseptics and European Guidelines for Antiseptic Application in Wound Treatment.Pharmaceuticals (Basel, Switzerland) · 2021Review
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objectives: Test the performance of topical antimicrobial wound solutions against microbial biofilms using in vitro, ex vivo and in vivo model systems at clinically relevant exposure times. Methods: Topical antimicrobial wound solutions were tested under three different conditions: (in vitro) 4% w/v Melaleuca oil, polyhexamethylene biguanide, chlorhexidine, povidone iodine and hypochlorous acid were tested at short duration exposure times for 15 min against 3 day mature biofilms of Staphylococcus aureus and Pseudomonas aeruginosa; (ex vivo) hypochlorous acid was tested in a porcine skin explant model with 12 cycles of 10 min exposure, over 24 h, against 3 day mature P. aeruginosa biofilms; and (in vivo) 4% w/v Melaleuca oil was applied for 15 min exposure, daily, for 7 days, in 10 patients with chronic non-healing diabetic foot ulcers complicated by biofilm. Results: In vitro assessment demonstrated variable efficacy in reducing biofilms ranging from 0.5 log10 reductions to full eradication. Repeated instillation of hypochlorous acid in a porcine model achieved <1 log10 reduction (0.77 log10, P = 0.1). Application of 4% w/v Melaleuca oil in vivo resulted in no change to the total microbial load of diabetic foot ulcers complicated by biofilm (median log10 microbial load pre-treatment = 4.9 log10 versus 4.8 log10, P = 0.43). Conclusions: Short durations of exposure to topical antimicrobial wound solutions commonly utilized by clinicians are ineffective against microbial biofilms, particularly when used in vivo. Wound solutions should not be used as a sole therapy and clinicians should consider multifaceted strategies that include sharp debridement as the gold standard.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.