Microdacyn for wound cleansing

Severe leg ulcers, pressure ulcers and diabetic foot cause great suffering for the affected and is associated with a large cost for the healthcare system. These wounds are difficult to treat and there is no consensus on best treatment. Microdacyn, formerly Dermacyn, is marketed as "an effective agent for the care and healing of chronic wounds, diabetic foot, burns, eye infection, viruses and fungi." and is approved as a Class IIB medical device product.

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SBU Enquiry Service

Consists of structured literature searches to highlight studies that can address questions received by the SBU Enquiry Service from Swedish healthcare or social service providers. We assess the risk of bias in systematic reviews and when needed also quality and transferability of results in health economic studies. Relevant references are compiled by an SBU staff member, in consultation with an external expert when needed.

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Published: Report no: ut202029 Registration no: SBU 2020/177

Question

What scientific studies are there on Microdacyn and Dermacyn for wound treatment?

Identified literature

Table 1. Systematic reviews with low/medium risk of bias.

Included studies Population/Intervention Outcome
Norman et al, 2017 [1]
Inclusion criteria: Published and unpublished randomised controlled trails (RCTs). Studies using quasi-randomisation were excluded.

Included studies: Search resulted in 629 unique records. 59 were included in the qualitative synthesis and 50 were included in the meta-analysis. Only 1 of the included studies tested super-oxidised water (Dermacyn)		 Population: All patients (both adults and children) undergoing elective or emergency surgery where (1) an incision is being made to form an open wound; or (2) an operative procedure to treat an existing wound.

Intervention: Intraoperative washout, either wound irrigation or intracavity lavage.		 Primary outcomes: Surgical site infection (SSI).
Wound dehiscence (wound reopening) within 30 days of operation.

Secondary outcomes:
30-day mortality
Use of systemic antibiotics
Infections that show antibiotic resistance
Adverse events
Surgical re‐intervention rates
Mean length of hospital stay
Hospital readmissions.
Authors' conclusion:
“There may be more infections in wounds irrigated with povidone iodine compared with Dermacyn. The RR for Mohd 2010 was 2.80 (95% CI, 1.05 to 7.47; 190 participants). This would represent an absolute difference of 95 more SSIs per 1000 people treated with povidone iodine than with superoxidised water (95% CI, 3 more to 341 more). This was low‐certainty evidence downgraded once for risk of bias and once for imprecision.”

References

Norman G, Atkinson RA, Smith TA, Rowlands C, Rithalia AD, Crosbie EJ, et al. Intracavity lavage and wound irrigation for prevention of surgical site infection. Cochrane Database Syst Rev 2017;10:Cd012234.

Literature search

PubMed via NLM 2020-04-15 
Microdacyn for wound cleansing
The search result, usually found at the end of the documentation, forms the list of abstracts.; [MeSH] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; [MeSH:NoExp] = Does not include terms found below this term in the MeSH hierarchy; [MAJR] = MeSH Major Topic; [TIAB] = Title or abstract; [TI] = Title; [AU] = Author; [TW] = Text Word; Systematic[SB] = Filter for retrieving systematic reviews; * = Truncation
Search terms Items found
Final microdacyn[All Fields] OR dermacyn[All Fields] OR microcyn[All Fields] 21

 

Cochrane Library via Wiley 2020-04-15 
Microdacyn for wound cleansing
The search result, usually found at the end of the documentation, forms the list of abstracts.; au = Author; MeSH = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; this term only = Does not include terms found below this term in the MeSH hierarchy; :ti = Title; :ab = Abstract; :kw = Keyword; * = Truncation; “ “ = Citation Marks; searches for an exact phrase; CDSR = Cochrane Database of Systematic Review; CENTRAL = Cochrane Central Register of Controlled Trials, “trials”; CRM = Method Studies; DARE = Database Abstracts of Reviews of Effects, “other reviews”; EED = Economic Evaluations; HTA = Health Technology Assessments
Search terms Items found
Final (microdacyn):ti,ab,kw OR (dermacyn):ti,ab,kw OR (microcyn):ti,ab,kw CDSR/1
CENTRAL/16

 

KSR Evidence 2020-04-14 
Microdacyn for wound cleansing
Search terms Items found
Final Microdacyn in All text OR Dermacyn in All text OR Microcyn in All text 1

 

Epistemonikos 2020-04-14 
Microdacyn for wound cleansing
Search terms Items found
Final Microdacyn in All text OR Dermacyn in All text OR Microcyn in All text 1

 

Embase via embase.com 2020-04-15 
Microdacyn for wound cleansing
/de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti,ab = Title or abstract; * = Truncation; ’ ’ = Citation Marks; searches for an exact phrase
Search terms Items found
Final microdacyn OR dermacyn OR microcyn 40

 

