The Use of Hypochlorous Acid in the Healing of a Diabetic Foot Ulcer
In these case study presentations, HOCl appears to be effective as a potent DFU antiseptic agent with anti-inflammatory and debridement properties. It is inexpensive, easy to use, safe, reduces odour and pain, as well as exudate. It is also not painful to apply, assisting in an elevated level of patient compliance.
Roos, H. (2022). The Use of Hypochlorous Acid in the Healing of a Diabetic Foot Ulcer. *Clinical Science*, *8*(4), 53-56.
The Use of Hypochlorous Acid in An Infected Burn Wound – A Case Study
Care of patients with burns is complex, could be lengthy and could be complicated by infection, especially if the prevailing bacteria are present as biofilms. This complication can be anticipated and treated with the use of HOCl, an effective agent against planktonic and biofilm bacteria. Furthermore, its effect on the modulation of inflammation ultimately yields improved outcomes. The patient in this case study, despite the formation of biofilm and inflammation, responded well to the local application of and daily dressing with HOCl and gauze. The results suggest that treatment of wounds with HOCl should be investigated for all burn cases where the wounds are not following the normal wound healing trajectory according to the wound healing phases.
Roos, H., Kana, B., & Naude, L. (2021). The use of hypochlorous acid in an infected burn wound–a case study. Wound Healing Southern Africa, 14(1), 21-24.
The Immediate and Delayed Post-Debridement Effects on Tissue Bacterial Wound Counts of Hypochlorous Acid Versus Saline Irrigation in Chronic Wounds
Hypochlorous acid irrigation with ultrasound debridement reduced bacterial growth in chronic open wounds more efficiently than saline alone. Postoperative wound closure outcomes suggest a remarkable reduction in wound complications after wound debridement using hypochlorous acid irrigation with ultrasound versus saline alone.
Hiebert, J. M., & Robson, M. C. (2016). The immediate and delayed post-debridement effects on tissue bacterial wound counts of hypochlorous acid versus saline irrigation in chronic wounds. Eplasty, 16.
Effect of Stabilized Hypochlorous Acid on Re-epithelialization and Bacterial Bioburden in Acute Wounds: A Randomized Controlled Trial in Healthy Volunteers
This study demonstrates immediate and durable antimicrobial action and beneficial effect on acute wound healing after irrigation and treatment with a stabilized hypochlorous acid formulation.
Burian, E. A., Sabah, L., Kirketerp-Møller, K., Gundersen, G., & Ågren, M. S. (2022). Effect of stabilized hypochlorous acid on re-epithelialization and bacterial bioburden in acute wounds: a randomized controlled trial in healthy volunteers. *Acta Dermato-Venereologica*, *102*, adv00727-adv00727.
Hypochlorous acid as a potential wound care agent: part II. Stabilized hypochlorous acid: its role in decreasing tissue bacterial bioburden and overcoming the inhibition of infection on wound healing.
This stabilized form of hypochlorous acid (NVC-101) could have potential application as an antimicrobial wound irrigation and treatment solution if its effective pH range can be maintained in the clinical situation. NVC-101 solution was equally effective at pH 3.5 or 4.0 and more efficient soon after its application. As opposed to other antimicrobials investigated in this animal model, NVC-101 controls the tissue bacterial bioburden without inhibiting the wound healing process.
Robson, M. C., Payne, W. G., Ko, F., Mentis, M., Donati, G., Shafii, S. M., ... & Bassiri, M. (2007). Hypochlorous acid as a potential wound care agent: part II. Stabilized hypochlorous acid: its role in decreasing tissue bacterial bioburden and overcoming the inhibition of infection on wound healing. Journal of burns and wounds, 6.
Hypochlorous acid: An ideal wound care agent with powerful microbicidal, antibiofilm, and wound healing potency
The stabilized HOCl solution had dose-dependent favorable effects on fibroblast and keratinocyte migration compared to povidone iodine and media alone. These features lead to a stabilized HOCl solution as an ideal wound care agent.
