Valenzuela AR, Perucho NS. The effectiveness of a 0.1% polyhexanide gel. Revista de enfermeria (Barcelona, Spain) 2008; 31(4): 7‐12. In Vitro Evaluation of Polihexanide, Octenidine and NaClO/HClO-BasedAntiseptics against Biofilm Formed by Wound Pathogens Clinician perspective on time and resource related to dressing changes. Available at https://www.wounds-uk.com/journals/issue/506/article-details/clinician-perspectives-on-time-and-resources-related-to-dressing-changes [accessed Jan 2021] Durante et al. Evaluation of the effectiveness of a polyhexanide and propyl-betaine based gel in the treatment of chronic wounds. Minerva Chir 2014;69:283-92

Atkin et al, (2020) Wound bed preparation: a case series using polyhexanide and betaine solution and gel—a UK perspective Atkin L, Stephenson J, Cooper DM. Wound bed preparation: a case series using polyhexanide and betaine solution and gel—a UK perspective. Journal of Wound Care 2020; 29(7): 380-6. Milne J. Wound-bed preparation: the importance of rapid and effective desloughing to promote healing. British journal of nursing 2015; 24: S52-S8. Bellingeri A, Falciani F, Traspedini P, et al. Effect of a wound cleansing solution on wound bed preparation and inflammation in chronic wounds: a single-blind RCT. J Wound Care 2016; 25(3): 160, 2-6, 8.Guest JF, Fuller GW, Vowden P. Cohort study evaluating the burden of wounds to the UK’s National Health Service in 2017/2018: update from 2012/2013. BMJ Open 2020;10:e045253. doi:10.1136/bmjopen-2020-045253 Andriessen AE, Eberlein T. Assessment of a wound cleansing solution in the treatment of problem wounds. Wounds 2008; 20(6):171–175

Andriessen (2008) is a retrospective comparative case series of 112 patients with venous leg ulcers with a follow-up time of 6 months. The EAC considered that Andriessen 2008 was a suitable data source because of the larger number of patients and longer follow up. However, the study was at high risk of bias because of potential selection and reporting bias.Halim AS, Khoo TL, Mat Saad AZ. Wound bed preparation from a clinical perspective. Indian Journal of Plastic Surgery 2012; 45(2): 193-202 Harding (2012) is a small, unpublished, UK pilot randomised controlled trial with 34 patients. The shorter follow-up period of 12 weeks meant that there was greater reliance on extrapolation for the calculation of transition probabilities for wound healing. There were some concerns about the randomisation process. Parnham A, Bousfield C. The influence of matrix metalloproteases and biofilm on chronic wound healing: a discussion. British journal of community nursing 2018; 23: S22-S9. International Wound Infection Institute. Wound infection in clinical practice. Wounds International, 2016 Care of acute or chronic wounds aims to improve their condition, help with healing and minimise risk of complications. Usually, wounds are cleansed with saline or water.

Newton H, Edwards J, Mitchell L, Percival SL. Role of slough and biofilm in delaying healing in chronic wounds: The management of biofilms with maintenance desloughing and antimicrobial therapy is fast becoming the accepted treatment strategy for chronic wounds. British journal of nursing 2017; 20(S20a): S4-S11. Atkin L, Bućko Z, Montero EC, et al. Implementing TIMERS: the race against hard-to-heal wounds. Journal of Wound Care 2019; 28: S1-S50. Andriessen AE, Eberlein T. Assessment of a wound cleansing solution in the treatment of problem wounds. Wounds: A Compendium of Clinical Research & Practice 2008; 20(6): 171-5. Most of the evidence about Prontosan's effectiveness is not of good quality. It may speed up wound healing and reduce infections compared with saline in chronic wounds, but more evidence is needed to confirm this. There is very little evidence about using Prontosan for treating acute wounds. Murphy C, Atkin L, Swanson T, et al. Defying hard-to-heal wounds with an early antibiofilm intervention strategy: wound hygiene. Journal of Wound Care 2020; 29(Sup3b): S1-S26.Research should be a randomised controlled trial on the effectiveness of Prontosan compared with saline or water in chronic wounds of different types. Wounds should be followed up until completely healed, and time to healing should be measured. Find out more details in further research.