Cinahl via ebsco.com 2020-03-23 
Microdacyn for wound cleansing
The search result, usually found at the end of the documentation, forms the list of abstracts.; AB = Abstract; AU = Author; DE = Term from the thesaurus; MM = Major Concept; TI = Title; TX = All Text. Performs a keyword search of all the database's searchable fields; ZC = Methodology Index; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search terms Items found
Final TX microcyn OR TX dermacyn OR TX microcyn 36

 

PubMed via NLM 2020-03-18 
Microdacyn for wound cleansing
The search result, usually found at the end of the documentation, forms the list of abstracts; [MeSH] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; [MeSH:NoExp] = Does not include terms found below this term in the MeSH hierarchy; [MAJR] = MeSH Major Topic; [TIAB] = Title or abstract; [TI] = Title; [AU] = Author; [TW] = Text Word; Systematic[SB] = Filter for retrieving systematic reviews; * = Truncation
Search terms Items found
Population:
1. ((((("wound"[Title/Abstract] AND ("healing"[Title/Abstract] OR "infection"[Title/Abstract])) OR "Wound Infection"[MeSH Terms]) OR "Wound Healing"[MeSH Terms]) OR "Ulcer"[Title/Abstract]) OR "Ulcer"[MeSH Terms]) OR "Diabetic Foot"[MeSH Terms] 320 589
Intervention:
2. ((((((((((("Hypochlorous Acid"[MeSH Terms] OR "Sodium Hypochlorite"[MeSH Terms]) OR ("Microcyn"[Title/Abstract] AND "technology"[Title/Abstract])) OR "super-oxidized"[Title/Abstract]) OR "superoxidized"[Title/Abstract]) OR "super oxidized"[Title/Abstract]) OR "super-oxidised"[Title/Abstract]) OR "superoxidised"[Title/Abstract]) OR "super-oxidised"[Title/Abstract]) OR "Hypochlorous Acid"[Title/Abstract]) OR "Sodium Hypochlorite"[Title/Abstract]) OR "Dermacyn"[Title/Abstract]) 10 774
Final 1 AND 2 247

 

Cochrane Library via Wiley 2020-03-18 
Microdacyn for wound cleansing
The search result, usually found at the end of the documentation, forms the list of abstracts.; au = Author; MeSH = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; this term only = Does not include terms found below this term in the MeSH hierarchy; :ti = Title; :ab = Abstract; :kw = Keyword; * = Truncation; “ “ = Citation Marks; searches for an exact phrase; CDSR = Cochrane Database of Systematic Review; CENTRAL = Cochrane Central Register of Controlled Trials, “trials”; CRM = Method Studies; DARE = Database Abstracts of Reviews of Effects, “other reviews”; EED = Economic Evaluations; HTA = Health Technology Assessments
Search terms Items found
Population:
1. MeSH descriptor: [Wound Infection] explode all trees 456
2. MeSH descriptor: [Wound Healing] explode all trees 5 689
3. MeSH descriptor: [Ulcer] explode all trees 1 298
4. MeSH descriptor: [Diabetic Foot] explode all trees 936
5. ("wound healing"):ti,ab,kw 9 686
6. ("wound infection"):ti,ab,kw 7 061
7. (ulcer):ti,ab,kw 17 557
8. ("diabetic foot"):ti,ab,kw 2 407
9. #1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 33 268
Intervention:
10. MeSH descriptor: [Hypochlorous Acid] explode all trees 456
11. MeSH descriptor: [Sodium Hypochlorite] explode all trees 444
12. ("Microcyn technology"):ti,ab,kw OR (super-oxidized):ti,ab,kw OR (superoxidized):ti,ab,kw OR ("super oxidized"):ti,ab,kw OR (super-oxidised):ti,ab,kw 26
13. (superoxidised):ti,ab,kw OR ("super-oxidised"):ti,ab,kw OR ("Hypochlorous Acid"):ti,ab,kw OR ("Sodium Hypochlorite"):ti,ab,kw OR (Dermacyn):ti,ab,kw 715
14. (Microdacyn):ti,ab,kw 4
15. #10 OR #11 OR #12 OR #13 OR #14 735
Final 9 AND 15 CDSR/5
CENTRAL/51

 

KSR Evidence 2020-03-23 
Microdacyn for wound cleansing
Search terms Items found
Population:
1. "Wound Infection" in all text 715
2. "Wound Healing" in all text 641
3. Ulcer in all text 734
4. "Diabetic Foot" in all text 288
5. #1 OR #2 OR #3 OR #4 OR 1 961
Intervention:
6. "Microcyn technology" in all text 0
7. super-oxidized in all text 2
8. superoxidized in all text 1
9. "super oxidized" in all text 1
10. super-oxidised in all text 1
11. superoxidised in all text 1
12. super-oxidised in all text 1
13. “Hypochlorous Acid” in all text 0
14. "Sodium Hypochlorite" in all text 23
15. Dermacyn in all text 1
16. Microdacyn in all text 0
17. #6 OR #7 OR #8 OR #9 OR #10 OR #11 OR #12 OR #13 OR #14 OR #15 OR #16 28
Final #5 AND #17 5

