[en] The pathogenesis of venous ulcers is complex. A critical bacterial colonization may play a harmfull role. The use of topical antibiotics is unwise, and that of antiseptics is still a matter of debate. Some authors contend that antiseptics mitigate wound healing through a toxic effect upon keratinocytes and fibroblasts. However, sound arguments support the paradoxical concept of beneficial cytotoxicity of antiseptics in the treatment of chronic venous ulcers.
Disciplines :
Dermatology
Author, co-author :
Henry, Frédérique ; Centre Hospitalier Universitaire de Liège - CHU > Dermatopathologie
Franchimont, Claudine ; Centre Hospitalier Universitaire de Liège - CHU > Dermatopathologie
Pierard, Gérald ; Centre Hospitalier Universitaire de Liège - CHU > Dermatopathologie
Language :
French
Title :
Ulcère veineux chronique et colonisation bactérienne critique. Quand antiseptique rime avec cytotoxicité bénéfique.
Halbert AR, Stacey MC, Rohr JB, Jopp-McKay A.: The effect of bacterial colonization on venous ulcer healing. Australas J Dermatol, 1992, 33, 75-80.
HERMANNS JF, PAQUET P, ARRESE JE, PIÉRARD-FRANCHIMONT C, PIÉRARD GE.: La cytotoxicité bénéfique des antiseptiques. Une antinomie paradoxale et controversée du traitement des plaies cutanées chroniques. Rev Med Liège, 1999, 54, 600-605.
BROOK I, FRAZIER EH.: Aerobic and anaerobic microbiology of chronic venous ulcers, Int J Dermatol, 1998, 37, 426-428.
PIÉRARD-FRANCHIMONT C, PIÉRARD GE.: Comment je traite ⋯ un ulcère cutané en ambulatoire. Rev Med Liege, 1998, 53, 1-6.
FUMAL I, BRAHAM C, PAQUET P, PIÉRARD-FRANCHIMONT C, PIÉRARD GE.: The beneficial toxicity paradox of antimicrobials in leg ulcer healing impaired by a polymicrobial flora: a proof-to-concept study. Dermatology, 2002, 204, suppl 1, 79-85.
PIÉRARD-FRANCHIMONT C, PAQUET R, ARRESE JE, PIÉRARD GE.: Healing rate and bacterial necrotizing vasculitis in venous leg ulcers. Dermatology, 1997, 194, 383-387.
WOLKENSTEIN P, VAILLANT L.: Les antiseptiques en peau lésée. Ann Dermatol Venereol, 1996, 123, 343-348.
FLEISCHER W, REIMER K.: Povidone-iodine in antisepsis. State of the art. Dermatology,1997, 195, suppl 2, 3-9.
NIEDNER R.: Cytotoxicity and sensitization of povidone-iodine and other frequently used anti-infective agents. Dermatology, 1997, 195, suppl. 2, 89-92.
NIEDNER R.: Cytotoxicity and sensitization of povidone-iodine and other frequently used anti-infective agents. Dermatology, 1997, 195, suppl. 2:89-92.
COOPER ML, LAXER JA, HANSBROUGH JF.: The cytotoxic effects of commonly used topical antimicrobial agents on human fibroblasts and keratinocytes. J Trauma 1992, 31, 775-784.
KAUTZKY F, HARTINGER A, KÖHLER LD, VOGT HJ.: In vitro cytotoxicity of antimicrobial agents to human keratinocytes. J Eur Acad Dermatol, 1996, 6, 159-166.
HELLEWELL TB, MAJOR DA, FORESMAN PA, RODEHEAVER GT.: A cytotoxicity evaluation of antimicrobial and nonantimicrobial wound cleansers. Wounds, 1997,9, 15-20.
NIEDNER R, SCHOPF E.: Inhibition of wound healing by antiseptics. Br J Dermatol, 1986, 115, suppl 31, 41-44.
GOLDENHIEM PD.: An appraisal of povidone-iodine and wound healing. Postgrad Med J, 1993, 69, suppl 3, 97-105.
MAYER DA, TSAPOGAS MJ.: Povidone-iodine and wound healing: a critical review. Wound, 1993, 5, 14-23.
KJOLSETH D, FRANK JM, BARKER JH, et al.: Comparison of the effects of commonly used wound agents on epithelialization and neovascularization. J Am Coll Surg, 1994, 179, 405-312.
HANSSON C, FAERGEMANN J.: The effect of antiseptic solutions on microorganisms in venous leg ulcers. Acta Dermatol Venereol, 1995, 75, 31-33.
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 Dennatol, 1998, 37, 390-396.
BLECH MF, MARTIN C, PICHON M, BORRELLY J, HARTEMANN P.: Evolution clinique et bactériologique des plaies en fonction de différents protocoles d'antisepsie locale. Rev Chir Orthoped, 1990, 76, 55-61.
GOTTARDI W.: The uptake and release of molecular iodine by the skin: chemical and bactericidal evidence of residual effects caused by povidone-iodine preparations. J Hosp Infect, 1995, 29, 9-18.
TRAORÉ O, FOURNET FAYARD S, LAVERAN H.: An in vitro evaluation in the activity of povidone-iodine against nosocomial bacterial strains. J Hosp Infect, 1996, 34, 217-222.
KUNISADA T, YAMADA K, ODA S, HARA O.: Investigation of the efficacy of povidone-iodine against antiseptic resistant species. Dermatology, 1997, 195, suppl 2, 14-18.
HELLEWELL TB, MAJOR DA, FORESMAN PA, RODEHEAVER GT.: A cytotoxicity evaluation of antimicrobial and nonantimicrobial wound cleansers. Wounds, 1997, 9, 15-20.
MIYACHI Y, IMAMURA S.: Use of sugar and povidone-iodine in the treatment of refractory cutaneous ulcers. J Dermatol Treat, 1990, 1, 191-193.
MOORE K, THOMAS A, HARDING KG.: Iodine released from the wound dressing iodosorb modulates the secretion of cytokines by human macrophages responding to bacterial lipopolysaccharide. Int J Biochem Cell Biol, 1997, 29, 163-171.
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 Dermatol, 1998, 37, 390-396.
REIMER K, VOGT PM, BROEGMANN B, HAUSER J, ROSSBACH O, KRAMER A, RUDOLPH P, BOSSE B, SCHREIER H, FLEISCHER W.: An innonvative topical drug formulation for wound healing and infection treatment: in vitro and in vivo investigations of a povidone-iodine liposome hydrogel. Dermatology, 2000, 201, 235-241.
MORAND JJ.: Détersion ou greffe d'ulcères chez les malades qui ont une prothèse articulaire. Ann Dermatol Venereol, 1999, 126, 91-95.
DELEIXHE-MAUHIN F, PIÉRARD GE, PIERARD-FRANCHIMONT C, CORNIL F, GOFFIN F.: A morphometric analysis of the healing rate of ulcerations on atrophie blanche during simple nursing care. Eur J Dermatol, 1991, 1, 101-104.
PIÉRARD GE, PIÉRARD-FRANCHIMONT C.: Planimetry of the healing rate of leg ulcers. Eur J Dermatol 1995, 5, 257-262.
PIÉRARD GE, ARRESE ESTRADA J, PIÉRARD-FRANCHIMONT C, DELEIXHE-MAUHIN F: Is there a link between dendrocytes, fibrosis and sclerosis? Dermatologica, 1990, 181, 264-265.
