PVP-iodine in hydrosomes and hydrogel—A novel concept in wound therapy leads to enhanced epithelialization and reduced loss of skin grafts

• Published in: Burns 2006-09, Vol.32 (6), p.698-705
• Main Authors: Vogt, P.M., Reimer, Karen, Hauser, J., Roßbach, O., Steinau, H.U., Bosse, B., Muller, S., Schmidt, T., Fleischer, W.
• Format: Article
• Language: English
• Subjects: Anti-Infective Agents, Local - administration & dosage; Biological and medical sciences; Burns; Burns - surgery; Clinical phase III study; Epithelium; Female; Graft Survival; Humans; Hydrogel, Polyethylene Glycol Dimethacrylate - administration & dosage; Hydrosome polyvinyl-pyrrolidone (PVP)-iodine preparation in hydrogel; Improved epithelialization; Improved healing; Male; Medical sciences; Mesh grafts; Middle Aged; Povidone-Iodine - administration & dosage; Single-Blind Method; Skin Transplantation - methods; Smokers; Surgical Mesh; Tobacco, tobacco smoking; Toxicology; Traumas. Diseases due to physical agents; Wound Healing - drug effects
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2006.01.007

Moist wound treatment improves healing at a possibly increased risk of bacterial infection and many local antiseptics impair healing. A moist treatment modality with efficient antimicrobial activity would be desirable. In this monocentric, randomized, observer blinded, phase III study, a new hydrosome 1 1 Hydrosomes are specific liposomes. polyvinyl-pyrrolidone (PVP)-iodine preparation in hydrogel containing iodine in a 3% concentration (Repithel ®) was investigated for its effect on epithelialization in patients receiving meshed skin grafts. Grafts of 167 patients (donor site defects, burn wounds, or chronic defects) were dressed either with Repithel ( n = 83) covered with a gauze (Jelonet ®), or Jelonet-gauze only ( n = 84) until healing. Grafts receiving Repithel healed significantly earlier (9.4 days versus 12.4 days; p < 0.0001) and faster than controls as measured by neo-epithelialization of mesh holes between days 7 and 11 (91.2 ± 22.8% versus 82.3% ± 28.6, p < 0.0001). A subgroup analysis showed that the effects on grafted burn wounds ( p = 0.0042) and chronic defects ( p < 0.0001) was more significant than on donor sites. Also a higher take rate of grafts ( p = 0.0053) and a reduced loss of grafts was observed with Repithel treatment (8 grafts versus 20 grafts) ( p = 0.0063, respectively). Smokers had improved graft take ( p = 0.0069) and higher rate of epithelialization ( p = 0.0040) compared to smokers of the control group. The results demonstrate significant clinical advantages of Repithel. This new local wound healing drug combines antisepsis and wound moisture efficiently resulting in significantly enhanced epithelialization, decreased transplant losses, and significantly improved healing especially in smokers.