Recomendaciones del uso de antimicrobianos en heridas crónicas

  1. Ángel Romero Collado 1
  2. José Verdú Soriano 2
  3. Erica Homs Romero 2
  1. 1 Universitat de Girona. GNEAUPP
  2. 2 Universitat d'Alacant
    info

    Universitat d'Alacant

    Alicante, España

    ROR https://ror.org/05t8bcz72

Revista:
Gerokomos: Revista de la Sociedad Española de Enfermería Geriátrica y Gerontológica

ISSN: 1134-928X

Ano de publicación: 2022

Volume: 33

Número: 2

Páxinas: 111-118

Tipo: Artigo

Outras publicacións en: Gerokomos: Revista de la Sociedad Española de Enfermería Geriátrica y Gerontológica

Resumo

ABSTRACT This article, based on GNEAUPP Technical Paper No. VIII, updates some concepts related to antimicrobials and adds new therapeutic tools to prevent and fight against one of the most important factors that prevent wound healing: problems related to microorganisms, classically infection and now also the impact of biofilms. The GNEAUPP's own evidence grading system is used, which classifies the strength of the recommendation as high, moderate or low. The antimicrobials analyzed in terms of their mode of action, commercial presentation, recommendations for use, contraindications and effectiveness on biofilm are: alcohol, chlorhexidine, sodium hypochlorite, octenidine, silver and iodophors. Also the effects of the so-called antibiofilm agents, although most of them have been performed in vitro. Finally, a series of recommendations are made to researchers to generate new evidence related to antimicrobials and their clinical applicability.

