Uso de antisépticos y antibióticos en el manejo de la carga bacteriana de heridas crónicas

  1. Daniel Ruiz Prieto 1
  2. Francisco Pedro García Fernández 2
  1. 1 Departamento de Enfermería. Vicedecano de la Facultad de Ciencias de la Salud. Universidad de Jaén.
  2. 2 Comité Director del GNEAUPP. Jaén. España.
Journal:
Gerokomos: Revista de la Sociedad Española de Enfermería Geriátrica y Gerontológica

ISSN: 1134-928X

Year of publication: 2020

Volume: 31

Issue: 4

Pages: 261-267

Type: Article

DOI: S1134-928X2020000500012 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Gerokomos: Revista de la Sociedad Española de Enfermería Geriátrica y Gerontológica

Abstract

ABSTRACT Objective: The objective of this review is to analyze the efficacy of different antiseptic dressings and local topical antibiotics in infected chronic wounds or with signs of critical colonization. Methodology: For the elaboration of this exploratory review several databases have been used (PubMed, CINAHL, Scopus, Cuiden, Cochrane and LILACS), using search chains adapted to each base. Different types of original studies and reviews on healing, complete healing and/or cost-benefit have been included, making an estimate of the costs of the treatments according to the availability of data. Studies on burns, gray literature, clinical cases or cases series have been excluded. Results: 20 articles have been included, of which 17 are original studies and 3 are reviews, obtaining that 19 articles treat on antiseptic dressings and 3 on local topical antibiotics used in infected chronic wounds or with signs of critical colonization, obtaining data on the effect that they produce in healing, complete healing and/or cost-benefit. All the products found have good results, although the most used and effective in these wounds is silver. Conclusions: Silver is the most effective product for the complete healing or reducing size, being very profitable, since the costs of silver treatments are lower, obtaining greater benefits for the patient. The dialkylcarbamoyl chloride is a good alternative, because it is a very effective and profitable product.

