Archive:Wound bed preparation - Revision history

Idea at 04:40, 29 September 2026

2026-09-29T04:40:36Z

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	~~{{Short description\|Medical treatment approach}}~~
	~~{{Multiple issues\|{{Original research\|date= October 2017}}~~
	~~{{essay-like\|date=June 2011}}~~
	~~{{More science citations needed\|date=September 2018}}}}~~
	'''Wound bed preparation''' ('''WBP''') is a systematic approach to wound management by identifying and removing barriers to healing. The concept was originally developed in plastic surgery.<ref>{{Citation\|author=Montandon, Denys\|year=1977\|title=Symposium on Wound Healing\|series=Volume 4, Issue 3 of Clinics in plastic surgery: an international quarterly\|publisher=W. B. Saunders Company\|location=Philadelphia, Pennsylvania}}</ref><ref>{{Citation\|author1=Robinson, J. B. \|author2=Friedman, R. M.\|year=1996\|title=Wound Healing and Closure\|journal=Selected Readings in Plastic Surgery\|volume=8\|issue=1}}</ref> It includes [[wound assessment]], [[debridement]], [[moisture balance]], [[bacterial balance]], and [[wound cleaning]].		'''Wound bed preparation''' ('''WBP''') is a systematic approach to wound management by identifying and removing barriers to healing. The concept was originally developed in plastic surgery.<ref>{{Citation\|author=Montandon, Denys\|year=1977\|title=Symposium on Wound Healing\|series=Volume 4, Issue 3 of Clinics in plastic surgery: an international quarterly\|publisher=W. B. Saunders Company\|location=Philadelphia, Pennsylvania}}</ref><ref>{{Citation\|author1=Robinson, J. B. \|author2=Friedman, R. M.\|year=1996\|title=Wound Healing and Closure\|journal=Selected Readings in Plastic Surgery\|volume=8\|issue=1}}</ref> It includes [[wound assessment]], [[debridement]], [[moisture balance]], [[bacterial balance]], and [[wound cleaning]].

Waza: 115 revisions imported: AfD preservation: Wound bed preparation (CC BY-SA)

2026-09-29T04:26:44Z

115 revisions imported: AfD preservation: Wound bed preparation (CC BY-SA)

← Older revision	Revision as of 04:26, 29 September 2026
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wikipedia>Jake Wartenberg: Wikipedia:Articles for deletion/Wound bed preparation closed as keep (XFDcloser)

2026-09-28T19:49:31Z

Wikipedia:Articles for deletion/Wound bed preparation closed as keep (XFDcloser)

← Older revision		Revision as of 19:49, 28 September 2026
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	~~{{Article for deletion/dated\|page=Wound bed preparation\|timestamp=20260906201932\|year=2026\|month=September\|day=6\|substed=yes\|help=off\|outcome=draftification}}~~
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	{{Multiple issues\|{{Original research\|date= October 2017}}		{{Multiple issues\|{{Original research\|date= October 2017}}
	{{essay-like\|date=June 2011}}		{{essay-like\|date=June 2011}}

wikipedia>Silvestertaylor: Nominated for draftification; see :Wikipedia:Articles for deletion/Wound bed preparation.

2026-09-06T20:19:32Z

Nominated for draftification; see Wikipedia:Articles for deletion/Wound bed preparation.

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wikipedia>Monkbot: Monkbot/task 21: Replace page(s) with article-number;

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	=== TIME acronym (Tissue, Inflammation and Infection, Moisture, Epithelial) ===		=== TIME acronym (Tissue, Inflammation and Infection, Moisture, Epithelial) ===
	Since the year 2000, the wound bed preparation concept has continued to improve. For example, the TIME acronym (Tissue management, [[Inflammation]] and [[infection]] control, Moisture balance, Epithelial (edge) advancement) has supported the transition of basic science to the bedside in order to exploit appropriate wound healing interventions<ref>{{cite web \|url=http://ewma.org/fileadmin/user_upload/EWMA/pdf/Position_Documents/2004/pos_doc_English_final_04.pdf \|title=Wound bed preparation: science applied to practice \|last1=Falanga \|first1=V \|year=2004 \|work=Wound Bed Preparation in Practice, EWMA Position Document 2004 \|~~accessdate~~=April 7, 2011 \|archive-date=October 8, 2011 \|archive-url=https://web.archive.org/web/20111008022946/http://ewma.org/fileadmin/user_upload/EWMA/pdf/Position_Documents/2004/pos_doc_English_final_04.pdf ~~\|url-status=dead~~ }}</ref> and has not deviated from the important tenets of debridement, moisture balance, and bacterial balance.		Since the year 2000, the wound bed preparation concept has continued to improve. For example, the TIME acronym (Tissue management, [[Inflammation]] and [[infection]] control, Moisture balance, Epithelial (edge) advancement) has supported the transition of basic science to the bedside in order to exploit appropriate wound healing interventions<ref>{{cite web \|url=http://ewma.org/fileadmin/user_upload/EWMA/pdf/Position_Documents/2004/pos_doc_English_final_04.pdf \|title=Wound bed preparation: science applied to practice \|last1=Falanga \|first1=V \|year=2004 \|work=Wound Bed Preparation in Practice, EWMA Position Document 2004 \|access-date=April 7, 2011 \|archive-date=October 8, 2011 \|archive-url=https://web.archive.org/web/20111008022946/http://ewma.org/fileadmin/user_upload/EWMA/pdf/Position_Documents/2004/pos_doc_English_final_04.pdf }}</ref> and has not deviated from the important tenets of debridement, moisture balance, and bacterial balance.

