Comparison of Skin Antiseptic Agents and the Role of 0.01% Hypochlorous Acid

Ann Q. Tran, MD ; Nicole Topilow, MD; Andrew Rong, MD; Patrice J. Persad, PhD; Michael C. Lee; James H. Lee; Apostolos G. Anagnostopoulos, MD; and Wendy W. Lee, MD, MS

Abstract

Background: Hypochlorous acid (HA) has both anti-microbial and wound-healing properties with a growing role for utilization in pre-procedural care on the face. 

Objectives: The authors sought to compare the antiseptic property of 0.01% HA solution, 5% povidone iodine (PI), 4% chlorhexidine gluconate (CHG), and 70% isopropyl alcohol (IPA) antiseptic on facial skin. 

Methods: This was a prospective single-center clinical trial.

Results: A total of 21 participants were recruited. Bacterial growth was seen in CHG (10%), IPA (71%), PI (81%), and HA (95%) of specimens (P < 0.001). CHG had less growth compared with HA (P = <0.001), IPA (P = <0.001), and PI (P = <0.001). No difference in bacterial growth was noted between HA and IPA (P = 0.063) or HA and PI (P = 0.25). Significant differences in mono-microbial and poly-microbial growth were seen between HA and IPA (P = 0.046) and HA and CHG (P = <0.001). Staphylococcus epidermidis grew less frequently in CHG (10%), followed by IPA (29%), PI (71%), and HA (71%). Staphylococcus capitis grew less frequently in CHG (0%), followed by PI (14%), HA (24%), and IPA (29%). 

Conclusions: CHG reduced the bacterial growth compared with HA, PI, and IPA. However, HA, PI, and IPA had insignificant differences in bactericidal effects. Our study provides a supporting role of HA to be considered as an antiseptic.

The Potential Use of Hypochlorous Acid and a Smart Prefabricated Sanitising Chamber to Reduce Occupation-Related COVID-19 Exposure

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Hypochlorous Acid as a Potential Wound Care Agent Part I. Stabilized Hypochlorous Acid: A Component of the Inorganic Armamentarium of Innate Immunity

Wang L, PhD, ^a Bassiri M, PhD, ^a Najafi R, PhD, ^a Najafi K, MD, ^b Yang J, BS, ^a Khosrovi B, PhD, ^a Hwong W, BS, ^a Barati E, BS, ^a Belisle B, PhD, ^a Celeri C, MS^a , and Robson MC, MD ^c

^aNovaBay Pharmaceuticals, Inc, Emeryville, CA; ^bEye Institute San Rafael, CA; and ^c Institute for  Tissue Regeneration, Repair and Rehabilitation, Bay Pines, FL.

Objective: Hypochlorous acid (HOCl), a major inorganic bactericidal compound of innate immunity, is effective against a broad range of microorganisms. Owing to its chemical nature, HOCl has never been used as a pharmaceutical drug for treating infection. In this article, we describe the chemical production, stabilization, and biological activity of a pharmaceutically useful formulation of HOCl. Methods: Stabilized HOCl is in the form of a physiologically balanced solution in 0.9% saline at a pH range of 3.5 to 4.0. Chlorine species distribution in solution is a function of pH. In aqueous solution, HOCl is the predominant species at the pH range of 3 to 6. At pH values less than 3.5, the solution exists as a mixture of chlorine in aqueous phase, chlorine gas, trichloride (Cl− 3 ), and HOCl. At pH greater than 5.5, sodium hypochlorite (NaOCl) starts to form and becomes the predominant species in the alkaline pH. To maintain HOCl solution in a stable form, maximize its antimicrobial activities, and minimize undesirable side products, the pH must be maintained at 3.5 to 5. Results: Using this stabilized form of HOCl, the potent antimicrobial activities of HOCl are demonstrated against a wide range of microorganisms. The in vitro cytotoxicity profile in L929 cells and the in vivo safety profile of HOCl in various animal models are described. Conclusion: On the basis of the antimicrobial activity and the lack of animal toxicity, it is predicted that stabilized HOCl has potential pharmaceutical applications in the control of soft tissue infection.

Irrigation Solutions in Wound Care and Breast Surgery: Evidence-Based Applications, Regulatory Considerations, and Future Directions

Stephanie M. Mueller ^1,2 , LaYow C. Yu ² , Michael Drake Pike ² , Hannah D. Shi ² and Dennis P. Orgill ^1,2,*

1 Division of Plastic and Reconstructive Surgery, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115, USA; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

2 Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (L.C.Y.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (M.D.P.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (H.D.S.)

* Correspondence: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Abstract

Background: Irrigation is a key strategy in reducing bioburden, disrupting biofilms, and supporting wound healing. While saline is the standard for its safety and availability, antiseptic and antibiotic solutions are often used in clinical scenarios that require infection control. However, the rise in antibiotic stewardship and concerns regarding cytotoxicity are reshaping current practices. This review identifies recent trends, current controversies, and persistent gaps in knowledge that warrant further investigation and regulatory attention. Methods: A literature review identified irrigation solutions commonly used in plastic surgery; labeling and concentrations were obtained from Devices@FDA, Drugs@FDA, and DailyMed, and PubMed, Cochrane Central, and Embase were searched (January 2022–July 2025) for human studies on acute wounds, chronic wounds, and implant-based breast surgery. Results: In acute wounds, saline and potable tap water effectively prevent infection. In chronic wounds, such as diabetic foot ulcers and pressure injuries, antiseptic agents, including hypochlorous acid, sodium hypochlorite, polyhexanide, and citrate-based solutions, have shown promise in improving healing and reducing infection. In implant-based breast reconstruction and augmentation, data on antiseptics, such as chlorhexidine, and changes in FDA guidance for povidone–iodine and bacitracin have prompted a reevaluation of intraoperative irrigation practices. Conclusion: Despite widespread use, many antiseptics remain off-label, and high-quality clinical studies comparing efficacy and safety are lacking.

Keywords: wound irrigation; saline irrigation; antiseptic irrigation; surgical site infection/prevention and control; breast pocket irrigation; Povidone–Iodine (PVI); Polyhexamethylene Biguanide/polyhexanide (PHMB); Hypochlorous Acid (HOCl); Sodium Hypochlorite (NaOCl); Triple antibiotic solution (TAS)

Phenotypic Switching Resulting From Developmental Plasticity: Fixed or Reversible?

Warren W. Burggren*

Developmental Integrative Biology, Department of Biological Sciences, University of North Texas, Denton, TX, United States

Fusobacterium nucleatum: More Than Just an Oral Anaerobe

Akash Patel , Monica Patel , Joseph Glowacki

1.Internal Medicine, St. Mary Medical Center, Langhorne , USA 2. Internal Medicine, Temple University Hospital, Philadelphia, USA 3. Internal Medicine, Rowan University School of Medicine, Stratford, USA

Corresponding author: Akash Patel, 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Abstract

Fusobacterium nucleatum is a strict anaerobe that is indigenous to the human oral cavity, where it coexists with more than 500 other species. It is associated with paranasal sinus, odontogenic, and pulmonary infections. In literature, cases of Fusobacterium nucleatum are rare. Here we report a case of a patient with multiple brain abscesses caused by Fusobacterium nucleatum. This case report looks to assist clinicians in determining the true etiology of this organism, which can change patient management based on the current literature review and similar case studies.

Categories: Internal Medicine, Infectious Disease, Neurosurgery

Keywords: anaerobes of clinical importance, colon cancer surveillance, periodontal disease, brain abscess, fusobacterium nucelatum