Bibliographic References

  • Barón Burgos, MM,Benítez Ramírez, MM,Caparrós Cervantes, A,Escarvajal López, ME,Martín Espinosa, MT,Moh Al-Lal, Y. (2015). Guía para la Prevención y Manejo de las UPP y heridas crónicas. Instituto Nacional de Gestión Sanitaria. Madrid.
  • García Fernández, FP,López Casanova, P,Segovia Gómez, T,Soldevilla Agreda, JJ,Verdú Soriano, J. (2012). Unidades Multidisciplinares de Heridas Crónicas: Clínicas de Heridas. 1. Grupo Nacional para el Estudio y Asesoramiento en Úlceras por Presión y Heridas Crónicas. Logroño.
  • Ballesteros Úbeda, MV. (2011). Manual de Protocolos y Procedimientos en el cuidado de las heridas. Hospital Universitario de Móstoles. Madrid.
  • García Fernández, FP,Soldevilla Agreda, JJ,Pancorbo Hidalgo, PL,Verdú Soriano, J,López Casanova, P,Rodríguez Palma, M. (2014). Clasificación-categorización de las lesiones relacionadas con la dependencia. 2. Grupo Nacional para el Estudio y Asesoramiento en Úlceras por Presión y Heridas Crónicas. Logroño.
  • Allué Gracia, MA,Ballabriga Escuer, MS,Clerencia Sierra, M,Gallego Domeque, L,García Espot, A,Moya Porté, MT. (2012). Heridas crónicas: un abordaje integral. Colegio Oficial de Enfermería de Huesca. Huesca.
  • Ramírez Hernández, GA. (2010). Fisiología de la cicatrización cutánea. RFS. 2. 69-78
  • Sainz-Espiga Michelena, I,Folguera Álvarez, C,Lebrancón Cortés, P,Valerdiz Casasola, S. (2016). Colonización crítica: la gran invisible. 1. Coloplast Productos Médicos. España.
  • Carville, K,Cuddigan, J,Fletcher, J,Fuchs, P,Harding, K,Ishikawa, O. (2008). La infección de las heridas en la práctica clínica. Consenso internacional. Medical Education Partnership Ltd. Londres.
  • García Fernández, FP,Soldevilla Agreda, JJ,Pancorbo Hidalgo, PL,Verdú Soriano, J,López Casanova, P,Rodríguez Palma, M. (2018). Manejo Local de Úlceras y Heridas. 2. Grupo Nacional para el Estudio y Asesoramiento en Úlceras por Presión y Heridas Crónicas. Logroño.
  • Pancorbo Hidalgo, PL,Verdú Soriano, J,Martínez Cuervo, F. (2016). Atención Integral de las Heridas Crónicas. 2. GNEAUPP-FSJJ. Logroño.
  • Pérez Santos, L,Turrado Muñoz, MÁ,Moral Arroyo, JA. (2017). Consultoría de heridas crónicas y agudas. Hospital Universitario Reina Sofía. Servicio Andaluz de Salud. Consejería de Salud. Junta de Andalucía. Córdoba.
  • Soldevilla Ágreda, JJ,Torra i Bou, JE,Posnett, J,Verdú Soriano, J,San Miguel, L,Mayan Santos, JM. (2007). Una aproximación al impacto del coste económico del tratamiento de las úlceras por presión en España. Gerokomos. 18. 201
  • Cabello, JB. (2005). CASPe Guías CASPe de Lectura Crítica de la Literatura Médica. CASPe. Alicante.
  • Cabello, JB. (2005). CASPe Guías CASPe de Lectura Crítica de la Literatura Médica. CASPe. Alicante.
  • Cabello, JB. (2005). CASPe Guías CASPe de Lectura Crítica de la Literatura Médica. CASPe. Alicante.
  • Cabello, JB. (2005). CASPe Guías CASPe de Lectura Crítica de la Literatura Médica. CASPe. Alicante.
  • Wang, J,Smith, J,Babidge, W,Maddern, G. (2007). Silver dressings versus other dressings for chronic wounds in a community care setting. J Wound Care. 16. 352
  • Zölß, C,Cech, JD. (2016). Efficacy of a new multifunctional surfactant-based biomaterial dressing with 1% silver sulphadiazine in chronic wounds. Int Wound J. 13. 738
  • Karlsmark, T,Bendz, SH,Larsen, JR,Andersen, KE,Roed-Petersen, J,Agerslev, RH. (2003). Clinical performance of a new silver dressing, Contreet Foam, for chronic exuding venous leg ulcers. J Wound Care. 12. 351
  • Meaume, S,Vallet, D,Nguyen Morere, M,Téot, L. (2005). Evaluation of a silver-releasing hydroalginate dressing in chronic wounds with signs of local infection. J Wound Care. 14. 411
  • Münter, KC,Beele, H,Russell, L,Crespi, A,Gröchenig, E,Basse, P. (2006). Effect of a sustained silver-releasing dressing on ulcers with delayed healing the CONTOP study. J Wound Care. 15. 199-206
  • Kammerlander, G,Locher, E,Suess-Burghart, A,Hallern, B von,Wipplinger, P. (2008). An investigation of Cutimed Sorbact® as an antimicrobial alternative in wound management. Wounds UK. 4. 10
  • Miller, CN,Newall, N,Kapp, SE,Lewin, G,Karimi, L,Carville, K. (2010). A randomized-controlled trial comparing cadexomer iodine and nanocrystalline silver on the healing of leg ulcers. Wound Repair Regen. 18. 359
  • Rueda López, J,Martínez Cuervo, F,Verdú Soriano, J,Segovia Gómez, T. (2010). Apósitos impregnados en agente antibacteriano. Rev ROL Enf. 33. 726
  • Sibbald, RG,Coutts, P,Woo, KY. (2011). Reduction of Bacterial Burden and Pain in Chronic Wounds Using a New Polyhexamethylene Biguanide Antimicrobial Foam Dressing-Clinical Trial Results. Adv Skin Wound Care. 24. 78-84
  • Lenselink, E,Andriessen, A. (2011). A cohort study on the efficacy of a polyhexanide-containing biocellulose dressing in the treatment of biofilms in wounds. J Wound Care. 20. 534
  • Manizate, F,Fuller, A,Gendics, C,Lantis, JC. (2012). A prospective, single-center, nonblinded, comparative, postmarket clinical evaluation of a bovine-derived collagen with ionic silver dressing versus a carboxymethylcellulose and ionic silver dressing for the reduction of bioburden in variable-etiology. Adv Skin Wound Care. 25. 220
  • Woo, KY,Coutts, PM,Sibbald, RG. (2012). A randomized controlled trial to evaluate an antimicrobial dressing with silver alginate powder for the management of chronic wounds exhibiting signs of critical colonization. Adv Skin Wound Care. 25. 503
  • O'Meara, S,Al-Kurdi, D,Martyn-St James, M,Ovington, LG,Richardson, R,Ologun, Y. (2014). Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst Rev.
  • Forlee, M,Rossington, A,Searle, R. (2014). A prospective, open, multicentre study to evaluate a new gelling fibre dressing containing silver in the management of venous leg ulcers. Int Wound J. 11. 438
  • Mosti, G,Magliaro, A,Mattaliano, V,Picerni, P,Angelotti, N. (2015). Comparative study of two antimicrobial dressings in infected leg ulcers: a pilot study. J Wound Care. 24. 121
  • Krasowski, G,Rybak, Z,Bartoszewicz, M,Olejniczak-Nowakowska, M,Junka, A,Tukiendorf, A. (2015). A comparison of an antibacterial sandwich dressing vs dressing containing silver. Wound Repair Regen. 23. 525
  • Nherera, LM,Woodmansey, E,Trueman, P,Gibbons, GW. (2016). Estimating the Clinical Outcomes and Cost Differences Between Standard Care With and Without Cadexomer Iodine in the Management of Chronic Venous Leg Ulcers Using a Markov Model. Ostomy Wound Manage. 62. 26-40
  • Palumbo, FP,Harding, KG,Abbritti, F,Bradbury, S,Ivins, N,Klein, D. (2016). New Surfactant-based Dressing Product to Improve Wound Closure Rates of Nonhealing Wounds: A European Multicenter Study Including 1036 Patients. Wounds. 28. 233
  • Harding, KG,Cains, J,Blair, S,Parsons, D,Ivins, NM,Bowler, P. (2016). Safety and performance evaluation of a next-generation antimicrobial dressing in patients with chronic venous leg ulcers. Int Wound J. 13. 442
  • Díaz, R,Percy-Douglas, R,Alvarado-Dumas, C. (2017). Estudio comparativo con membranas multifuncionales y apósitos húmedos a seco, en pacientes con heridas crónicas difíciles de curar. Ensayo clínico aleatorizado. Rev Guatem cir. 23. 24-35
  • Totty, JP,Bua, N,Smith, GE,Harwood, AE,Carradice, D,Wallace, T. (2017). Dialkylcarbamoyl chloride (DACC)-coated dressings in the management and prevention of wound infection: a systematic review. J Wound Care. 26. 107
  • Sibbald, RG,Elliott, JA,Verma, L,Brandon, A,Persaud, R,Ayello, EA. (2017). Update: Topical Antimicrobial Agents for Chronic Wounds. Adv Skin Wound Care. 30. 438
Data source: Dialnet