	The TIME framework is not a continuum and as such is applicable to a wide range of [[wound]]s. The WBP model can be effectively applied only when a high level of precision is utilized in the assessment of the patient and their wound. The [[corollary]] of this is that intervention demands an equally high level of precision and this should be preceded by a comprehensive wound assessment.		The TIME framework is not a continuum and as such is applicable to a wide range of [[wound]]s. The WBP model can be effectively applied only when a high level of precision is utilized in the assessment of the patient and their wound. The [[corollary]] of this is that intervention demands an equally high level of precision and this should be preceded by a comprehensive wound assessment.
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	=== Moisture balance ===		=== Moisture balance ===
	Establishing a moisture balance beneficial to the wound bed is another prerequisite of care. The natural response to injury is inflammation typified by the local expression of [[histamine]] and [[bradykinin]]<ref name=White>{{cite web \|url=http://www.worldwidewounds.com/2006/September/White/Modern-Exudate-Mgt.html \|title=Modern exudate management: a review of wound treatments \|last1=White \|first1=RJ \|last2=Cutting \|first2=KF \|year=2006 \|publisher=World Wide Wounds \|~~accessdate~~=12 December 2009 \|archive-date=30 January 2010 \|archive-url=https://web.archive.org/web/20100130221105/http://www.worldwidewounds.com/2006/september/White/Modern-Exudate-Mgt.html ~~\|url-status=dead~~ }}</ref> and leading to [[vasodilation]] of the vessels that are in relative close proximity to the site of injury. As [[Serum (blood)\|serum]] based fluid moves out of the vessels into the [[Interstitial fluid\|interstitial spaces]] the resultant soft tissue [[oedema]] manifests on the wound surface as exudate.<ref>{{cite journal \|author=Thomas S \|year=1997 \|title=Assessment and management of wound exudate \|journal=J Wound Care \|volume=6 \|issue=7 \|pages=327–30 \|doi=10.12968/jowc.1997.6.7.327 \|pmid=9325827 \|s2cid=250137311 }}</ref> In the chronic wound this exudate contains a surfeit of [[proteolytic enzyme]]s and other components not seen in acute wounds and these compounds have a corrosive effect on the wound bed and surrounding peri-wound skin.<ref name=White/> The application of [[Dressing (medical)\|dressings]], [[Negative-pressure wound therapy\|topical negative pressure]], [[compression garment]]s and leg elevation/exercise have been identified as methods for management of wound exudate.<ref name=White/>		Establishing a moisture balance beneficial to the wound bed is another prerequisite of care. The natural response to injury is inflammation typified by the local expression of [[histamine]] and [[bradykinin]]<ref name=White>{{cite web \|url=http://www.worldwidewounds.com/2006/September/White/Modern-Exudate-Mgt.html \|title=Modern exudate management: a review of wound treatments \|last1=White \|first1=RJ \|last2=Cutting \|first2=KF \|year=2006 \|publisher=World Wide Wounds \|access-date=12 December 2009 \|archive-date=30 January 2010 \|archive-url=https://web.archive.org/web/20100130221105/http://www.worldwidewounds.com/2006/september/White/Modern-Exudate-Mgt.html }}</ref> and leading to [[vasodilation]] of the vessels that are in relative close proximity to the site of injury. As [[Serum (blood)\|serum]] based fluid moves out of the vessels into the [[Interstitial fluid\|interstitial spaces]] the resultant soft tissue [[oedema]] manifests on the wound surface as exudate.<ref>{{cite journal \|author=Thomas S \|year=1997 \|title=Assessment and management of wound exudate \|journal=J Wound Care \|volume=6 \|issue=7 \|pages=327–30 \|doi=10.12968/jowc.1997.6.7.327 \|pmid=9325827 \|s2cid=250137311 }}</ref> In the chronic wound this exudate contains a surfeit of [[proteolytic enzyme]]s and other components not seen in acute wounds and these compounds have a corrosive effect on the wound bed and surrounding peri-wound skin.<ref name=White/> The application of [[Dressing (medical)\|dressings]], [[Negative-pressure wound therapy\|topical negative pressure]], [[compression garment]]s and leg elevation/exercise have been identified as methods for management of wound exudate.<ref name=White/>

	=== Bacterial balance ===		=== Bacterial balance ===
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	=== Criteria for a cleansing agent ===		=== Criteria for a cleansing agent ===
	Wound cleansing forms an integral part of wound management and generally suggests the application of a [[fluid]] to aid the removal of surface [[contaminant]]s, bacteria, and debris from the wound surface and surrounding skin.<ref>Rodeheaver GT, Ratliff CR. Wound Cleansing, Wound Irrigation, Wound Disinfection. In: D.I. Krasner GTR, R.G. Sibbald, editor. Chronic Wound Care: A Clinical Source Book for Healthcare Professionals. Malvern, P.A.: HMP Communications, 2007.</ref> Water as a cleansing agent, especially in chronic wounds has been proposed<ref name="Cutting" /> and is widely used<ref>{{cite journal \|author=Hall S \|year=2007 \|title=A review of the effect of tap water versus normal saline on infection rates in acute traumatic wounds \|journal=Journal of Wound Care \|volume=16 \|issue=1 \|pages=38–41 \|doi=10.12968/jowc.2007.16.1.26990 \|pmid=17334147 }}</ref> especially in the management of infected wounds.<ref>{{cite journal\|last1=Fernandez\|first1=R\|last2=Griffiths\|first2=R\|title=Water for wound cleansing.\|journal=The Cochrane Database of Systematic Reviews\|date=15 February 2012\|issue=2\|~~pages~~=CD003861\|doi=10.1002/14651858.CD003861.pub3\|pmid=22336796}}</ref> Despite the plethora of work focussing on the value of [[water]]/[[Saline (medicine)\|saline]] in wound cleansing there is no current consensus as to whether water has an active role to play in the promotion of healing.		Wound cleansing forms an integral part of wound management and generally suggests the application of a [[fluid]] to aid the removal of surface [[contaminant]]s, bacteria, and debris from the wound surface and surrounding skin.<ref>Rodeheaver GT, Ratliff CR. Wound Cleansing, Wound Irrigation, Wound Disinfection. In: D.I. Krasner GTR, R.G. Sibbald, editor. Chronic Wound Care: A Clinical Source Book for Healthcare Professionals. Malvern, P.A.: HMP Communications, 2007.</ref> Water as a cleansing agent, especially in chronic wounds has been proposed<ref name="Cutting" /> and is widely used<ref>{{cite journal \|author=Hall S \|year=2007 \|title=A review of the effect of tap water versus normal saline on infection rates in acute traumatic wounds \|journal=Journal of Wound Care \|volume=16 \|issue=1 \|pages=38–41 \|doi=10.12968/jowc.2007.16.1.26990 \|pmid=17334147 }}</ref> especially in the management of infected wounds.<ref>{{cite journal\|last1=Fernandez\|first1=R\|last2=Griffiths\|first2=R\|title=Water for wound cleansing.\|journal=The Cochrane Database of Systematic Reviews\|date=15 February 2012\|issue=2\|article-number=CD003861\|doi=10.1002/14651858.CD003861.pub3\|pmid=22336796}}</ref> Despite the plethora of work focussing on the value of [[water]]/[[Saline (medicine)\|saline]] in wound cleansing there is no current consensus as to whether water has an active role to play in the promotion of healing.

	With this unclear position in mind, alternative cleansing agents such as [[antiseptic]]s that possess the potential to improve clinical outcomes should be considered.		With this unclear position in mind, alternative cleansing agents such as [[antiseptic]]s that possess the potential to improve clinical outcomes should be considered.
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	[[Polyhexamethylene biguanide hydrochloride]] is a fast-acting, broad-spectrum synthetic compound that binds to the [[cell envelope]] of both [[Gram-positive bacteria\|Gram-positive]] and [[Gram-negative bacteria]], disrupting the bacterial [[cell membrane]] and enabling seepage of ions.<ref>{{cite journal \|vauthors=Broxton P, Woodcock PM, Gilbert P \|year=1983 \|title=A study of the antibacterial activity of some polyhexamethylene biguanides towards Escherichia coli ATCC 8739 \|journal=Journal of Applied Bacteriology \|volume=54 \|issue=3 \|pages=345–53 \|doi=10.1111/j.1365-2672.1983.tb02627.x\|pmid=6348014 }}</ref><ref>{{cite journal \|vauthors=Broxton P, Woodcock PM, Gilbert P \|year=1984 \|title=Binding of some polyhexamethylene biguanides to the cell envelope of Escherichia coli ATCC 8739 \|journal=Microbios \|volume=41 \|issue=163 \|pages=15–22 \|pmid=6396498 }}</ref> PHMB has a long history of use as a [[contact lens]] cleanser, [[mouthwash]] and more recently in wound care.		[[Polyhexamethylene biguanide hydrochloride]] is a fast-acting, broad-spectrum synthetic compound that binds to the [[cell envelope]] of both [[Gram-positive bacteria\|Gram-positive]] and [[Gram-negative bacteria]], disrupting the bacterial [[cell membrane]] and enabling seepage of ions.<ref>{{cite journal \|vauthors=Broxton P, Woodcock PM, Gilbert P \|year=1983 \|title=A study of the antibacterial activity of some polyhexamethylene biguanides towards Escherichia coli ATCC 8739 \|journal=Journal of Applied Bacteriology \|volume=54 \|issue=3 \|pages=345–53 \|doi=10.1111/j.1365-2672.1983.tb02627.x\|pmid=6348014 }}</ref><ref>{{cite journal \|vauthors=Broxton P, Woodcock PM, Gilbert P \|year=1984 \|title=Binding of some polyhexamethylene biguanides to the cell envelope of Escherichia coli ATCC 8739 \|journal=Microbios \|volume=41 \|issue=163 \|pages=15–22 \|pmid=6396498 }}</ref> PHMB has a long history of use as a [[contact lens]] cleanser, [[mouthwash]] and more recently in wound care.