Referencias bibliográficas

  • Blanco Blanco, J,Blasco García, C,Ballesté Torralba, J,Casamada Humet, N,García González, F,Gago Fornells, M. (2002). Recomendaciones sobre la utilización de antisépticos en el cuidado de heridas crónicas. Grupo Nacional para el Estudio y Asesoramiento en Úlceras por Presión y Heridas Crónicas. Logroño.
  • López-Casanova, P,Pancorbo-Hidalgo, PL,Verdú-Soriano, J,Rodríguez-Palma, M,Soldevilla-Ágreda, JJ,García-Fernández, F. (2020). Qué no hacer en las heridas crónicas. Recomendaciones basadas en la evidencia. 2. Grupo Nacional para el Estudio y Asesoramiento en Úlceras por Presión y Heridas Crónicas. Logroño.
  • Verdú Soriano, J,López-Casanova, P,Sánchez Romero, I,Segovia Gómez, T. (2018). Toma de muestras para el laboratorio de microbiología. Procedimientos y recomendaciones. Grupo Nacional para el Estudio y Asesoramiento en Úlceras por Presión y Heridas Crónicas. Logroño.
  • (2016). International Wound Infection Institute (IWII) Wound infection in clinical practice. Wounds International. London.
  • Zapata-Sampedro, M,Zambrano Muñoz, M,Castro Varela, L. (2012). Colonización crítica. Una revisión de evidencias. Enferm Docente. 98. 26-34
  • Dissemond, J,Strohal, R,Mastronicola, D,Senneville, E,Moisan, C,Edward-Jones, V. (2020). Therapeutic Index for Local Infections score validity: A retrospective European analysis. J Wound Care. 29. 726
  • Dissemond, J,Gerber, V,Lobmann, R,Kramer, A,Mastronicola, D,Senneville, E. (2020). Therapeutic index for local infections score (TILI): A new diagnostic tool. J Wound Care. 29. 720
  • Rahim, K,Saleha, S,Zhu, X,Huo, L,Basit, A,Franco, OL. (2017). Bacterial Contribution in Chronicity of Wounds. Microb Ecol. 73. 710
  • Malone, M,Bjarnsholt, T,McBain, AJ,James, GA,Stoodley, P,Leaper, D. (2017). The prevalence of biofilms in chronic wounds: A systematic review and meta-analysis of published data. J Wound Care. 26. 20
  • Dowd, SE,Wolcott, RD,Kennedy, J,Jones, C,Cox, SB. (2011). Molecular diagnostics and personalised medicine in wound care: Assessment of outcomes. J Wound Care. 20. 232
  • (2016). World Union of Wound Healing Societes (WUWHS) Management of Biofilm. Wounds International. London.
  • García-Fernández, FP,Pancorbo-Hidaldo, PL,Soldevilla-Ágreda, JJ,Verdú Soriano, J,López-Casanova, P,Rodríguez-Palma, M. (2018). Manejo Local de las Úlceras y Heridas. 2. Grupo Nacional para el Estudio de las Úlceras por Presión y Heridas Crónicas. Logroño.
  • Schultz, G,Bjarnsholt, T,James, GA,Leaper, DJ,McBain, AJ,Malone, M. (2017). Consensus guidelines for the identification and treatment of biofilms in chronic nonhealing wounds. Wound Repair Regen. 25. 744
  • Percival, SL,Cooper, RA,Lipsky, BA. (2010). Microbiology of wounds. CRC Press. Boca Raton (Florida).
  • Romero-Collado, A,Raurell-Torreda, M,Zabaleta-del-Olmo, E,Homs-Romero, E,Bertran-Noguer, C. (2015). Course Content Related to Chronic Wounds in Nursing Degree Programs in Spain. J Nurs Scholarsh. 47. 51-61
  • Lipsky, BA,Dryden, M,Gottrup, F,Nathwani, D,Seaton, RA,Stryja, J. (2016). Antimicrobial stewardship in wound care: a Position Paper from the British Society for Antimicrobial Chemotherapy and European Wound Management Association. J Antimicrob Chemother. 71. 3026
  • Ousey, K. (2018). The role of topical metronidazole in management of infected wounds. Wounds UK. 14. 105
  • Bowler, PG. (2018). Antibiotic resistance and biofilm tolerance: A combined threat in the treatment of chronic infections. J Wound Care. 27. 273
  • Roberts, CD,Leaper, DJ,Assadian, O. (2017). The Role of Topical Antiseptic Agents Within Antimicrobial Stewardship Strategies for Prevention and Treatment of Surgical Site and Chronic Open Wound Infection. Adv Wound Care (New Rochelle). 6. 63-71
  • Kramer, A,Dissemond, J,Kim, S,Willy, C,Mayer, D,Papke, R. (2018). Consensus on Wound Antisepsis: Update 2018. Skin Pharmacol Physiol. 31. 28-58
  • Norman, G,Christie, J,Liu, Z,Westby, MJ,Jefferies, JM,Hudson, T. (2017). Antiseptics for burns. Cochrane Database Syst Rev.
  • (2015). World Health Organization Global Action Plan on Antimicrobial Resistance. WHO Documents Production Services. Genève.
  • Dumville, JC,Lipsky, BA,Hoey, C,Cruciani, M,Fiscon, M,Xia, J. (2017). Topical antimicrobial agents for treating foot ulcers in people with diabetes. Cochrane Database Syst Rev. 6.
  • Diomedi, A,Chacón, E,Delpiano, L,Hervé, B,Jemenao, MI,Medel, M. (2017). Antisépticos y desinfectantes. apuntando al uso racional. Recomendaciones del Comité Consultivo de Infecciones Asociadas a la Atención de Salud, Sociedad Chilena de Infectología. Rev Chil Infectología. 34. 156
  • McDonell, G,Russell, AD. (1999). Antiseptics and Disinfectants: Activity, Action, and Resistance. Clin Microbiol Rev. 12. 147
  • Williamson, DA,Carter, GP,Howden, BP. (2017). Current and Emerging Topical Antibacterials and Antiseptics: Agents, Action, and Resistance Patterns. Clin Microbiol Rev. 30. 827
