Acetic Acid & Pseudomonas Aeruginosa

·         The concentrations effective for eliminating P. aeruginosa on small ulcerations and burns varied between 1 and 5%, and eradication occurred after 2–16 days . ·         On wounds, concentrations >2% caused pain and >5% caused a burning sensation.	Kramer, A., Dissemond, J., Kim, S., Willy, C., Mayer, D., Papke, R.,. Assadian, O. (2017). Consensus on Wound Antisepsis: Update 2018. Skin Pharmacology and Physiology,31(1), 28-58. doi:10.1159/000481545 Retrieved from https://www.karger.com/Article/Pdf/481545
·         Compresses with diluted acetic acid (0.5%–1%) can lower wound pH and create a hostile environment for Pseudomonas and other bacteria that prefer an alkaline environment.	Sibbald RG1, Elliott JA, Verma L, Brandon A, Persaud R, Ayello EA. (2017) Update: Topical Antimicrobial Agents for Chronic Wounds. Adv Skin Wound Care.  Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28914678
·         Acetic acid with concentration of 1% has shown to be efficacious against wide range of bacteria as well as fungi, simultaneously accelerating wound healing. ·         Patients were treated for a variable period of 7–21 days with 1% acetic acid. ·         There was a decrease in wound size, surrounding inflammation and induration after treatment with acetic acid, suggestive of wound healing. There was a marked improvement in terms of discharge, odour and granulation tissue. ·          Apart from stinging sensation on application complained by few patients, there were no significant side effects of the use of acetic acid for dressings. ·         Infected skin grafting donor sites also showed a decrease in the amount of soakage after treatment with 1% acetic acid and healed spontaneously without the need of grafting.	Agrawal, K. S., Sarda, A. V., Shrotriya, R., Bachhav, M., Puri, V., & Nataraj, G. (2017). Acetic acid dressings: Finding the Holy Grail for infected wound management. Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India, 50(3), 273–280. doi:10.4103/ijps.IJPS_245_16
·         When used as soaks, a concentration of 5 per cent was the most effective for eliminating P. aeruginosa from wounds; the organism was eliminated from two wounds within 2 days, 6 wounds within 5 days and 2 wounds within 7 days. The longest period for elimination was 14 days. ·          Acetic acid was less successful when used at 0.50%  in immersion baths, elimination of P. aeruginosa required between 2 and 17 days treatment.	Sloss, J. M., Cumberland, N., & Milner, S. M. (1993). Acetic acid used for the elimination of Pseudomonas aeruginosa from burn and soft tissue wounds. Journal of the Royal Army Medical Corps,139(2), 49-51. doi:10.1136/jramc-139-02-04
·         Acetic acid in 1% and 5% concentrations has been widely used in an attempt to reduce pH. ·         Application of sterile gauze swabs soaked in 1%-5% concentrations to ulcers and burn wounds has been used in different studies.10-14  ·         Topical application of acetic acid in a concentration of 5% to burn and soft tissue wounds has been found to be an effective treatment for P. aeruginosainfections.10-14  ·         A 0.5% acetic acid irrigation solution is effective in clearing P. aeruginosa from contaminated or infected wound beds. ·         Though not bactericidal, acetic acid creates an acidic environment unfavorable for growth of P. aeruginosa.15  ·         Thus, irrigation of wounds with acetic acid solution proved to be effective in clearing P. aeruginosa from wound beds.	Basavraj S. Nagoba, Namdev M. Suryawanshi, Bharat Wadher ,Sohan Selkar(2015) Acidic Environment and Wound Healing: A Review Retrieved from https://www.woundsresearch.com/article/acidic-environment-and-wound-healing-review

Prepared by: Nur Nabiha R. [31.07.2019]