Sodium hypochlorite has long been recognized for its effectiveness as an antiseptic and disinfectant. In his historic pioneering work, in which he proved in a convincing clinical trial the importance of hand disinfection, Semmelweis used sodium hypochlorite as a hand wash and disinfectant to reduce mortality from childbed fever . In another historic discovery, Carrel and Dakin introduced 0.45-0.5% buffered sodium hypochlorite for the treatment of trauma wounds during the First World War [2, 3]. This solution, known as Dakin's solution revolutionized the treatment of trauma wounds and was used during and after the war. The effectiveness of sodium hypochlorite solution as an antimicrobial is unquestioned; however, its practical use in medicine had been limited due to its reduced stability. However, the method of manufacture makes the medical use of sodium hypochlorite a viable option.
Electrolytically produced sodium hypochlorite solutions, e.g. ExSept (Amuchina), differ from other commercially produced sodium hypochlorites by their method of manufacture. The electrolytic process yields a sodium hypochlo-rite solution that is stable at a lower pH eliminating the need to add large quantities of stabilizers, as with other sodium hypochlorites, that are both detrimental to wound healing and reduce the antimicrobial activity of the solution. The result is a highly effective antimicrobial with very good biocompatibility.
The ExSept solutions discussed herein have also been reviewed by numerous health agencies as both medical devices and medical drugs. These review agencies include, but are not limited to, the Canadian Health Ministry, Mexican Health Ministry, Italian Ministry of Health, French Ministry of Health, Swiss Ministry of Health and the US Food and Drug Administration.
This book provides the clinician with a sound understanding of how elec-trolytically produced sodium hypochlorite solutions differ from commercial sodium hypochlorite solutions, and presents different uses of this solution as both an antiseptic and disinfectant and to alleviate some of the stereotypes associated with the medical use of sodium hypochlorite solutions. A work from an International Faculty, presenting many different experiences with ExSept/ Amuchina solutions specifically in the arena of dialysis, is included in this book. The studies present both in vitro controlled laboratory evaluations and clinical in vivo, prospective, randomized trials.
The beneficial penetration of the use of electrolytically produced sodium hypochlorite solutions in dialysis has made excellent progress; however, further advances are expected as the efficacy and safety of the product becomes more widely understood.
Claudio Ronco Gary Mishkin
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