Efficacy of hypochlorous acid solution in comparison with povidone iodine solution for the management of infected diabetic foot ulcers.

BACKGROUND: For infected diabetic foot ulcers (DFUs), a standard management procedure includes wound bed preparation via debridement and cleansing using an effective and safe antiseptic solution. The objective of this study was to evaluate and compare the antimicrobial and wound-healing effects of hypochlorous acid (HOCl) with povidone iodine (PVP-I) for managing infected DFUs. METHODS: This study was conducted on (57) mildly-to-moderately infected DFU patients; divided into group A (n = 29) and group B (n = 28) receiving HOCl (0.02%) and PVP-I (10%), respectively, as cleansing and dressings solution and evaluated on day 14 and 30 of management for the percent of isolated bacterial strains, reduction in mean ulcer area, percent of patients according to the wound bed preparation (WBP) score system, and C-reactive protein (CRP) level. RESULTS: The percentage of isolated bacterial strains revealed that HOCl was more effective than PVP-I against Gram-negative bacteria (P < 0.05), but HOCl and PVP-I showed the same activity against Gram-positive bacteria (P > 0.05). The percent of patients according to the WBP score and mean ulcer area in groups A and B were significantly different (P < 0.05). On day 14 of management, a moderate association between CRP level (>10 mg/L) or (<10 mg/L) and positive or negative microbiological culture results (phi = 0.367) was observed, and the baseline cut-off value of CRP level for positive microbiological cultures was >10 mg/L. CONCLUSION: According to the current study results regarding microbiological culture, mean ulcer area, and percent of granulation tissue; HOCl showed superior antimicrobial activity compared with that of PVP-I, resulting in accelerated wound healing.