Classification of wounds at risk and their antimicrobial treatment with polihexanide: a practice-oriented expert recommendation.

Currently, there are no generally accepted definitions for wounds at risk of infection. In clinical practice, too many chronic wounds are regarded as being at risk of infection, and therefore many topical antimicrobials - in terms of frequency and duration of use - are applied to wounds. Based on expert discussion and current knowledge, a clinical assessment score was developed. The objective of this wounds at risk (W.A.R.) score is to allow decision-making on the indication for the use of antiseptics on the basis of polihexanide. The proposed clinical classification of W.A.R. shall facilitate the decision for wound antisepsis and allow an appropriate general treatment regimen with the focus on the prevention of wound infection. The W.A.R. score is based on a clinically oriented risk assessment using concrete patient circumstances. The indication for the use of antiseptics results from the addition of differently weighted risk causes, for which points are assigned. Antimicrobial treatment is justified in the case of 3 or more points.

A practice-oriented recommendation for treatment of critically colonised and locally infected wounds using polihexanide.

UNLABELLED: The problem of wound infection presents a special challenge in the treatment of acute as well as chronic wounds. Typical complications not only jeopardise the successful outcome of treatment modalities as a whole; they may result in amputation or even become life-threatening. Polihexanide is an antimicrobial substance which is highly appropriate for use in critically colonised or infected acute and chronic wounds. This finding is based primarily on the broad antimicrobial spectrum and good cell and tissue compatibility of polihexanide, its capability of binding to organic matrix, the low risk of contact sensitisation, and the fact that it promotes wound healing. Furthermore, there has been no conclusive evidence to date of any pathogens developing resistances under the use of polihexanide. SUMMARY: Wound infections are special and challenging situations in therapy of acute and chronic wounds. Typical complications are risky not only for therapeutic process but also for amputation and viability of patients. Polihexanide is an exceedingly appropriate antimicrobial substance for using in critical colonised and local infected acute and chronic wounds. This evaluation is based on different properties of the compound like the broad antimicrobial spectrum, the excellent cell and tissue tolerability, the binding capacity to organic matrix, low risk of contact sensitisation and adjuvant effects to wound healing. Up to now there are no microbial resistances observed.