	It is regarded as being quite safe to use as it has been incorporated as a [[preservative]] in [[cosmetics]].<ref>{{cite journal \|vauthors=Schnuch A, Geier J, Uter W, Basketter DA, Jowsey IR \|year=2007 \|title=The biocide polyhexamethylene biguanide remains an uncommon contact allerge \|journal=Contact Dermatitis \|volume=56 \|issue=4 \|pages=235–39 \|doi=10.1111/j.1600-0536.2007.01089.x\|pmid=17343627 \|s2cid=25660466 }}</ref> A retrospective analysis of wound cleanser clinical efficacy and cost-effectiveness focused on polyhexamethylene biguanide solution, [[~~Ringer’s~~ solution\|Ringer's solution]] or saline in 112 [[Venous ulcer\|venous leg ulcer]] patients.<ref name=Andriessen>{{cite journal \|vauthors=Andriessen AE, Eberlein T \|year=2008 \|title=Assessment of a wound cleansing solution in the treatment of problem wounds \|journal=Wounds \|volume=20 \|issue=6 \|pages=229–36 \|pmid=25942522 }}</ref> The study group received the polyhexamethylene biguanide solution (n=59) and the control group received either [[~~Ringer’s~~ solution\|Ringer's solution]] or saline (n=53). In both arms, [[ulcer]] healing patterns were evaluated. Within the first 3 months of treatment, a shorter [[time]] to healing was recorded in the study group when compared with the [[control group]] - 60% v. 28% with corresponding [[mean]] [[time]] to healing being 3.31 months (study group) compared to 4.42 months (control group) p= <0.0001. More patients in the polyhexamethylene biguanide group healed in the 6-month period when compared with the controls - 97% v. 89%. The authors concluded that optimization of the local wound environment was significantly influenced through cleansing with polyhexanide solution.		It is regarded as being quite safe to use as it has been incorporated as a [[preservative]] in [[cosmetics]].<ref>{{cite journal \|vauthors=Schnuch A, Geier J, Uter W, Basketter DA, Jowsey IR \|year=2007 \|title=The biocide polyhexamethylene biguanide remains an uncommon contact allerge \|journal=Contact Dermatitis \|volume=56 \|issue=4 \|pages=235–39 \|doi=10.1111/j.1600-0536.2007.01089.x\|pmid=17343627 \|s2cid=25660466 }}</ref> A retrospective analysis of wound cleanser clinical efficacy and cost-effectiveness focused on polyhexamethylene biguanide solution, [[Ringer's solution\|Ringer's solution]] or saline in 112 [[Venous ulcer\|venous leg ulcer]] patients.<ref name=Andriessen>{{cite journal \|vauthors=Andriessen AE, Eberlein T \|year=2008 \|title=Assessment of a wound cleansing solution in the treatment of problem wounds \|journal=Wounds \|volume=20 \|issue=6 \|pages=229–36 \|pmid=25942522 }}</ref> The study group received the polyhexamethylene biguanide solution (n=59) and the control group received either [[Ringer's solution\|Ringer's solution]] or saline (n=53). In both arms, [[ulcer]] healing patterns were evaluated. Within the first 3 months of treatment, a shorter [[time]] to healing was recorded in the study group when compared with the [[control group]] - 60% v. 28% with corresponding [[mean]] [[time]] to healing being 3.31 months (study group) compared to 4.42 months (control group) p= <0.0001. More patients in the polyhexamethylene biguanide group healed in the 6-month period when compared with the controls - 97% v. 89%. The authors concluded that optimization of the local wound environment was significantly influenced through cleansing with polyhexanide solution.

	In an in vitro model developed to compare the efficiency of wound-rinsing solutions, Kaehn ''et al.'' compared four sterile wound-cleansing solutions (saline, [[Ringer's solution]], Prontosan® and Octenisept®) using a wound coating model consisting of slides containing dried [[blood plasma]] or [[fibrin]].<ref>{{cite journal \|author=Kaehn K \|year=2009 \|title=An in-vitro model for comparing the efficiency of wound-rinsing solutions \|journal=Journal of Wound Care \|volume=18 \|issue=6 \|pages=229–36 \|doi=10.12968/jowc.2009.18.6.42800 \|pmid=19661846 }}</ref> The concentration of dissolved proteins was measured and the findings indicate that a surfactant containing solution (polyhexamethylene biguanide with [[betaine]]) (Prontosan®) was more effective than [[Saline (medicine)\|saline]] in removing the [[protein]] (adhered dried plasma or fibrin). The proteins in the [[antiseptic]] solution (Octenisept®) were [[Denaturation (biochemistry)\|denatured]] and became insoluble. The authors suggest this implies that the antiseptic solution is unsuitable as a 'general' wound cleanser and that its use should be restricted to infected wounds.		In an in vitro model developed to compare the efficiency of wound-rinsing solutions, Kaehn ''et al.'' compared four sterile wound-cleansing solutions (saline, [[Ringer's solution]], Prontosan® and Octenisept®) using a wound coating model consisting of slides containing dried [[blood plasma]] or [[fibrin]].<ref>{{cite journal \|author=Kaehn K \|year=2009 \|title=An in-vitro model for comparing the efficiency of wound-rinsing solutions \|journal=Journal of Wound Care \|volume=18 \|issue=6 \|pages=229–36 \|doi=10.12968/jowc.2009.18.6.42800 \|pmid=19661846 }}</ref> The concentration of dissolved proteins was measured and the findings indicate that a surfactant containing solution (polyhexamethylene biguanide with [[betaine]]) (Prontosan®) was more effective than [[Saline (medicine)\|saline]] in removing the [[protein]] (adhered dried plasma or fibrin). The proteins in the [[antiseptic]] solution (Octenisept®) were [[Denaturation (biochemistry)\|denatured]] and became insoluble. The authors suggest this implies that the antiseptic solution is unsuitable as a 'general' wound cleanser and that its use should be restricted to infected wounds.

wikipedia>Entranced98: Adding short description: "Medical treatment approach"

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Adding short description: "Medical treatment approach"

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wikipedia>Eva1una77: Typo correction

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Typo correction

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	* infected exudate is present,		* infected exudate is present,
	* there is contamination by a [[foreign body]] including dirt and bacteria		* there is contamination by a [[foreign body]] including dirt and bacteria
	* ~~revitalised~~ tissue ([[Sloughing\|slough]] and [[necrosis]]) is present.		* devitalised tissue ([[Sloughing\|slough]] and [[necrosis]]) is present.

