"The development of slow-release antiseptic agents, such as those based on iodine, has rendered antiseptics safe, effective, and reliable in the management of difficult wounds. In my own practice, I have found these therapeutic agents particularly useful in the bacterial 'de-colonization' of chronic wounds, an important step in the overall approach to wound bed preparation. As a result, patient management is greatly facilitated, whether one is simply applying standard treatments or using more advanced therapies.
The bacterial burden decreases, as does wound exudate. Quite frankly, I don't know what I would do without the use of slow-release antiseptics, particularly in the outpatient setting. I do know that some of my clinician colleagues are still fearful of the word 'antiseptics'. This fear is rooted in old literature on the use of 'straight' antiseptics, with no mechanisms for slow and smart delivery.
However, in the field of medicine and in caring for patients, one needs to adapt while remaining critical, and most of all be vigilant about new opportunities that can help our patients."
Vincent Falanga, MD
Professor of Dermatology and Biochemistry
Dr Marazzi patients with Diabetic Foot Ulcers:
Female, 39 years old, with diabetic ulcer in her right foot for 2 years.
Male, 66 years old, with diabetic ulcer (right foot) for 2 months.
Further Recommended Reading
Antibiotics and Antiseptics for Venous Leg Ulcers - Cochrane Review 2010 (PDF - 226kb)
Antimicrobial dressing efﬁcacy against mature Pseudomonas aeruginosa bioﬁlm on porcine skin explants Priscilla L Phillips1,2, Qingping Yang1, Stephen Davis3, Edith M Sampson2, John I Azeke1,∗, Aﬁfa Hamad1& Gregory S Schultz1
Burks R I, 'Povidone iodine solution in wound treatment' Phys Ther 1998;78:212-18
Clancy J. McVicar A, 'Homeostasis - The key concept to physiological control' Brit-J-Theatre-Nurse, vol 7, No 4, July 1997:25-34
Danielsen L, Cherry G W, Harding K, Rolloman O, 'Cadexomer Iodine in ulcers colonized by Pseudomonas aeruginosa' Journal of Wound Care, April, Vol 6, No. 4 1997:169-172
Falanga V. 'Classifications for wound bed preparation and stimulation of chronic wounds' Wound Repair and Regeneration Vol.. 8, No. 5, 347-352
Hansson C. 'The effects of cadexomer iodine paste in the treatment of venous leg ulcers compared with hydrocolloid dressing and paraffin gauze dressing. Int. J. Dermatology 1998;37 pp390-396
Hansson C, Persson L-M, Stenquist et al. 'The effects of Cadexomer Iodine dressing treatment on exudating, sloughy venous leg ulcers in comparison with hydrocolloid dressing and paraffin gauze dressing' Int.J Dermatology 1998 May;37(5):390-6.
Hunt T K. 'Disinfectectants, antiseptics and antibiotics' Iodine & Wound Physiology, Information Transfer Ltd, UK 1995; 2.1-2.6
Ishibashi Y, Ohkawara A, Kukita A et al. Clinical evaluation of NI-009 on various cutaneous ulcers. Comparative study with Debrisan. J Clin Therap Med 1990; 6(4): 785-816
Inflammation, Healing and Repair. In: MacSween RNM, Whaley K, Arnold E, editors. Muir's Textbook of Pathology, 13th Edition. Little Brown and Company 1993. p. 112-129
Martensson LI. Iodine and wound physiology. Proceedings of the 5th Annual Meeting of the European Tissue Repair Society, Padua, Italy. 1995
Martin P. Wound Healing - aiming for perfect skin regeneration. Science 1997; 276(4): 75-81
Mertz PM, Davis SC, Oliveira-Gandia M, Eaglestein WH. The wound environment: Implications from research studies for healing and infection. Wounds 1996; 8(1): 1-8
Mertz PM. Cadexomer Iodine ointment decreases Staph. aureus in partial thickness wounds and stimulates epidermal wound healing. Soc for Invest Derm. 1993
Moore K. Thomas A, Harding KG. The effect of Iodosorb on cytokine production by human macrophages. In: Iodine and Wound Physiology. UK: Information Transfer Ltd 1995: 5.1-5.14
Salman H, Leakey A. GR Micro Ltd. Data on File 2001
Schmidt RJ, Kirby AJ, Chung LY. Cadexomer iodine formulations may modulate the redox environment of wounds. In: Iodine & Wound Physiology. UK: Information Transfer Ltd 1995; 6.1- 6.26
Sibbald RG, Orsted H, Schultz GS, Coutts P, Keast D. Preparing the wound bed 2003 - Focus on Infection and inflammation. Ostomy Wound Management 2003; 49(11): 24-51
Westrin B, Larsson M. Lund University. Data on File 1997
1 Gustavson B. Cadexomer Iodine: Introduction. In: Cadexomer Iodine. Fox JA, Fisher H, editors. Stuttgart: Schattauer Verlag 1983. p. 35-41
