Wound healing is a complex process; many factors, including the presence of bacteria, can potentially delay actual healing. Increasing evidence shows that some bacteria within chronic wounds live within biofilm communities in which bacteria are protected from host defenses and develop resistance to systemic antibiotic treatment.1 Bacteria in biofilm behave differently from planktonic bacteria of the same organism in terms of their response to antibiotic treatment and human immunity.2,3 The biofilm is formed when a group of microorganisms stick to each other and become embedded within a self-produced matrix of extracellular polymeric substance composed of extracellular DNA, polysaccharides, and proteins.3 Among the most common biofilm-forming bacteria are Staphylococcus aureus and Pseudomonas aeruginosa.2 In order to disrupt biofilm within a wound, an agent must kill the bacteria and decrease the polysaccharides and proteins in the extracellular matrix of the biofilm.
Although the exact role of biofilm in chronic wound healing remains unclear, treatments that kill microorganisms within biofilms and disrupt the extracellular matrix of the biofilm may aid in the healing of chronic wounds.4 Hypochlorous acid (HOCl) is a naturally occurring small molecule generated by white blood cells in the human body. In vitro testing has shown hypochlorous acid can rapidly kill important wound pathogens, including antibiotic-resistant, methicillin-resistant S aureus and P aeruginosa. The time for inactivating these organisms is extremely rapid (<30 seconds).4
An important attribute of the human body’s immune system is its ability to instigate a rapid attack against invading pathogens by releasing highly potent oxidizing substances such as hypochlorous acid. After engulfing the invading pathogens, neutrophils release an oxidative burst of hypochlorous acid that very quickly destroys the engulfed bacteria, virus, or fungi. The HOCl, produced by neutrophils, kills microorganisms by binding to critical cell membrane components and affecting cell permeability. This leads to the rupture of the cell membrane and subsequent disintegration of cells.4