Abstract
Introduction Antiseptic and antibacterial solutions are increasingly used in the treatment of various types of wounds. The successful stabilization of wounds using a combination Sodium Hypochlorite/Hypochlorous acid (NaOCl/HOCl) or superoxidized solution (SOS) has been reported, serving as an effective solution without irritating mammal cells and without posing a carcinogenic hazard. Presently, no systematic review or meta-analysis is available that compares the effectiveness of these antiseptic solutions. The present study aims to investigate the role of NaOCl/HOCl in the treatment of wounds. Methods The systematic review with extended to network meta-analysis (NMA) was conducted using NaOCl/HOCl, povidone-iodine, octenidine dihydrochloride, polyhexamethylene biguanide, alcohol, and silver compared with normal saline. The primary outcome was wound healing. Using surface under the cumulative ranking curve (SUCRA), the direct and indirect comparisons were conducted with the probability of selecting the best treatment. Results A total of 507 studies were identified from PUBMED and SCOPUS databases, and 64 articles were duplicates. Among 29 studies included, 22 randomized controlled trials (RCTs) and 7 cohort studies met our inclusion criteria. NaOCl/HOCl had a higher chance of wound healing 1.07-1.30 times compared with all the regimens. NaOCl/HOCl has the probability of providing the best treatment, followed by silver and octenidine with SUCRAs of 36.9, 23.1, and 21.8, respectively. Conclusions NaOCl/HOCl ranks first and proves to have the highest efficacy, followed by silver, octenidine, and PHMB for treatment.
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