Hypochlorous Acid Preserved Wound Cleanser (HAPWOC) soaked moist dressing management for chronic wounds; a case series.

Introduction: 2 critical components of the chronic wound milieu are biofilm and pH. Chronic wounds have a pH of 7.15-9 as compared to nominal skin pH of 5.5. Elevated chronic wound pH, biofilm and bacterial colonization impair closure. Targeting wound pH and associated biofilms could potentially provide a simplified and economic advantageous method to promote wound healing. Maintaining a moist wound environment is favorable. To maintain a moist wound bed, dressing changes typically must be changed twice per day. The cleansing or wound bed preparation (WBP) liquid used may be varied. The WBP liquid used in this study is an antimicrobial hypochlorous acid whose chemical formula is HOCl.Objective: This retrospective case series evaluated the efficacy of HAPWOC moistened BID dressings for wound etiologies including surgical (abdomen, orthopedic, vascular, breast), trauma, venous and diabetic ulcers. In the seven abdominal wounds, 4 originated from surgical procedures for malignant cases, 2 with chronic mesh exposure.Method: In this series of 22 patients, moist HAPWOC BID dressings were initiated at consult and continued thru last follow up (13 patients), wound closure (8 patients), or performance of skin grafting (1 patient). All patients were advised to use adjunctive micronutrients, Micronized Purified Flavonoid Fractions (MPFF), limb edema was managed with dynamic dermal microdeformation fuzzy wale compression and inelastic compression. Wound size was documented, debridement was performed as indicated. No adjunctive advanced dressings were utilized. Both in person clinic visits and telehealth care were utilized in the pandemic.Results: Eight patients had closed wounds within 3-5 visits (8-16 weeks), 11 patients had 2-7 visits with 40-98% progression to full granulation tissue. One patient underwent skin grafting after four weeks. No patient experienced adverse events. A detailed analysis of healing trajectory and notable cases are provided.Conclusions: This case series demonstrates that a moist HOCl preserved BID dressing regime can be effective in a wide variety of chronic wound types, can be performed in an efficient manner (as demonstrated by pandemic and telehealth conditions), with excellent outcomes. This strategy has the potential for a favorable economic impact; a prospective study is indicated with comparative cost determinations.