	Wound cleansing is often undertaken as a ritual exercise rather than as an evidence-based activity. However, it has a role to play in all four domains of the WBP model. Wounds that are 'clean' and progressing do not require extraneous cleansing.<ref>{{cite book \|last1=Williams \|first1=C \|last2=Young \|first2=T \|title=Myth and Reality in Wound Care \|year=1998 \|publisher=Quay Books \|location=Dinton, Wilts}}</ref>		Wound cleansing is often undertaken as a ritual exercise rather than as an evidence-based activity. However, it has a role to play in all four domains of the WBP model. Wounds that are 'clean' and progressing do not require extraneous cleansing.<ref>{{cite book \|last1=Williams \|first1=C \|last2=Young \|first2=T \|title=Myth and Reality in Wound Care \|year=1998 \|publisher=Quay Books \|location=Dinton, Wilts}}</ref>

wikipedia>Citation bot: Add: pmid, authors 1-1. Removed parameters. Some additions/deletions were parameter name changes. | Use this bot. Report bugs. | Suggested by Abductive | #UCB_toolbar

2024-12-06T02:30:42Z

Add: pmid, authors 1-1. Removed parameters. Some additions/deletions were parameter name changes. | Use this bot. Report bugs. | Suggested by Abductive | #UCB_toolbar

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	* revitalised tissue ([[Sloughing\|slough]] and [[necrosis]]) is present.		* revitalised tissue ([[Sloughing\|slough]] and [[necrosis]]) is present.

	Wound cleansing is often undertaken as a ritual exercise rather than as an evidence-based activity. However, it has a role to play in all four domains of the WBP model. Wounds that are 'clean' and progressing do not require extraneous cleansing.<ref>{{cite book \|last1=Williams \|~~first~~=C \|last2=Young \|first2=T \|title=Myth and Reality in Wound Care \|year=1998 \|publisher=Quay Books \|location=Dinton, Wilts}}</ref>		Wound cleansing is often undertaken as a ritual exercise rather than as an evidence-based activity. However, it has a role to play in all four domains of the WBP model. Wounds that are 'clean' and progressing do not require extraneous cleansing.<ref>{{cite book \|last1=Williams \|first1=C \|last2=Young \|first2=T \|title=Myth and Reality in Wound Care \|year=1998 \|publisher=Quay Books \|location=Dinton, Wilts}}</ref>

	=== Criteria for a cleansing agent ===		=== Criteria for a cleansing agent ===
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	[[Polyhexamethylene biguanide hydrochloride]] is a fast-acting, broad-spectrum synthetic compound that binds to the [[cell envelope]] of both [[Gram-positive bacteria\|Gram-positive]] and [[Gram-negative bacteria]], disrupting the bacterial [[cell membrane]] and enabling seepage of ions.<ref>{{cite journal \|vauthors=Broxton P, Woodcock PM, Gilbert P \|year=1983 \|title=A study of the antibacterial activity of some polyhexamethylene biguanides towards Escherichia coli ATCC 8739 \|journal=Journal of Applied Bacteriology \|volume=54 \|issue=3 \|pages=345–53 \|doi=10.1111/j.1365-2672.1983.tb02627.x\|pmid=6348014 }}</ref><ref>{{cite journal \|vauthors=Broxton P, Woodcock PM, Gilbert P \|year=1984 \|title=Binding of some polyhexamethylene biguanides to the cell envelope of Escherichia coli ATCC 8739 \|journal=Microbios \|volume=41 \|issue=163 \|pages=15–22 \|pmid=6396498 }}</ref> PHMB has a long history of use as a [[contact lens]] cleanser, [[mouthwash]] and more recently in wound care.		[[Polyhexamethylene biguanide hydrochloride]] is a fast-acting, broad-spectrum synthetic compound that binds to the [[cell envelope]] of both [[Gram-positive bacteria\|Gram-positive]] and [[Gram-negative bacteria]], disrupting the bacterial [[cell membrane]] and enabling seepage of ions.<ref>{{cite journal \|vauthors=Broxton P, Woodcock PM, Gilbert P \|year=1983 \|title=A study of the antibacterial activity of some polyhexamethylene biguanides towards Escherichia coli ATCC 8739 \|journal=Journal of Applied Bacteriology \|volume=54 \|issue=3 \|pages=345–53 \|doi=10.1111/j.1365-2672.1983.tb02627.x\|pmid=6348014 }}</ref><ref>{{cite journal \|vauthors=Broxton P, Woodcock PM, Gilbert P \|year=1984 \|title=Binding of some polyhexamethylene biguanides to the cell envelope of Escherichia coli ATCC 8739 \|journal=Microbios \|volume=41 \|issue=163 \|pages=15–22 \|pmid=6396498 }}</ref> PHMB has a long history of use as a [[contact lens]] cleanser, [[mouthwash]] and more recently in wound care.

	It is regarded as being quite safe to use as it has been incorporated as a [[preservative]] in [[cosmetics]].<ref>{{cite journal \|vauthors=Schnuch A, Geier J, Uter W, Basketter DA, Jowsey IR \|year=2007 \|title=The biocide polyhexamethylene biguanide remains an uncommon contact allerge \|journal=Contact Dermatitis \|volume=56 \|issue=4 \|pages=235–39 \|doi=10.1111/j.1600-0536.2007.01089.x\|pmid=17343627 \|s2cid=25660466 }}</ref> A retrospective analysis of wound cleanser clinical efficacy and cost-effectiveness focused on polyhexamethylene biguanide solution, [[Ringer’s solution\|Ringer's solution]] or saline in 112 [[Venous ulcer\|venous leg ulcer]] patients.<ref name=Andriessen>{{cite journal \|vauthors=Andriessen AE, Eberlein T \|year=2008 \|title=Assessment of a wound cleansing solution in the treatment of problem wounds \|journal=Wounds \|volume=20 \|issue=6 \|pages=229–36 }}</ref> The study group received the polyhexamethylene biguanide solution (n=59) and the control group received either [[Ringer’s solution\|Ringer's solution]] or saline (n=53). In both arms, [[ulcer]] healing patterns were evaluated. Within the first 3 months of treatment, a shorter [[time]] to healing was recorded in the study group when compared with the [[control group]] - 60% v. 28% with corresponding [[mean]] [[time]] to healing being 3.31 months (study group) compared to 4.42 months (control group) p= <0.0001. More patients in the polyhexamethylene biguanide group healed in the 6-month period when compared with the controls - 97% v. 89%. The authors concluded that optimization of the local wound environment was significantly influenced through cleansing with polyhexanide solution.		It is regarded as being quite safe to use as it has been incorporated as a [[preservative]] in [[cosmetics]].<ref>{{cite journal \|vauthors=Schnuch A, Geier J, Uter W, Basketter DA, Jowsey IR \|year=2007 \|title=The biocide polyhexamethylene biguanide remains an uncommon contact allerge \|journal=Contact Dermatitis \|volume=56 \|issue=4 \|pages=235–39 \|doi=10.1111/j.1600-0536.2007.01089.x\|pmid=17343627 \|s2cid=25660466 }}</ref> A retrospective analysis of wound cleanser clinical efficacy and cost-effectiveness focused on polyhexamethylene biguanide solution, [[Ringer’s solution\|Ringer's solution]] or saline in 112 [[Venous ulcer\|venous leg ulcer]] patients.<ref name=Andriessen>{{cite journal \|vauthors=Andriessen AE, Eberlein T \|year=2008 \|title=Assessment of a wound cleansing solution in the treatment of problem wounds \|journal=Wounds \|volume=20 \|issue=6 \|pages=229–36 \|pmid=25942522 }}</ref> The study group received the polyhexamethylene biguanide solution (n=59) and the control group received either [[Ringer’s solution\|Ringer's solution]] or saline (n=53). In both arms, [[ulcer]] healing patterns were evaluated. Within the first 3 months of treatment, a shorter [[time]] to healing was recorded in the study group when compared with the [[control group]] - 60% v. 28% with corresponding [[mean]] [[time]] to healing being 3.31 months (study group) compared to 4.42 months (control group) p= <0.0001. More patients in the polyhexamethylene biguanide group healed in the 6-month period when compared with the controls - 97% v. 89%. The authors concluded that optimization of the local wound environment was significantly influenced through cleansing with polyhexanide solution.