  • Webster, J,Osborne, S. (2015). Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database Syst Rev.
  • Navarro Gracia, JF. (2016). Proyecto Infección Quirúrgica Zero. Sociedad Española de Medicina Preventiva, Salud Pública e Higiene. Pamplona.
  • (2016). World Health Organization Global guidelines for the prevention of surgical site infection. WHO Documents Production Sevices. Genève.
  • Stryja, J,Sandy-Hodgetts, K,Collier, M,Moser, C,Ousey, K,Probst, S. (2020). Surgical site infection: presenting and managing surgical site infection accross health care sectors. J Wound Care. 29. 1-69
  • Ban, KA,Minei, JP,Laronga, C,Harbrecht, BG,Jensen, EH,Fry, DE. (2017). American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. J Am Coll Surg. 18. 379
  • Shen, Y,Stojicic, S,Haapasalo, M. (2011). Antimicrobial efficacy of chlorhexidine against bacteria in biofilms at different stages of development. J Endod. 37. 657
  • Bonez, PC,Santos Alves, CF dos,Dalmolin, TV,Agertt, VA,Mizdal, CR,Flores, VDC. (2013). Chlorhexidine activity against bacterial biofilms. Am J Infect Control. 41. 119
  • Stojicic, S,Shen, Y,Haapasalo, M. (2013). Effect of the source of biofilm bacteria, level of biofilm maturation, and type of disinfecting agent on the susceptibility of biofilm bacteria to antibacterial agents. J Endod. 39. 473
  • Inoue, Y,Endo, S,Kondo, K,Ito, H,Omori, H,Saito, K. (1997). Trial of electrolyzed strong acid aqueous solution lavage in the treatment of peritonitis and intraperitoneal abscess. Artif Organs. 21. 28-31
  • Garg, PK,Kumar, A,Sharda, VK,Saini, A,Garg, A,Shandu, A. (2013). Evaluation of intraoperative peritoneal lavage with super-oxidized solution and normal saline in acute peritonitis. Arch Int Surg. 3. 43
  • Allie, DE. (2006). Super-Oxideized Microcyn Technology in Lower-Extremity Wounds. Wounds A Compend Clin Res Pract. 18. 3-6
  • Wolvos, TA. (2006). Advanced Wound care with Stable, Super-Oxidized Water. Wounds A Compend Clin Res Pract. 18. 11
  • Hübner, NO,Siebert, J,Kramer, A. (2010). Octenidine dihydrochloride, a modern antiseptic for skin, mucous membranes and wounds. Skin Pharmacol Physiol. 23. 244
  • Radu, CA,Gazyakan, E,Germann, G,Riedel, K,Reichenberger, M,Ryssel, H. (2011). Optimizing Suprathel(r)-therapy by the use of Octenidine-Gel(r). Burns. 37. 294
  • Sibbald, RG,Elliott, JA,Verma, L,Brandon, A,Persaud, R,Ayello, EA. (2017). Update: Topical Antimicrobial Agents for Chronic Wounds. Adv Ski Wound Care. 30. 438
  • Kedziora, A,Speruda, M,Krzyzewska, E,Rybka, J,Lukowiak, A,Bugla-Ploskonska, G. (2018). Similarities and differences between silver ions and silver in nanoforms as antibacterial agents. Int J Mol Sci. 19.
  • Lo, SF,Hayter, M,Chang, CJ,Hu, WY,Lee, LL. (2008). A systematic review of silver-releasing dressings in the management of infected chronic wounds. J Clin Nurs. 17. 1973
  • Adderley, U,Holt, I. (2014). Topical agents and dressings for fungating wounds. Cochrane Database Syst Rev.
  • O'Meara, S,Al-Kurdi, D,Ologun, Y,Ovington, LG,Martyn-St James, M,Richardson, R. (2014). Antibiotics and antiseptics for venous leg ulcers. Cochrane Database Syst Rev.
  • Chindera, K,Mahato, M,Kumar Sharma, A,Horsley, H,Kloc-Muniak, K,Kamaruzzaman, NF. (2016). The antimicrobial polymer PHMB enters cells and selectively condenses bacterial chromosomes. Sci Rep. 6.
  • Norman, G,Dumville, JC,Moore, ZEH,Tanner, J,Christie, J. (2016). Antibiotics and antiseptics for pressure ulcers. Cochrane Database Syst Rev.
  • To, E,Dyck, R,Gerber, S,Kadavil, S,Woo, KY. (2016). The Effectiveness of Topical Polyhexamethylene Biguanide (PHMB) Agents for the Treatment of Chronic Wounds: A Systematic Review. Surg Technol Int. 29. 45-51
  • Bigliardi, PL,Alsagoff, SAL,El-Kafrawi, HY,Pyon, JK,Wa, CTC,Villa, MA. (2017). Povidone iodine in wound healing: A review of current concepts and practices. Int J Surg. 44. 260
  • Woo, K,Dowsett, C,Costa, B,Ebohon, S,Woodmansey, EJ,Malone, M. (2021). Efficacy of topical cadexomer iodine treatment in chronic wounds: Systematic review and meta-analysis of comparative clinical trials. Int Wound J. 18. 586
  • Angel, D,Morey, P,Storer, J,Mwipatayi, B. (2008). The great debate over iodine in wound care continues: a review of the literature. Wound Pract Res J Aust Wound Manag Assoc. 16. 6-21
  • Kamiya, H,Ehara, T,Matsumoto, T. (2012). Inhibitory effects of lactoferrin on biofilm formation in clinical isolates of Pseudomonas aeruginosa. J Infect Chemother. 18. 47-52
  • Ammons, MC,Copié, V. (2013). Mini-review: Lactoferrin: a bioinspired, anti-biofilm therapeutic. Biofouling. 29. 443
  • Anjum, A,Sim, CH,Ng, SF. (2018). Hydrogels Containing Antibiofilm and Antimicrobial Agents Beneficial for Biofilm-Associated Wound Infection: Formulation Characterizations and In vitro Study. AAPS PharmSciTech. 19. 1219
  • Percival, SL,Salisbury, AM. (2018). The efficacy of tetrasodium EDTA on biofilms. Adv Exp Med Biol. 1057. 101