 

Embase via embase.com 2020-03-23 
Microdacyn for wound cleansing
/de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti,ab = Title or abstract; * = Truncation; ’ ’ = Citation Marks; searches for an exact phrase
Search terms Items found
Population:
1. 'wound infection'/exp OR 'contaminated wound':ti,ab OR 'infection, wound':ti,ab OR 'wound contamination':ti,ab OR 'wound infection':ti,ab OR 'wound infections':ti,ab OR 'wound sepsis':ti,ab OR 'wound healing'/exp OR 'granulation, wound':ti,ab OR 'healing, wound':ti,ab OR 'repair, wound':ti,ab OR 'wound healing':ti,ab OR 'wound regeneration':ti,ab OR 'wound repair':ti,ab OR 'ulcer'/exp OR 'chronic ulcer':ti,ab OR 'coagulation ulcer':ti,ab OR 'stereoral ulcer':ti,ab OR 'ulcer':ti,ab OR 'ulceratio':ti,ab OR 'ulceration':ti,ab OR 'ulcus':ti,ab OR 'ulcus phagedaenicum':ti,ab OR 'venous ulcer':ti,ab OR 'diabetic foot'/exp OR 'diabetic foot':ti,ab OR 'foot ulcer, diabetic':ti,ab 527 322
Intervention:
2. 'hypochlorous acid'/exp OR 'hypochlorous acid':ti,ab OR 'hypochlorous acids':ti,ab OR 'hypochlorite sodium'/exp OR 'dakin solution':ti,ab OR 'antiformin':ti,ab OR 'chloros':ti,ab OR 'chlorox':ti,ab OR 'clorox':ti,ab OR 'dakin':ti,ab OR 'deosan':ti,ab OR 'eau de javel':ti,ab OR 'household bleach':ti,ab OR 'hypochlorite sodium':ti,ab OR 'hypochlorite sodium solution':ti,ab OR 'hypochlorite sodium solution, diluted':ti,ab OR 'hyposan':ti,ab OR 'javel water':ti,ab OR 'milton':ti,ab OR 'p3 n148':ti,ab OR 'sodium hypochlorite':ti,ab OR 'sodium hypochlorite solution':ti,ab OR 'voxsan':ti,ab OR 'super oxidized':ti,ab OR 'superoxidized water'/exp OR superoxidized:ti,ab OR dermacyn:ti,ab OR microdacyn:ti,ab OR microcyn:ti,ab 13 221
Study types:
3. 1 AND 2 483
Final #3 AND ('evidence based medicine'/de OR 'evidence based practice'/de OR 'meta analysis'/de OR 'systematic review'/de) 27

 

Cinahl via ebsco.com 2020-03-23 
Microdacyn for wound cleansing
The search result, usually found at the end of the documentation, forms the list of abstracts.; AB = Abstract; AU = Author; DE = Term from the thesaurus; MM = Major Concept; TI = Title; TX = All Text. Performs a keyword search of all the database's searchable fields; ZC = Methodology Index; * = Truncation; “ “ = Citation Marks; searches for an exact phrase
Search terms Items found
Population:
1. (MH "Wound Infection+") OR (MH "Wound Healing+") OR (MH "Venous Ulcer") OR (MH "Heel Ulcer") OR (MH "Pressure Ulcer+") OR (MH "Foot Ulcer+") OR (MH "Skin Ulcer+") OR (MH "Leg Ulcer+") OR (MH "Diabetic Foot") 70 959
2. TI "wound infection" OR TI "wound healing" OR TI "venous ulcer" OR TI "heel ulcer" OR TI "pressure ulcer" OR TI "foot ulcer" OR TI "skin ulcer" OR TI "leg ulcer" OR TI "diabetic foot" 12 879
3. AB "wound infection" OR AB "wound healing" OR AB "venous ulcer" OR AB "heel ulcer" OR AB "pressure ulcer" OR AB "foot ulcer" OR AB "skin ulcer" OR AB "leg ulcer" OR AB "diabetic foot" 21 658
4. 1 OR 2 OR 3 78 691
Intervention:
5. (MH "Hypochlorous Acid+") OR (MH "Sodium Hypochlorite") 1 047
6. TI "Microcyn technology" OR TI super-oxidized OR TI superoxidized OR TI "super oxidized" OR TI super-oxidised OR TI superoxidised OR TI super-oxidised OR TI "Hypochlorous Acid" OR TI "Sodium Hypochlorite" OR TI Dermacyn OR TI Microdacyn 281
7. AB "Microcyn technology" OR AB super-oxidized OR AB superoxidized OR AB "super oxidized" OR AB super-oxidised OR AB superoxidised OR AB super-oxidised OR AB "Hypochlorous Acid" OR AB "Sodium Hypochlorite" OR AB Dermacyn OR AB Microdacyn 734
8. 5 OR 6 OR 7 1 408
Final 4 AND 8 95
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