Sakarya, S., Gunay, N., Karakulak, M., Ozturk, B., & Ertugrul, B. (2014). Hypochlorous acid: an ideal wound care agent with powerful microbicidal, antibiofilm, and wound healing potency. Wounds, 26(12), 342-350.
Status report on topical hypochlorous acid: Clinical relevance of specific formulations, potential modes of action, and study outcomes
Topical formulations of stabilized, pH-neutral HOCl (e.g., solution, gel, spray) have been evaluated in several studies demonstrating both antimicrobial effects and therapeutic benefit in many cutaneous disorders, including seborrheic dermatitis, atopic dermatitis-associated pruritus, acne vulgaris, diabetic foot ulcers, and hypertrophic scars/keloids. Topical HOCl appears to be well tolerated and safe, without any major adverse events reported.
Del Rosso, J. Q., & Bhatia, N. (2018). Status report on topical hypochlorous acid: clinical relevance of specific formulations, potential modes of action, and study outcomes. The Journal of Clinical and Aesthetic Dermatology, 11(11), 36.
Testing the efficacy of topical antimicrobial treatments using a two and five species chronic wound biofilm model
HOCl gel shows promise as a new topical antimicrobial for wounds, especially due to its ability to inhibit P. aeruginosa.
Nedelea, A. G., Plant, R. L., Robins, L. I., & Maddocks, S. E. (2022). Testing the efficacy of topical antimicrobial treatments using a two and five species chronic wound biofilm model. Journal of Applied Microbiology, 132(1), 715-724.
Hypochlorous acid antiseptic washout improves patient comfort after intravitreal injection: A patient reported outcomes study
This study suggests that the use of HOCL 0.01% spray after Betadine® 5% for IVI prophylaxis will offer improved patient comfort as a rinse for Betadine®. The known spectrum of antiseptic coverage provided by HOCl 0.01% spray was equal to or better than Betadine®, and affects the majority of the pathogens commonly implicated in endophthalmitis. This research reports on the novel use of HOCL 0.01% as an ocular surface antiseptic.
Fam, A., Finger, P. T., Tomar, A. S., Garg, G., & Chin, K. J. (2020). Hypochlorous acid antiseptic washout improves patient comfort after intravitreal injection: A patient reported outcomes study. Indian Journal of Ophthalmology, 68(11), 2439.
Effect of stabilized hypochlorous acid on re-epithelialization and bacterial bioburden in acute wounds: A randomized controlled trial in healthy volunteers
Median bacterial counts were lower with stabilized hypochlorous acid compared with control and were further reduced after irrigation and treatment of both groups on day 4, but remained lower in the stabilized hypochlorous acid group compared with the control group. This study demonstrates immediate and durable antimicrobial action and a beneficial effect on acute wound healing after irrigation and treatment with a stabilized hypochlorous acid formulation.
Burian, E. A., Sabah, L., Kirketerp-Møller, K., Gundersen, G., & Ågren, M. S. (2022). Effect of stabilized hypochlorous acid on re-epithelialization and bacterial bioburden in acute wounds: A randomized controlled trial in healthy volunteers. Acta Dermato-Venereologica, 102, adv00727-adv00727.
Hypochlorous acid gel technology — Its impact on post-procedure treatment and scar prevention
There have been many studies evaluating the beneficial effects of HOCL solution on wound healing; however, there is limited data reviewing the effect of HOCL scar gel. However, the scar gel has demonstrated benefits over silicone gel treatment. In a randomized, double-blind study including 44 adults with a linear or widespread HTS or keloid scars, comparing HOCL scar gel to treatment with silicone gel, favorable results for HOCL gel were demonstrated.
Gold, M. H., Andriessen, A., Dayan, S. H., Fabi, S. G., Lorenc, Z. P., & Henderson Berg, M. H. (2017). Hypochlorous acid gel technology—Its impact on postprocedure treatment and scar prevention. Journal of cosmetic dermatology, 16(2), 162-167.