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Eur J Pediatr Surg 2009; 19(3): 179-183
DOI: 10.1055/s-0029-1216379
Special Report

© Georg Thieme Verlag KG Stuttgart · New York

Persistent Subcutaneous Oedema and Aseptic Fatty Tissue Necrosis after Using Octenisept®

C. J. Schupp 1 , S. Holland-Cunz 1
  • 1Division of Pediatric Surgery, University Hospital Heidelberg, Heidelberg, Germany
Further Information

Publication History

received November 14, 2008

accepted after revision January 25, 2009

Publication Date:
04 June 2009 (online)

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Abstract

Introduction: Wound management and the prevention and treatment of tissue infections are part of daily routine. Octenisept® (Schülke & Mayr), an antiseptic with a broad antimicrobiological effect, is widely used for various indications. This paper reports prolonged oedema and tissue swelling after treatment of deep wounds with Octenisept® in three children.

Case reports: Three paediatric patients, aged between 2 months and 4 years, were treated with Octenisept® in different hospitals. One initially presented with an abscess of the gluteal area, two with deep wounds of the cheek following injury with a wooden stick. The wounds were cleaned and washed out with Octenisept®. Adequate drainage was in place at all times.

Common findings: We observed aseptic, non painful subcutaneous tissue swelling and oedema in all three cases after wound lavage with Octenisept®. This occurred shortly after the wound was initially treated and lasted for weeks until the symptoms slowly declined. It was not accompanied by persistent general infection parameters. A biopsy taken from one patient demonstrated an aseptic inflammatory reaction and oedema of the subcutaneous tissue, with partial tissue necrosis. Neither surgical revision nor antibiotic therapy brought any improvement.

Conclusions: Retrospectively, one can consider these occurrences as a consequence of the use of Octenisept®, since the changes are consistent with those described by Schülke & Mayr when Octenisept® was accidentally administered by subcutaneous injection or under pressure to flush deep hand stab wounds that were not drained. The underlying pathobiological mechanism remains unclear. Hence, we recommend not to apply Octenisept® in any wound cavity until further investigation has taken place. If aseptic fatty tissue necrosis and oedema develop after using Octenisept®, further surgical intervention or antibiotic treatment will not give any benefit. Changes subside slowly. So far, adequate treatment is not available.

Key words

Octenisept - wound management - antiseptic agent - abscess

References

  • 1 Braunwarth H. Octenidine dihydrochloride–a new antiseptic agent.  Krankenpfl J. 2000;  38 63
    Google Scholar
  • 2 Decker EM, Weiger R, Wiech I. et al . Comparison of antiadhesive and antibacterial effects of antiseptics on Streptococcus sanguinis.  Eur J Oral Sci. 2003;  111 144-148
    Google Scholar
  • 3 Kalteis T, Lüring C, Schaumburger J. et al . Tissue toxicity of antiseptics.  Z Orthop Ihre Grenzgeb. 2003;  141 233-238
    Google Scholar
  • 4 Kramer A, Roth B, Müller G. et al . Influence of aseptic agents polyhexanide and octenidine on FL cells and on healing of experimental superficial aseptic wounds in piglets. A double-blind, randomized, stratified, controlled, parallel-group study.  Skin Pharmacol Physiol. 2004;  17 141-146
    Google Scholar
  • 5 Langer S, Sedigh Salakdeh M, Goertz O. et al . The impact of topical antiseptics on skin microcirculation.  Eur J Med Res. 2004;  29 ((9)) 449-454
    Google Scholar
  • 6 Mueller G, Kramer A. In vitro action of a combination of selected antimicrobial agents and adult bovine articular cartilage (sesamoid bone).  Cem Biol Interact. 2003;  145 331-336
    Google Scholar
  • 7 Schülke, Mayr. Wichtige Information zur Arzneimittelsicherheit von Octenisept® (Octenidindihydrochlorid, Phenoxyethanol) Ödematöse Schwellungen und Gewebeschädigungen nach Einbringen unter Druck in Stichwunden bei handchirurgischen Eingriffen. Boxed warning, Norderstedt 07.  Februar 2008; 
    Google Scholar
  • 8 Schülke&Mayr . Octenisept®.  http://www.schuelke-mayr.com
    Google Scholar
  • 9 Schülke&Mayr . Adjuvante und unterstützende Wundversorgung mit Octenisept®.  http://www.schuelke-mayr.com
    Google Scholar
  • 10 Sopata M, Ciupinska M, Giowacka A. et al . Effect of Octenisept® antiseptic on bioburden of neoplastic ulcers in patients with advanced cancer.  J Wound Care. 2008;  17 24-27
    Google Scholar

Correspondence

Dr. S. Holland-Cunz

Division of Pediatric Surgery

University Hospital Heidelberg

Im Neuenheimer Feld 110

69120 Heidelberg

Germany

Phone: +49/6221/56 62 81

Fax: +49/6221/56 51 05

Email: Stefan.Holland-Cunz@med.uni-heidelberg.de

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