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Demystifying Myths on Prontosan®
Prontosan® has been around for many years, yet there are some misconceptions around the use of Prontosan®.
This information is meant for medical professionals only. Please confirm that you are a medical professional before accessing the information.
Confirm Yes, I am a health care professional. Cancel No, I am not a health care professional.Biofilm is the primary barrier to healing. Prontosan® Irrigation Solution and Prontosan® Wound Gel/Gel X are indicated for cleansing, rinsing, and decontaminating acute, chronic wounds, and burns that are at risk of infection by aiding the removal of bacteria and debris, and disrupting biofilm.
Over 90% of chronic wounds and over 6% of acute wounds contain biofilm1 which is a major barrier to wound healing. Biofilm development and inflammatory host response occurs within 6 hours. Chronic wounds are usually coated with slough, necrotic tissue and/or biofilm. These coatings are extremely difficult to remove and may delay normal wound healing. Therefore it is important to use a wound cleanser with superior cleansing activity like Prontosan Wound Irrigation Solution.
Proper cleansing and decontamination is also indicated in acute wounds since these are generally contaminated with foreign body, debris and micro-organisms. It is well known that such contamination can cause a delay in healing and give rise to complications like infection.
As indicated in the JWC International Consensus2: Defying hard to heal wounds using an early biofilm intervention strategy: wound hygiene, it is recommended to cleanse the wound and periwound as the first step of wound hygiene to address biofilm in all hard to heal wounds.
Compatibility tests and many years of usage have shown there is no interaction or limitations in use between Prontosan® and foam or silicone dressings, they can be perfectly combined in treatment. The combined use of Prontosan® with foam or silicone has been carefully monitored. No difference or effects on the dressings has been noticed3.
The clinical evidence demonstrates that by routinely introducing a Prontosan regime as part of your patient pathway you will achieve better results including: Improved patient outcomes, including time to heal; helps to prevent complications; and helps to reduce spend on antimicrobials and antibiotics.
In a model calculation from the UK, based on the average reduction in treatment time of patients with Venous Leg Ulcers, the cost saving from changing to the Prontosan® regime compared to saline is, on average £400 per patient4.
There is some misconception that Hydrogels have the same mode of action as Prontosan® Wound Gel/Gel X.
The purpose of a Hydrogel is to provide moisture and hydration to the wound. Where Prontosan® Gel and Prontosan® Gel X is different, it includes an antimicrobial and is indicated for cleansing, moistening and decontamination of acute, chronic and infected dermal wounds and burns. Prontosan® Wound Gel/Gel X acts as an effective barrier to reduce colonisation and to decontaminate the wound bed between dressing changes, therefore has continued action to remove and prevent reconstitution of the biofilm. However, not only does Prontosan® Wound Gel/Gel X prevent the reformation of biofilm, it maintains a moist wound healing environment conducive to natural healing.8
There is no reported antimicrobial resistance to PHMB.
Prontosan’s mode of action can be described as a non-specific electrostatic interaction with the bacterial cell wall. The attachment of polyhexanide to the bacterial cell wall results in a disorganisation of the biological structure of the bacteria. The physicochemical action on the bacterial envelope prevents or impedes the development of resistant bacterial strains. Thus, PHMB is particularly suitable and useful in the struggle against multi-drug resistant bacteria.9
In fact the opposite is true. Prontosan is especially designed for the long term treatment of hard-to-heal wounds. There is no limit for the treatment duration with Prontosan Wound Irrigation Solution.
Efficacy and cytotoxicity vary significantly between existing cleansing solutions. Generally, increasing antimicrobial activity is associated with decreasing cell viability.10
In a study on the toxic side effects of clinically used antiseptics, Prontosan has shown higher efficacy and has demonstrated less toxicity against other typically used skin antiseptics on the market.11
It is to be reminded that Cytotoxicity of different solutions shall be closely monitored and used under the control of healthcare professional to avoid any adverse events.
Breakdown of wound care costs5 | Cost drivers | How Prontosan® reduces costs |
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40% Nursing time | Length of treatment time |
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20% Dressing |
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1. Attinger, Christopher and Randy Wolcott. “Clinically Addressing Biofilm in Chronic Wounds.” Advances in Wound Care 1.3 (2012): 127-132.
2. Murphy C, Atkin L, Swanson T, Tachi M, Tan YK, Vega de Ceniga M, Weir D, Wolcott R. International consensus document. Defying hard-to-heal wounds with an early antibiofilm intervention strategy: wound hygiene. J Wound Care 2020; 29(Suppl 3b):S1–28.
3. DG Kammerlander, KP Gerhard, Use of Prontosan with modern moist wound healing dressings, 2002.
4. Collier Mark, "Evidence Of The Reduction Of Hospital Acquired Infections (HCAI'S) Followinf the Introduction Of A Standard Antimicrobial Wound Cleansing Solution To All Surgical Areas Within A Large Acute NHS Trust In The UK". Wounds UK 2014.
5. Moller A, Kaehn K, Nolte A. Experiences with the use of polyhexanide-containing wound products in the management of chronic wounds — results of a methodical and retrospective analysis of 953 patients. Wund Management, 2008; 3: 112-117.
6. Bellingeri, A. et al. “Effect Of A Wound Cleansing Solution On Wound Bed Preparation And Inflammation In Chronic Wounds: A Single-Blind RCT”. Journal of Wound Care 25.3 (2016): 160-168. Web.
7. Andriessen, AE and T Eberlein. “Assessment Of A Wound Cleansing Solution In The Treatment Of Problem Wounds”. Wounds 20.6 (2008): 171-175. Web. 23 Sept. 2016.
8. Prontosan® Wound Gel/Gel X Instruction for Use.
9. 2010-Kaehn-PHMB-A-Safe-and-Highly-Effective-Biocide.
10. Safety and efficacy profiles of different commercial sodium hypochlorite/hypochlorous acid solutions (NaCIO/HCIO): antimicrobial efficacy, cytotoxic impact and physiochemical parameters in vitro. Journal of Antimicrobial Chemotherapy, 2019.Anna-Lena Severing, Julian-Dario Rembe, Verna Koester and Ewa k. Stuermer.
11. Evaluation of toxic side effects of clinically used antiseptics in vitro. Hirsch T, Koerber A, Jacobsen F et al. J Surg Res 2010; 164(2); 344-350.
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