Evaluation of the tissue toxicity of antiseptics by the hen's egg test on the chorioallantoic membrane (HETCAM)
- Equal contributors
1 Department of General and Visceral Surgery, Klinikum Ludwigsburg, Germany
2 Department of Radio oncology, University Hospital Düsseldorf, Germany
3 Physiology and Biophysics, College of Medicine, University of California, Irvine, USA
4 Department of Surgery, University Hospital Düsseldorf, Germany
5 Institute for Hygiene and Biotechnology, Hohenstein Research Institutes, Boennigheim, Germany
6 Department of Dermatology, University Hospital Düsseldorf, Germany
7 Ludwig Boltzmann Institute for Experimental and Clinical Traumatology, Research Center AUVA, Austrian Cluster for Tissue Regeneration, Wien, Austria
8 Department of Surgery, Krankenhaus Hannover, Germany
European Journal of Medical Research 2010, 15:204-209 doi:10.1186/2047-783X-15-5-204Published: 18 May 2010
Antiseptics are frequently used for the prophylaxis and treatment of local infections of chronic wounds. Whereas local antiseptics in general have a positive effect on wound healing an uncritical use may impair wound healing due to toxic side effects.
We sought to assess the vascular irritation potential of different antiseptic solutions and ointments commonly used for short and long term application as a measure of tissue toxicity.
The vascular irritation was evaluated by the hen's egg test (HET) on the chorioallantoic membrane (CAM). The effects on the vessels of a mucous membrane were directly assessed by stereomicroscopic observation in vivo.
Severe CAM irritation was observed after short-term applications of 1% octenidin-2HCl (Octeni sept™), 72% isopropanol (Cutasept™), 0.35% chloroxylenol (Dettol™) and 10% PVP-I ointment (Betaisodona™). Medium irritations were observed for 10% PVP-I solution (Betaisodona™), 3% lysosomal PVP-I ointment (Repithel™), 1.8% cadexomer-iodine ointment (Iodosorb™) and 1% cadexomer-iodine pellets (Iodosorb™). Finally, slight irritations were observed for 1% PVP-I solution (Betaisodona™), 0.1% polyhexanid plus betain (Prontosan™) and 1% silver-sulfadiazine ointment (Flammazine™), whereas 0.04% polyhexanid solution (Lavanid™), washings from sterile maggots of Lucilia sericata and filtrated enzymes from Clostridium histolyticum (Iruxol-N™) showed no effects of irritation. In the long-term approaches, no vascular irritations were found for polyhexanid, washings from Lucilia sericata and enzyme filtrations from Clostridium histolyticum.
The vascular injuries caused by the studied antiseptics are an indirect indicator of their tissue toxicity. Strikingly, even therapeutic substances, which have been regarded as safe in their application for the treatment of chronic wounds in clinical studies, showed severe irritations on the CAM. We suggest that agents with no or low irritation potential on the CAM should be preferred in the clinical practice in order to obtain optimal results.