	In an in vitro model developed to compare the efficiency of wound-rinsing solutions, Kaehn ''et al.'' compared four sterile wound-cleansing solutions (saline, [[Ringer's solution]], Prontosan® and Octenisept®) using a wound coating model consisting of slides containing dried [[blood plasma]] or [[fibrin]].<ref>{{cite journal \|author=Kaehn K \|year=2009 \|title=An in-vitro model for comparing the efficiency of wound-rinsing solutions \|journal=Journal of Wound Care \|volume=18 \|issue=6 \|pages=229–36 \|doi=10.12968/jowc.2009.18.6.42800 \|pmid=19661846 }}</ref> The concentration of dissolved proteins was measured and the findings indicate that a surfactant containing solution (polyhexamethylene biguanide with [[betaine]]) (Prontosan®) was more effective than [[Saline (medicine)\|saline]] in removing the [[protein]] (adhered dried plasma or fibrin). The proteins in the [[antiseptic]] solution (Octenisept®) were [[Denaturation (biochemistry)\|denatured]] and became insoluble. The authors suggest this implies that the antiseptic solution is unsuitable as a 'general' wound cleanser and that its use should be restricted to infected wounds.		In an in vitro model developed to compare the efficiency of wound-rinsing solutions, Kaehn ''et al.'' compared four sterile wound-cleansing solutions (saline, [[Ringer's solution]], Prontosan® and Octenisept®) using a wound coating model consisting of slides containing dried [[blood plasma]] or [[fibrin]].<ref>{{cite journal \|author=Kaehn K \|year=2009 \|title=An in-vitro model for comparing the efficiency of wound-rinsing solutions \|journal=Journal of Wound Care \|volume=18 \|issue=6 \|pages=229–36 \|doi=10.12968/jowc.2009.18.6.42800 \|pmid=19661846 }}</ref> The concentration of dissolved proteins was measured and the findings indicate that a surfactant containing solution (polyhexamethylene biguanide with [[betaine]]) (Prontosan®) was more effective than [[Saline (medicine)\|saline]] in removing the [[protein]] (adhered dried plasma or fibrin). The proteins in the [[antiseptic]] solution (Octenisept®) were [[Denaturation (biochemistry)\|denatured]] and became insoluble. The authors suggest this implies that the antiseptic solution is unsuitable as a 'general' wound cleanser and that its use should be restricted to infected wounds.

wikipedia>Navadda: /* Wound cleansing and excision */ Fixed grammar

2024-10-30T05:03:50Z

Wound cleansing and excision: Fixed grammar

← Older revision		Revision as of 05:03, 30 October 2024
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	In an in vitro model developed to compare the efficiency of wound-rinsing solutions, Kaehn ''et al.'' compared four sterile wound-cleansing solutions (saline, [[Ringer's solution]], Prontosan® and Octenisept®) using a wound coating model consisting of slides containing dried [[blood plasma]] or [[fibrin]].<ref>{{cite journal \|author=Kaehn K \|year=2009 \|title=An in-vitro model for comparing the efficiency of wound-rinsing solutions \|journal=Journal of Wound Care \|volume=18 \|issue=6 \|pages=229–36 \|doi=10.12968/jowc.2009.18.6.42800 \|pmid=19661846 }}</ref> The concentration of dissolved proteins was measured and the findings indicate that a surfactant containing solution (polyhexamethylene biguanide with [[betaine]]) (Prontosan®) was more effective than [[Saline (medicine)\|saline]] in removing the [[protein]] (adhered dried plasma or fibrin). The proteins in the [[antiseptic]] solution (Octenisept®) were [[Denaturation (biochemistry)\|denatured]] and became insoluble. The authors suggest this implies that the antiseptic solution is unsuitable as a 'general' wound cleanser and that its use should be restricted to infected wounds.		In an in vitro model developed to compare the efficiency of wound-rinsing solutions, Kaehn ''et al.'' compared four sterile wound-cleansing solutions (saline, [[Ringer's solution]], Prontosan® and Octenisept®) using a wound coating model consisting of slides containing dried [[blood plasma]] or [[fibrin]].<ref>{{cite journal \|author=Kaehn K \|year=2009 \|title=An in-vitro model for comparing the efficiency of wound-rinsing solutions \|journal=Journal of Wound Care \|volume=18 \|issue=6 \|pages=229–36 \|doi=10.12968/jowc.2009.18.6.42800 \|pmid=19661846 }}</ref> The concentration of dissolved proteins was measured and the findings indicate that a surfactant containing solution (polyhexamethylene biguanide with [[betaine]]) (Prontosan®) was more effective than [[Saline (medicine)\|saline]] in removing the [[protein]] (adhered dried plasma or fibrin). The proteins in the [[antiseptic]] solution (Octenisept®) were [[Denaturation (biochemistry)\|denatured]] and became insoluble. The authors suggest this implies that the antiseptic solution is unsuitable as a 'general' wound cleanser and that its use should be restricted to infected wounds.

	In a double-blind, randomised, stratified, controlled, parallel-group study<ref>{{cite journal \|vauthors=Kramer A, Roth B, Müller G, Rudolph P, Klöcker N \|year=2004 \|title=Influence of the Antiseptic Agents Polyhexanide and Octenidine on FL Cells and on Healing of Experimental Superficial Aseptic Wounds in Piglets \|journal=Skin Pharmacol Physiol \|volume=17 \|issue=3 \|pages=141–46 \|doi=10.1159/000077241\|pmid=15087593 \|s2cid=22661415 }}</ref> the influence of two antiseptics ([[octenidine]], [[polyhexanide]]) versus a [[placebo]] of Ringer's solution on wound healing in a porcine model was conducted. Assessment of healing was recorded using [[planimetry]] and [[histopathology]]. At nine days post wounding the octenidine treated wounds demonstrated retarded contraction at significantly greater extent than [[placebo]] and [[polyhexanide]]. At days 18 and 28 the polyhexanide treated wounds supported contraction significantly more than [[placebo]] and [[octenidine]]. The [[polyhexanide]] treated wounds led to complete wound closure after 22.9 days, in comparison to the placebo octenidine treated wounds respectively, 24.1 days (p < 0.05) and 28.3 days (no statistical difference to [[placebo]]).		In a double-blind, randomised, stratified, controlled, parallel-group study<ref>{{cite journal \|vauthors=Kramer A, Roth B, Müller G, Rudolph P, Klöcker N \|year=2004 \|title=Influence of the Antiseptic Agents Polyhexanide and Octenidine on FL Cells and on Healing of Experimental Superficial Aseptic Wounds in Piglets \|journal=Skin Pharmacol Physiol \|volume=17 \|issue=3 \|pages=141–46 \|doi=10.1159/000077241\|pmid=15087593 \|s2cid=22661415 }}</ref> the influence of two antiseptics ([[octenidine]], [[polyhexanide]]) versus a [[placebo]] of Ringer's solution on wound healing in a porcine model was conducted. Assessment of healing was recorded using [[planimetry]] and [[histopathology]]. At nine days post wounding, the octenidine-treated wounds demonstrated retarded contraction at significantly greater extent than [[placebo]] and [[polyhexanide]]. At days 18 and 28 the polyhexanide treated wounds supported contraction significantly more than [[placebo]] and [[octenidine]]. The [[polyhexanide]] treated wounds led to complete wound closure after 22.9 days, in comparison to the placebo octenidine treated wounds respectively, 24.1 days (p < 0.05) and 28.3 days (no statistical difference to [[placebo]]).

