Dakin's Solution in the Treatment of Severe Diabetic Foot Infections

• Autor(a) principal: Duarte, B
• Data de Publicação: 2020
• Outros Autores: Formiga, A, Neves, J
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.17/4045
• topic: HSAC DER; HCC CIR; Adult; Aged; Administration, Topical; Female; Aged, 80 and over; Middle Aged; Male; Diabetic Foot / complications*; Diabetic Foot / drug therapy; Disinfectants / therapeutic use; Humans; Follow-Up Studies; Limb Salvage / methods*; Retrospective Studies; Severity of Illness Index; Sodium Hypochlorite / therapeutic use*; Treatment Outcome; Wound Healing / drug effects*; Wound Infection / diagnosis; Wound Infection / drug therapy*; Wound Infection / etiology

Acute necrotising diabetic foot (DF) infections are common, costly, and do not infrequently result in debilitating major lower-extremity amputations. Dakin's solution is a long-standing topical antiseptic that has shown benefit in this clinical setting, but its use is undermined by a presumed risk of cytotoxicity. In this single-centre case series, we retrospectively evaluated 24 patients with severe necrotising DF infections treated with a cyclical instillation of Dakin's solution at a referral multidisciplinary DF unit. Most patients achieved favourable outcomes in infection control and limb salvage, with only one patient (4.2%) requiring a major (at or above-the-ankle) amputation. The mean time to complete or near-complete wound granulation was 5.4 weeks. Of the 12 patients who completed 12 or more months of longitudinal follow up, only 2 (12.2%) had a wound recurrence. In this severe DF infection patient cohort, Dakin's solution led to a clinically meaningful improvement. No remarkable impairment in the wound-healing process was observed.