Wound healing support
Adjunctive intervention in chronic wounds, major surgery, and burns. Vitamin and mineral supplementation is considered in patients with confirmed nutritional deficiency or malnutrition. In patients without deficiency, an effect on healing time is not proven.
ICD-10 T14.15 drugs
Also known as: Adjuvant nutritional support for wound healing
Drugs used for this condition
- BChlorhexidineFirst line · Biguanide antiseptic for skin and mucous membranesAntiseptic for acute and chronic wound care. Use 0.02–0.05% aqueous solutions; higher concentrations are cytotoxic and impair healing. SEMI recommends it for routine clean-contaminated wound care, not for deep wound cavities.
- CPropolis (bee product)Add-on therapy · Bee product, supplement. Not registered as monomedicine in EU or AEMPS; OTC segment in Italy and GermanyTopical propolis (ointments, sprays, gels) is used to accelerate healing of wounds, burns and aphthous stomatitis. Moderate-quality RCTs exist in aphthous stomatitis (Samet 2007), chronic diabetic foot ulcers (Henshaw 2014) and venous leg ulcers: topical propolis showed moderate ulcer area reduction and pain decrease as an adjunct to standard care. NICE for diabetic foot and AAU/SEMI for venous ulcers list offloading, moist dressings, infection control and compression as base therapy; propolis can be considered as an adjunct, not a substitute. Oral propolis drops and tablets are not in dermatology guidelines.
- DAscorbic acidCase-by-case decision · Vitamins. AntioxidantsThe evidence base is weak and mixed. Supplemental vitamin C 500–1,000 mg daily is considered in patients with nutritional deficiency, after major surgery, with burns, or in older adults with pressure ulcers – only as part of overall nutritional correction. NPUAP/EPUAP 2019 recommend vitamin C as part of nutritional support in pressure ulcers. The 2014 Cochrane review on vitamins and pressure ulcer healing (Langer 2014) is methodologically weak; large RCTs are absent. In patients without confirmed deficiency, isolated vitamin C does not affect wound healing time. The foundational approach is nutritional status assessment and correction of deficiencies as a whole, not mega-dose ascorbic acid.
Marketing claims without evidence base
The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.
- DEthanolNot recommended · Skin antiseptic and disinfectantPouring alcohol into a wound is a first aid box habit worth leaving in the past. The AEMPS ficha técnica states the ban directly: do not apply to deep and extensive wounds and avoid contact with mucous membranes, because alcohol is strongly irritating. The reason lies in the mechanism: ethanol denatures proteins indiscriminately, and the cells at the wound edges suffer along with the bacteria while healing gains nothing. A fresh wound is first rinsed with running water or saline, contamination is removed, then the edges are treated with an antiseptic suitable for wounds and covered with a dressing. Deep, dirty and bite wounds, and wounds with gaping edges, need a doctor and a tetanus vaccination check. If alcohol is advised to be poured into the wound itself, consider seeking a second opinion.
- DIsopropanolNot recommended · Skin antiseptic and disinfectantAn alcohol antiseptic is meant for intact skin and is not poured into a wound. The AEMPS ficha técnica limits use to external application on the skin and forbids swallowing, while open surfaces are not part of the indication. The mechanism is the same as with ethanol: protein denaturation proceeds indiscriminately, both microbes and wound edge cells suffer, and healing gets no faster. The order for a fresh wound is simple: rinse with running water or saline, remove dirt, treat the surrounding skin with a suitable antiseptic and cover with a dressing. Deep, bite and contaminated wounds, and wounds with gaping edges, are managed by a doctor, who also checks tetanus vaccination. If an alcohol solution is advised to be poured straight into the wound, consider seeking a second opinion.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit