Advancing wound care: Antiseptic strategies – povidone-iodine

Abstract

Microbial contamination remains a major challenge in wound healing and is frequently associated with delayed tissue repair, chronic infection and additional tissue damage. Effective management of microbial burden is, therefore, a central objective in wound care. In this context, topical antiseptics play an important role in limiting microbial proliferation and supporting the healing process.

This review examines the pharmacological properties of commonly used antiseptics in wound management. Particular attention is given to their mechanism of action, antimicrobial spectrum of activity and potential for resistance development. The antiseptics discussed include iodine-based products, biguanides such as chlorhexidine, octenidine, oxidising agents, silver-containing formulations and honey as a natural therapeutic agent.

Unlike antibiotics, which typically act on specific molecular targets, antiseptics exert their broad-spectrum antimicrobial activity through multiple mechanisms. These include disruption of microbial cell membranes, protein denaturation and oxidative damage. Because several cellular targets are affected simultaneously, the likelihood of rapid resistance development is generally reduced.

The selection of an appropriate antiseptic should not rely solely on antimicrobial potency. Factors such as cytotoxicity, tissue compatibility and overall safety must also be considered. Careful selection of antiseptic agents, guided by current evidence, is therefore essential to optimise wound-healing outcomes, while supporting responsible stewardship in pharmacy practice.