	==== Prontosan ====		==== Prontosan ====

wikipedia>Navadda: /* Wound cleansing and excision */ typo, capitalization

2024-10-30T05:01:57Z

Wound cleansing and excision: typo, capitalization

← Older revision		Revision as of 05:01, 30 October 2024
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	[[Polyhexamethylene biguanide hydrochloride]] is a fast-acting, broad-spectrum synthetic compound that binds to the [[cell envelope]] of both [[Gram-positive bacteria\|Gram-positive]] and [[Gram-negative bacteria]], disrupting the bacterial [[cell membrane]] and enabling seepage of ions.<ref>{{cite journal \|vauthors=Broxton P, Woodcock PM, Gilbert P \|year=1983 \|title=A study of the antibacterial activity of some polyhexamethylene biguanides towards Escherichia coli ATCC 8739 \|journal=Journal of Applied Bacteriology \|volume=54 \|issue=3 \|pages=345–53 \|doi=10.1111/j.1365-2672.1983.tb02627.x\|pmid=6348014 }}</ref><ref>{{cite journal \|vauthors=Broxton P, Woodcock PM, Gilbert P \|year=1984 \|title=Binding of some polyhexamethylene biguanides to the cell envelope of Escherichia coli ATCC 8739 \|journal=Microbios \|volume=41 \|issue=163 \|pages=15–22 \|pmid=6396498 }}</ref> PHMB has a long history of use as a [[contact lens]] cleanser, [[mouthwash]] and more recently in wound care.		[[Polyhexamethylene biguanide hydrochloride]] is a fast-acting, broad-spectrum synthetic compound that binds to the [[cell envelope]] of both [[Gram-positive bacteria\|Gram-positive]] and [[Gram-negative bacteria]], disrupting the bacterial [[cell membrane]] and enabling seepage of ions.<ref>{{cite journal \|vauthors=Broxton P, Woodcock PM, Gilbert P \|year=1983 \|title=A study of the antibacterial activity of some polyhexamethylene biguanides towards Escherichia coli ATCC 8739 \|journal=Journal of Applied Bacteriology \|volume=54 \|issue=3 \|pages=345–53 \|doi=10.1111/j.1365-2672.1983.tb02627.x\|pmid=6348014 }}</ref><ref>{{cite journal \|vauthors=Broxton P, Woodcock PM, Gilbert P \|year=1984 \|title=Binding of some polyhexamethylene biguanides to the cell envelope of Escherichia coli ATCC 8739 \|journal=Microbios \|volume=41 \|issue=163 \|pages=15–22 \|pmid=6396498 }}</ref> PHMB has a long history of use as a [[contact lens]] cleanser, [[mouthwash]] and more recently in wound care.

	It is regarded as being quite safe to use as it has been incorporated as a [[preservative]] in [[cosmetics]].<ref>{{cite journal \|vauthors=Schnuch A, Geier J, Uter W, Basketter DA, Jowsey IR \|year=2007 \|title=The biocide polyhexamethylene biguanide remains an uncommon contact allerge \|journal=Contact Dermatitis \|volume=56 \|issue=4 \|pages=235–39 \|doi=10.1111/j.1600-0536.2007.01089.x\|pmid=17343627 \|s2cid=25660466 }}</ref> A retrospective analysis of wound cleanser clinical efficacy and cost-effectiveness ~~focussed~~ on ~~Polyhexamethylene~~ biguanide solution, [[Ringer’s solution\|Ringer's solution]] or saline in 112 [[Venous ulcer\|venous leg ulcer]] patients.<ref name=Andriessen>{{cite journal \|vauthors=Andriessen AE, Eberlein T \|year=2008 \|title=Assessment of a wound cleansing solution in the treatment of problem wounds \|journal=Wounds \|volume=20 \|issue=6 \|pages=229–36 }}</ref> The study group received the ~~Polyhexamethylene~~ biguanide solution (n=59) and the control group received either [[Ringer’s solution\|Ringer's solution]] or saline (n=53). In both arms, [[ulcer]] healing patterns were evaluated. Within the first 3 months of treatment, a shorter [[time]] to healing was recorded in the study group when compared with the [[control group]] - 60% v. 28% with corresponding [[mean]] [[time]] to healing being 3.31 months (study group) compared to 4.42 months (control group) p= <0.0001. More patients in the ~~Polyhexamethylene~~ biguanide group healed in the 6-month period when compared with the controls - 97% v. 89%. The authors concluded that optimization of the local wound environment was significantly influenced through cleansing with polyhexanide solution.		It is regarded as being quite safe to use as it has been incorporated as a [[preservative]] in [[cosmetics]].<ref>{{cite journal \|vauthors=Schnuch A, Geier J, Uter W, Basketter DA, Jowsey IR \|year=2007 \|title=The biocide polyhexamethylene biguanide remains an uncommon contact allerge \|journal=Contact Dermatitis \|volume=56 \|issue=4 \|pages=235–39 \|doi=10.1111/j.1600-0536.2007.01089.x\|pmid=17343627 \|s2cid=25660466 }}</ref> A retrospective analysis of wound cleanser clinical efficacy and cost-effectiveness focused on polyhexamethylene biguanide solution, [[Ringer’s solution\|Ringer's solution]] or saline in 112 [[Venous ulcer\|venous leg ulcer]] patients.<ref name=Andriessen>{{cite journal \|vauthors=Andriessen AE, Eberlein T \|year=2008 \|title=Assessment of a wound cleansing solution in the treatment of problem wounds \|journal=Wounds \|volume=20 \|issue=6 \|pages=229–36 }}</ref> The study group received the polyhexamethylene biguanide solution (n=59) and the control group received either [[Ringer’s solution\|Ringer's solution]] or saline (n=53). In both arms, [[ulcer]] healing patterns were evaluated. Within the first 3 months of treatment, a shorter [[time]] to healing was recorded in the study group when compared with the [[control group]] - 60% v. 28% with corresponding [[mean]] [[time]] to healing being 3.31 months (study group) compared to 4.42 months (control group) p= <0.0001. More patients in the polyhexamethylene biguanide group healed in the 6-month period when compared with the controls - 97% v. 89%. The authors concluded that optimization of the local wound environment was significantly influenced through cleansing with polyhexanide solution.

