You are here

  • Home
  • Online First
  • Analysis of povidone iodine, chlorhexidine acetate and polyhexamethylene biguanide as wound disinfectants: in vitro cytotoxicity and antibacterial activity

Article Text

Article menu

other Versions

Original research
Analysis of povidone iodine, chlorhexidine acetate and polyhexamethylene biguanide as wound disinfectants: in vitro cytotoxicity and antibacterial activity
  1. Mingshi Zhang1,
  2. Jian Jin2,3,
  3. Yingying Liu4,
  4. Chi Ben4,
  5. Haihang Li4,
  6. Dasheng Cheng4,
  7. Yu Sun4,
  8. Wang Guang-Yi5 and
  9. Shihui Zhu4
  1. 1Department of Burns, Wenzhou Medical University, Wenzhou, Zhejiang, China
  2. 2Department of Polymer Science, Fudan University, Shanghai, China
  3. 3Shanghai Depeac Biotechnology Co., Ltd, Shanghai, China
  4. 4Department of Burns, Naval Medical University, Yangpu, Shanghai, China
  5. 5Department of Burns, Changhai Hospital, Yangpu, Shanghai, China
  1. Correspondence to Dr Shihui Zhu; doctorzhushihui{at}163.com

Abstract

Objectives Even though disinfectants are commonly used in clinical practice and daily life, there are few studies on their antibacterial ability and cytotoxicity, which are closely related to the safety and effectiveness of their use. To provide a basis for the use of disinfectants, the cytotoxicity and antibacterial activity of three most commonly used disinfectants, povidone-iodine, chlorhexidine acetate and polyhexamethylene biguanide (PHMB), were investigated.

Design A CCK-8 assay was used to measure the activities of human fibroblasts (HF) and keratinocytes (HaCat), the two most important cells in wound healing, following their exposure to disinfectants. The effects of different times and concentrations were included. The antibacterial activity of disinfectants against Staphylococcus aureus, Acinetobacter baumannii, Klebsiella pneumoniae was reflected by their minimum inhibitory concentration and minimum bactericidal concentration.

Results All three disinfectants showed strong cytotoxicity in direct contact with HF and HaCat cells. Cytotoxicity increased with increasing exposure time and concentration. S. aureus, A. baumannii and K. pneumoniae comprised 70%, 55% and 85% of the strains sensitive to povidone iodine; 50%, 45% and 80% of the strains sensitive to chlorhexidine acetate; and 60%, 45% and 80% of the strains sensitive to PHMB, respectively.

Conclusions All three disinfectants were cytotoxic; therefore, it is necessary to pay attention to the use time and concentration in the clinical setting. All three disinfectants were cytotoxic, with povidone-iodine being the most cytotoxic even at low concentrations. PHMB had better antibacterial efficacy against S. aureus and is suitable for the treatment of shallow wounds primarily. All three tested bacteria were significantly more sensitive to PHMB than to the other disinfectants.

  • Infectious disease
  • Skin disorders

Data availability statement

All data relevant to the study are included in the article or uploaded as online supplemental information. Data can be accessed through jinjiannavy@163.com.

https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/bmjnph-2022-000431

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    All data relevant to the study are included in the article or uploaded as online supplemental information. Data can be accessed through jinjiannavy@163.com.

    View Full Text

    Supplementary materials

    • Supplementary Data

      This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

    Footnotes

    • MZ, JJ and YL contributed equally.

    • Contributors MZ: design experiment, cell experiment, data analysis, article writing; JJ: guarantor, design experiment, cell experiment, bacterial experiment, data analysis; YL: cell experiment, bacterial experiment; CB: bacterial experiment; HL: bacterial experiment, data analysis; DC: bacterial experiment; YS: clinical guidance; WG-Y: design experiment, clinical guidance; SZ: design experiment, data analysis, article writing.

    • Funding We received funding from the following institutions: National Key R&D Program of China (2019YFA0110600, 2019YFA0110601, 2019YFA0110602, 2019YFA0110603); Medical and health science and technology project of Hangzhou (B20200432). Medical and health science and technology project of Zhejiang province (2022RC237). Science and technology action innovation plan of Shanghai(21SQBS00400). Special policy for science and technology park around Shanghai University (2021-HSD-8-1-004).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed by Kiarash Ghazvini, United Kingdom of Great Britain and Northern Ireland.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.