2 Drosou A, Falabella A, Kirsner RS. Antiseptics on Wounds: An Area of Controversy. Wounds 2003 15(5): 149-66.
3 LeVeen HH, LeVeen RF, LeVeen EG. The mythology of povidone-iodine and the development of self-sterilizing plastics. SURGERY 1993 Feb; 176(2):183-190
4 Haughton W, Young T. Common problems in wound care: malodorous wounds. BJN 1995 4, (16):959-963
5 Thomas S. Treating malodorous wounds. Community Outlook, 1989 Oct :27-28,30
6 Falanga V. Iodine containing pharmaceuticals: a reappraisal. Proceedings of the 6th European Conference on Advances in Wound Healing. London: Macmillan Magazines Ltd 1997
7 Tröeng T, Skog E, Arnesjö B, Gjöres JE, Bergljung L, Gundersen J et al. A randomised multicentre trial to compare the efficacy of cadexomer iodine and standard treatment in the management of chronic venous ulcers in out patients. In: Cadexomer Iodine, Fox JA, Fisher H editors. Stuttgart:Schattauer Verlag 1983. p. 43-50
8 Hillstrom L. Iodosorb compared to standard treatment in chronic venous leg ulcers - a multi center study. Acta Chir Scand Suppl. 1988; 544: 53-56
9 Holloway GA. Johansen KH, Barnes RW, Pierce GE. Multicenter trial of cadexomer iodine to treat venous stasis ulcers. West J Med 1989;151: 35-38
10 Sundberg J. Poster presentation. The European Wound Management Association Conference, Milan, Italy 1997
11 Mertz PM, Oliveira Gandia MF, Davis SC. The evaluation of cadexomer iodine wound dressing on methicillin resistant staphylococcus aureus (MRSA) in acute wounds. Dermatol Surg 1999; 25(2): 89-93.
12 Sundberg J, Meller R. A retrospective review of the use of cadexomer iodine in the treatment of chronic wounds. Wounds 1997; 9(3):68-86.
13 Gilchrist B, Should iodine be considered in wound management? J Wound Care 1997; 6(3): 148-50.
14 Jones V, Milton T. When and how to use iodine dressings. Nursing Times 2000; 96 (45 suppl):2-3
15 Collier, M. Recognition and management of wound infections. Worldwidewounds, January 2005.
16 Ormiston MC, Seymour MT, Venn GE,Cohen RI, Fox JA Controlled trial of Iodosorb in chronic venous ulcers. BMJ 1985; 291:308-310.
17 Skog E. et al A randomised trial comparing cadexomer iodine and standard treatment in the out-patient management of chronic venous ulcers Br J Dermatol 1983; 109(1): 77-83.
18 Zhou L.H. Nahm W.K. Badiavas E, Yufit T and Falanga V. Slow release iodine preparation and wound healing: in-vitro effects consistent with lack of in-vivo toxicity in human chronic wounds. British Journal of Dermatology 2002; 146(3): 365-374
19 Mertz PM, Davis S, Brewer L, Franzen L. Can antimicrobials be effective without impairing wound healing? The evaluation of a cadexomer iodine ointment. Wounds 1994; 6(6): 184-93