Giorgia Fabrizio1 , Francesca Sivori2 , Ilaria Cavallo2 ,
Mauro Truglio2 , Luigi Toma3 , Francesca Sperati4 ,
Massimo Francalancia2 , Francisco Obregon2 , Luisa Pamparau2 ,
Daniela Kovacs5 , Fulvia Pimpinelli2 * and Enea Gino Di Domenico1 *
1Department of Biology and Biotechnology "C. Darwin", Sapienza University of Rome, Rome, Italy,
2Microbiology and Virology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy, 3Medical
Directorate, IRCCS Regina Elena National Cancer Institute, Rome, Italy, 4UOSD Clinical Trial Center,
Biostatistics and Bioinformatics, IRCCS San Gallicano Dermatological Institute, Rome, Italy,
5Cutaneous Physiopathology, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
Sodium hypochlorite (NaOCl) is widely recognized for its broad-spectrum antimicrobial efficacy in skin wound care. This study investigates the effectiveness of NaOCl against a range of bacterial and fungal isolates from pressure ulcer (PU) patients. We analyzed 20 bacterial isolates from PU patients, comprising carbapenem resistant Klebsiella pneumoniae (CRKP), multidrug-resistant Acinetobacter baumannii (MDRAB), methicillin-resistant Staphylococcus aureus (MRSA), methicillin-susceptible Staphylococcus aureus (MSSA), along with 5 Candida albicans isolates. Antibiotic resistance profiles were determined using standard susceptibility testing. Whole-genome sequencing (WGS) was employed to identify antimicrobial resistance genes (ARGs) and disinfectant resistance genes (DRGs). Genetic determinants of biofilm formation were also assessed. The antimicrobial activity of NaOCl was evaluated by determining the minimum inhibitory concentration (MIC) and the minimal biofilm eradication concentration (MBEC) for both planktonic and biofilm-associated cells. CRKP and MDRAB showed resistance to fluoroquinolones and carbapenems, while MRSA exhibited resistance to β-lactams and levofloxacin. MSSA displayed a comparatively lower resistance profile. WGS identified significant numbers of ARGs in CRKP and MDRAB, with fewer DRGs compared to MRSA and MSSA. All isolates possessed genes associated with fimbriae production and adhesion, correlating with pronounced biofilm biomass production. NaOCl demonstrated substantial antimicrobial activity against both planktonic cells and biofilms. The MIC90 for planktonic bacterial cells was 0.125 mg/mL, and the MBEC90 ranged from 0.225 to 0.5 mg/mL. For planktonic C. albicans, the MIC90 was 0.150 mg/ mL, and the MBEC90 was 0.250 mg/mL. These results highlight the challenge in treating biofilm-associated infections and underscore the potential of NaOCl as a robust antimicrobial agent against difficult-to-treat biofilm infections at concentrations lower than those typically found in commercial disinfectants.
KEYWORDS
NaOCl, biofilm, Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus, Candida albicans, sodium hypochlorite solution, skin, ESKAPE
Marianna Blyumin-Karasik1 | Jessica Colon2 | Sophie Gaer1 | Isabella Vigil1 | Sylvie Nguyen2 | Jordan Rosen1
1Precision Skin & Body Institute, Davie, Florida, USA | 2Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Davie, Florida, USA
Correspondence: Marianna Blyumin-Karasik (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。)
Received: 12 May 2025 | Revised: 7 August 2025 | Accepted: 12 August 2025
Funding: The authors received no specific funding for this work.
Keywords: aesthetic | cosmeceuticals | hypochlorous acid | integrated skincare | laser treatment | photoaging | resurfacing laser
ABSTRACT
Background: Laser resurfacing treatments have revolutionized dermatological procedures by improving skin texture, tone, and quality. Effective periprocedural care remains essential to reduce side effects, support healing, and optimize aesthetic outcomes. Hypochlorous acid (HOCl), a naturally occurring oxidant with anti-inflammatory and antimicrobial properties, has demonstrated efficacy in promoting wound healing and minimizing scarring.
Aim: To evaluate the use of stabilized HOCl mist in the periprocedural care of patients undergoing laser resurfacing.
Methods: Ten patients underwent treatment with UltraClear, CO2RE, and/or GentleMax Pro laser devices. Stabilized HOCl mist was applied before and after the procedure, with continued application twice daily for 1week posttreatment. Follow-up assessments at 1–3weeks and 1–3months post-procedure included clinical photography, tolerability evaluation, and aesthetic outcome assessment. Outcomes measured included Clinician Erythema Assessment (CEA), 4-point Edema Scale, Investigator Global Assessment of Pigmentation Scale (IPA), and Global Aesthetic Improvement Scale (GAIS). Statistical analysis was performed using the Friedman and Wilcoxon signed-rank tests.
Results: HOCl mist was associated with accelerated recovery, including a noticeable reduction in erythema and pigmentation. Statistically significant improvements were observed in CEA (p=0.007) and IPA (p=0.012) scores, indicating reduced clinical severity and pigment alteration. Edema and GAIS scores showed no statistically significant change.
Conclusion: Stabilized HOCl mist is well-tolerated and may significantly aid post-procedural recovery by minimizing side effects and reducing discomfort. Results support the potential role of stabilized HOCl mist as a beneficial adjunct in post-laser skincare, contributing to faster healing, reduced inflammation, and enhanced cosmetic results.
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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