	In an in vitro model developed to compare the efficiency of wound-rinsing solutions, Kaehn ''et al.'' compared four sterile wound-cleansing solutions (saline, [[Ringer's solution]], Prontosan® and Octenisept®) using a wound coating model consisting of slides containing dried [[blood plasma]] or [[fibrin]].<ref>{{cite journal \|author=Kaehn K \|year=2009 \|title=An in-vitro model for comparing the efficiency of wound-rinsing solutions \|journal=Journal of Wound Care \|volume=18 \|issue=6 \|pages=229–36 \|doi=10.12968/jowc.2009.18.6.42800 \|pmid=19661846 }}</ref> The concentration of dissolved proteins was measured and the findings indicate that a surfactant containing solution (polyhexamethylene biguanide with [[betaine]]) (Prontosan®) was more effective than [[Saline (medicine)\|saline]] in removing the [[protein]] (adhered dried plasma or fibrin). The proteins in the [[antiseptic]] solution (Octenisept®) were [[Denaturation (biochemistry)\|denatured]] and became insoluble. The authors suggest this implies that the antiseptic solution is unsuitable as a 'general' wound cleanser and that its use should be restricted to infected wounds.		In an in vitro model developed to compare the efficiency of wound-rinsing solutions, Kaehn ''et al.'' compared four sterile wound-cleansing solutions (saline, [[Ringer's solution]], Prontosan® and Octenisept®) using a wound coating model consisting of slides containing dried [[blood plasma]] or [[fibrin]].<ref>{{cite journal \|author=Kaehn K \|year=2009 \|title=An in-vitro model for comparing the efficiency of wound-rinsing solutions \|journal=Journal of Wound Care \|volume=18 \|issue=6 \|pages=229–36 \|doi=10.12968/jowc.2009.18.6.42800 \|pmid=19661846 }}</ref> The concentration of dissolved proteins was measured and the findings indicate that a surfactant containing solution (polyhexamethylene biguanide with [[betaine]]) (Prontosan®) was more effective than [[Saline (medicine)\|saline]] in removing the [[protein]] (adhered dried plasma or fibrin). The proteins in the [[antiseptic]] solution (Octenisept®) were [[Denaturation (biochemistry)\|denatured]] and became insoluble. The authors suggest this implies that the antiseptic solution is unsuitable as a 'general' wound cleanser and that its use should be restricted to infected wounds.

← Older revision		Revision as of 04:40, 29 September 2026
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	~~{{Short description\|Medical treatment approach}}~~
	~~{{Multiple issues\|{{Original research\|date= October 2017}}~~
	~~{{essay-like\|date=June 2011}}~~
	~~{{More science citations needed\|date=September 2018}}}}~~
	'''Wound bed preparation''' ('''WBP''') is a systematic approach to wound management by identifying and removing barriers to healing. The concept was originally developed in plastic surgery.<ref>{{Citation\|author=Montandon, Denys\|year=1977\|title=Symposium on Wound Healing\|series=Volume 4, Issue 3 of Clinics in plastic surgery: an international quarterly\|publisher=W. B. Saunders Company\|location=Philadelphia, Pennsylvania}}</ref><ref>{{Citation\|author1=Robinson, J. B. \|author2=Friedman, R. M.\|year=1996\|title=Wound Healing and Closure\|journal=Selected Readings in Plastic Surgery\|volume=8\|issue=1}}</ref> It includes [[wound assessment]], [[debridement]], [[moisture balance]], [[bacterial balance]], and [[wound cleaning]].		'''Wound bed preparation''' ('''WBP''') is a systematic approach to wound management by identifying and removing barriers to healing. The concept was originally developed in plastic surgery.<ref>{{Citation\|author=Montandon, Denys\|year=1977\|title=Symposium on Wound Healing\|series=Volume 4, Issue 3 of Clinics in plastic surgery: an international quarterly\|publisher=W. B. Saunders Company\|location=Philadelphia, Pennsylvania}}</ref><ref>{{Citation\|author1=Robinson, J. B. \|author2=Friedman, R. M.\|year=1996\|title=Wound Healing and Closure\|journal=Selected Readings in Plastic Surgery\|volume=8\|issue=1}}</ref> It includes [[wound assessment]], [[debridement]], [[moisture balance]], [[bacterial balance]], and [[wound cleaning]].

← Older revision		Revision as of 19:49, 28 September 2026
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	{{Short description\|Medical treatment approach}}		{{Short description\|Medical treatment approach}}
	~~<!-- Please do not remove or change this AfD message until the discussion has been closed. -->~~
	~~{{Article for deletion/dated\|page=Wound bed preparation\|timestamp=20260906201932\|year=2026\|month=September\|day=6\|substed=yes\|help=off\|outcome=draftification}}~~
	~~<!-- Once discussion is closed, please place on talk page: {{Old AfD multi\|page=Wound bed preparation\|date=6 September 2026\|result='''keep'''}} -->~~
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	{{Multiple issues\|{{Original research\|date= October 2017}}		{{Multiple issues\|{{Original research\|date= October 2017}}
	{{essay-like\|date=June 2011}}		{{essay-like\|date=June 2011}}

← Older revision		Revision as of 20:19, 6 September 2026
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	{{Short description\|Medical treatment approach}}		{{Short description\|Medical treatment approach}}
			<!-- Please do not remove or change this AfD message until the discussion has been closed. -->
			{{Article for deletion/dated\|page=Wound bed preparation\|timestamp=20260906201932\|year=2026\|month=September\|day=6\|substed=yes\|help=off\|outcome=draftification}}
			<!-- Once discussion is closed, please place on talk page: {{Old AfD multi\|page=Wound bed preparation\|date=6 September 2026\|result='''keep'''}} -->
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	{{Multiple issues\|{{Original research\|date= October 2017}}		{{Multiple issues\|{{Original research\|date= October 2017}}
	{{essay-like\|date=June 2011}}		{{essay-like\|date=June 2011}}

← Older revision		Revision as of 15:11, 31 August 2025
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	{{Multiple issues\|{{Original research\|date= October 2017}}		{{Multiple issues\|{{Original research\|date= October 2017}}
	{{essay-like\|date=June 2011}}		{{essay-like\|date=June 2011}}

← Older revision		Revision as of 02:30, 6 December 2024
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	* revitalised tissue ([[Sloughing\|slough]] and [[necrosis]]) is present.		* revitalised tissue ([[Sloughing\|slough]] and [[necrosis]]) is present.

	Wound cleansing is often undertaken as a ritual exercise rather than as an evidence-based activity. However, it has a role to play in all four domains of the WBP model. Wounds that are 'clean' and progressing do not require extraneous cleansing.<ref>{{cite book \|last1=Williams \|~~first~~=C \|last2=Young \|first2=T \|title=Myth and Reality in Wound Care \|year=1998 \|publisher=Quay Books \|location=Dinton, Wilts}}</ref>		Wound cleansing is often undertaken as a ritual exercise rather than as an evidence-based activity. However, it has a role to play in all four domains of the WBP model. Wounds that are 'clean' and progressing do not require extraneous cleansing.<ref>{{cite book \|last1=Williams \|first1=C \|last2=Young \|first2=T \|title=Myth and Reality in Wound Care \|year=1998 \|publisher=Quay Books \|location=Dinton, Wilts}}</ref>

