The Economical Use of Hocl Wound Cleanser and Hocl Hydrogel to Treat a Nonhealing Pyoderma Gangrenosum Lower-Leg Ulcer: A Patient Case Report

Introduction: Nonhealing wounds are estimated to cost the health-care system $31.2B annually. When health benefits are exhausted, patients are left to treat their wounds at home. This patient is a fragile, non-ambulatory, 86-year-old female with a 4-year-old, nonhealing wound that tested positive for pyoderma gangrenosum. The following comorbidities complicated the outcome: lupus, CHF, HTN, gout, and diabetes. Patient takes steroids daily and was unable to administer compression dressings. The patient self-treated with guidance from the author following 18 months of consistent home health care with no resolution and exhausted insurance benefits. Prior treatments include: Santyl, Medihoney, various silvers, alginates, Aquacel AG, Bactroban, and sharp debridement. Biofilm evidence was noted at the onset of treatment.

Method: Treatment consisted of cleansing the wound with a stable HOCl wound cleanser every day for the first 10 days. After that, it was used three times per week followed by spraying HOCl hydrogel liberally on the wound. A secondary absorbent dressing was applied over the hydrogel.

Discussion: Chronic wounds often contain biofilm that perpetuates the inflammatory phase of wound healing. Treatment with HOCl resulted in effective debridement and reduction in biofilm, which led to progressive wound healing. Hypochlorous acid (HOCl), even in trace amounts, has been shown to kill most pathogens within 30 seconds of exposure.

Research “supports stabilized HOCl solution as an ideal wound care solution with a powerful and rapid killing effect on different types of microorganisms, biofilms, and microbicidal effect within the biofilm. Foremost, it has dose-dependent favorable effects on fibroblast and keratinocyte migration.”

This 4-year-old, previously nonhealing wound healed within six months when more costly treatments used previously were not effective.

Conclusion: This case demonstrates a cost-effective solution for the treatment of nonhealing wounds with a proprietary stable HOCl wound cleanser and hydrogel. Further studies are needed to validate these findings.