Synergistic effect of two formulations of hypochlorous acid in the treatment of 346 chronic ulcers

Abstract

Our objective was to assess the efficacy of two successive applications of hypochlorous acid, first as a liquid and then as a gel because liquid hypochlorous acid is effective but has little residual effect, while the gel form has more residual power, and compare it with that of other products. An experimental non-randomised study was carried out, treating 346 chronic ulcers in 220 patients. The antiseptic treatment has been divided into ‘hypochlorous acid’ (Clortech), ‘hypochlorous acid liquid + gel’ (Clortech + Microdacyn60R-hydrogel) and ‘Others’ (Prontosan or Chlorhexidine or Microdacyn60R-hydrogel). Bivariate and multivariate studies analysed the characteristics of the patients and their ulcers, including size, symptoms, signs, treatments received and their duration, and so on. The ulcers were complicated, of long evolution, and most had a vascular origin. On average, antiseptic treatment lasted 14 weeks. At the time of their discharge, or last treatment in the clinics, 59% of the ulcers had healed completely, 9.5% worsened, and 6.9% had become infected during this period. In the bivariate and multivariate studies, we took as reference the ‘others’ treatments that showed no significant differences in healing time or infection rates compared with liquid hypochlorous acid 100–500 mg/L alone. However, hypochlorous acid liquid + gel showed a synergistic effect, with a higher probability of achieving complete healing (four times) and a lower probability of infection (a fifth), compared to the ‘other’ antiseptics. In conclusion, a synergistic effect was found with the successive application of hypochlorous acid in liquid followed by gel, an effect that increased healing probability and decreased the risk of the ulcer becoming infected.