	=== Criteria for a cleansing agent ===		=== Criteria for a cleansing agent ===
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	[[Polyhexamethylene biguanide hydrochloride]] is a fast-acting, broad-spectrum synthetic compound that binds to the [[cell envelope]] of both [[Gram-positive bacteria\|Gram-positive]] and [[Gram-negative bacteria]], disrupting the bacterial [[cell membrane]] and enabling seepage of ions.<ref>{{cite journal \|vauthors=Broxton P, Woodcock PM, Gilbert P \|year=1983 \|title=A study of the antibacterial activity of some polyhexamethylene biguanides towards Escherichia coli ATCC 8739 \|journal=Journal of Applied Bacteriology \|volume=54 \|issue=3 \|pages=345–53 \|doi=10.1111/j.1365-2672.1983.tb02627.x\|pmid=6348014 }}</ref><ref>{{cite journal \|vauthors=Broxton P, Woodcock PM, Gilbert P \|year=1984 \|title=Binding of some polyhexamethylene biguanides to the cell envelope of Escherichia coli ATCC 8739 \|journal=Microbios \|volume=41 \|issue=163 \|pages=15–22 \|pmid=6396498 }}</ref> PHMB has a long history of use as a [[contact lens]] cleanser, [[mouthwash]] and more recently in wound care.		[[Polyhexamethylene biguanide hydrochloride]] is a fast-acting, broad-spectrum synthetic compound that binds to the [[cell envelope]] of both [[Gram-positive bacteria\|Gram-positive]] and [[Gram-negative bacteria]], disrupting the bacterial [[cell membrane]] and enabling seepage of ions.<ref>{{cite journal \|vauthors=Broxton P, Woodcock PM, Gilbert P \|year=1983 \|title=A study of the antibacterial activity of some polyhexamethylene biguanides towards Escherichia coli ATCC 8739 \|journal=Journal of Applied Bacteriology \|volume=54 \|issue=3 \|pages=345–53 \|doi=10.1111/j.1365-2672.1983.tb02627.x\|pmid=6348014 }}</ref><ref>{{cite journal \|vauthors=Broxton P, Woodcock PM, Gilbert P \|year=1984 \|title=Binding of some polyhexamethylene biguanides to the cell envelope of Escherichia coli ATCC 8739 \|journal=Microbios \|volume=41 \|issue=163 \|pages=15–22 \|pmid=6396498 }}</ref> PHMB has a long history of use as a [[contact lens]] cleanser, [[mouthwash]] and more recently in wound care.

	It is regarded as being quite safe to use as it has been incorporated as a [[preservative]] in [[cosmetics]].<ref>{{cite journal \|vauthors=Schnuch A, Geier J, Uter W, Basketter DA, Jowsey IR \|year=2007 \|title=The biocide polyhexamethylene biguanide remains an uncommon contact allerge \|journal=Contact Dermatitis \|volume=56 \|issue=4 \|pages=235–39 \|doi=10.1111/j.1600-0536.2007.01089.x\|pmid=17343627 \|s2cid=25660466 }}</ref> A retrospective analysis of wound cleanser clinical efficacy and cost-effectiveness focused on polyhexamethylene biguanide solution, [[Ringer’s solution\|Ringer's solution]] or saline in 112 [[Venous ulcer\|venous leg ulcer]] patients.<ref name=Andriessen>{{cite journal \|vauthors=Andriessen AE, Eberlein T \|year=2008 \|title=Assessment of a wound cleansing solution in the treatment of problem wounds \|journal=Wounds \|volume=20 \|issue=6 \|pages=229–36 }}</ref> The study group received the polyhexamethylene biguanide solution (n=59) and the control group received either [[Ringer’s solution\|Ringer's solution]] or saline (n=53). In both arms, [[ulcer]] healing patterns were evaluated. Within the first 3 months of treatment, a shorter [[time]] to healing was recorded in the study group when compared with the [[control group]] - 60% v. 28% with corresponding [[mean]] [[time]] to healing being 3.31 months (study group) compared to 4.42 months (control group) p= <0.0001. More patients in the polyhexamethylene biguanide group healed in the 6-month period when compared with the controls - 97% v. 89%. The authors concluded that optimization of the local wound environment was significantly influenced through cleansing with polyhexanide solution.		It is regarded as being quite safe to use as it has been incorporated as a [[preservative]] in [[cosmetics]].<ref>{{cite journal \|vauthors=Schnuch A, Geier J, Uter W, Basketter DA, Jowsey IR \|year=2007 \|title=The biocide polyhexamethylene biguanide remains an uncommon contact allerge \|journal=Contact Dermatitis \|volume=56 \|issue=4 \|pages=235–39 \|doi=10.1111/j.1600-0536.2007.01089.x\|pmid=17343627 \|s2cid=25660466 }}</ref> A retrospective analysis of wound cleanser clinical efficacy and cost-effectiveness focused on polyhexamethylene biguanide solution, [[Ringer’s solution\|Ringer's solution]] or saline in 112 [[Venous ulcer\|venous leg ulcer]] patients.<ref name=Andriessen>{{cite journal \|vauthors=Andriessen AE, Eberlein T \|year=2008 \|title=Assessment of a wound cleansing solution in the treatment of problem wounds \|journal=Wounds \|volume=20 \|issue=6 \|pages=229–36 \|pmid=25942522 }}</ref> The study group received the polyhexamethylene biguanide solution (n=59) and the control group received either [[Ringer’s solution\|Ringer's solution]] or saline (n=53). In both arms, [[ulcer]] healing patterns were evaluated. Within the first 3 months of treatment, a shorter [[time]] to healing was recorded in the study group when compared with the [[control group]] - 60% v. 28% with corresponding [[mean]] [[time]] to healing being 3.31 months (study group) compared to 4.42 months (control group) p= <0.0001. More patients in the polyhexamethylene biguanide group healed in the 6-month period when compared with the controls - 97% v. 89%. The authors concluded that optimization of the local wound environment was significantly influenced through cleansing with polyhexanide solution.

	In an in vitro model developed to compare the efficiency of wound-rinsing solutions, Kaehn ''et al.'' compared four sterile wound-cleansing solutions (saline, [[Ringer's solution]], Prontosan® and Octenisept®) using a wound coating model consisting of slides containing dried [[blood plasma]] or [[fibrin]].<ref>{{cite journal \|author=Kaehn K \|year=2009 \|title=An in-vitro model for comparing the efficiency of wound-rinsing solutions \|journal=Journal of Wound Care \|volume=18 \|issue=6 \|pages=229–36 \|doi=10.12968/jowc.2009.18.6.42800 \|pmid=19661846 }}</ref> The concentration of dissolved proteins was measured and the findings indicate that a surfactant containing solution (polyhexamethylene biguanide with [[betaine]]) (Prontosan®) was more effective than [[Saline (medicine)\|saline]] in removing the [[protein]] (adhered dried plasma or fibrin). The proteins in the [[antiseptic]] solution (Octenisept®) were [[Denaturation (biochemistry)\|denatured]] and became insoluble. The authors suggest this implies that the antiseptic solution is unsuitable as a 'general' wound cleanser and that its use should be restricted to infected wounds.		In an in vitro model developed to compare the efficiency of wound-rinsing solutions, Kaehn ''et al.'' compared four sterile wound-cleansing solutions (saline, [[Ringer's solution]], Prontosan® and Octenisept®) using a wound coating model consisting of slides containing dried [[blood plasma]] or [[fibrin]].<ref>{{cite journal \|author=Kaehn K \|year=2009 \|title=An in-vitro model for comparing the efficiency of wound-rinsing solutions \|journal=Journal of Wound Care \|volume=18 \|issue=6 \|pages=229–36 \|doi=10.12968/jowc.2009.18.6.42800 \|pmid=19661846 }}</ref> The concentration of dissolved proteins was measured and the findings indicate that a surfactant containing solution (polyhexamethylene biguanide with [[betaine]]) (Prontosan®) was more effective than [[Saline (medicine)\|saline]] in removing the [[protein]] (adhered dried plasma or fibrin). The proteins in the [[antiseptic]] solution (Octenisept®) were [[Denaturation (biochemistry)\|denatured]] and became insoluble. The authors suggest this implies that the antiseptic solution is unsuitable as a 'general' wound cleanser and that its use should be restricted to infected wounds.