13
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Recomendaciones del uso de antimicrobianos en heridas crónicas Translated title: Recommendations on the application of antimicrobials in chronic wounds

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          RESUMEN En este artículo, basado en el documento técnico n.º VIII del GNEAUPP, se actualizan algunos conceptos relacionados con los antimicrobianos y se añaden nuevas herramientas terapéuticas para prevenir y luchar frente a uno de los factores más importantes que impiden que cicatrice una herida: los problemas relacionados con los microorganismos, clásicamente la infección y, ahora, también el impacto de los biofilms. Se asume el sistema propio del GNEAUPP de gradación de la evidencia, que clasifica la fuerza de la recomendación en alta, moderada o baja. Los antimicrobianos analizados mediante su modo de actuación, presentación comercial, recomendaciones de uso, contraindicaciones y efectividad sobre el biofilm son: el alcohol, la clorhexidina, el hipoclorito sódico, la octenidina, la plata y los yodóforos. También los efectos de los llamados agentes antibiofilm, aunque la mayoría se han realizado in vitro. Para finalizar, se realizan una serie de recomendaciones dirigidas a los investigadores para generar nuevas evidencias relacionadas con los antimicrobianos y su aplicabilidad clínica.

          Translated abstract

          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.

          Related collections

          Most cited references55

          • Record: found
          • Abstract: not found
          • Article: not found

          American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update.

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            The prevalence of biofilms in chronic wounds: a systematic review and meta-analysis of published data.

            The presence of biofilms in chronic non-healing wounds, has been identified through in vitro model and in vivo animal data. However, human chronic wound studies are under-represented and generally report low sample sizes. For this reason we sought to ascertain the prevalence of biofilms in human chronic wounds by undertaking a systematic review and meta-analysis. Our initial search identified 554 studies from the literature databases (Cochrane Library, Embase, Medline). After removal of duplicates, and those not meeting the requirements of inclusion, nine studies involving 185 chronic wounds met the inclusion criteria. Prevalence of biofilms in chronic wounds was 78.2 % (confidence interval [CI 61.6-89, p<0.002]). The results of our meta-analysis support our clinical assumptions that biofilms are ubiquitous in human chronic non-healing wounds.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Bacterial Contribution in Chronicity of Wounds.

              A wound is damage of a tissue usually caused by laceration of a membrane, generally the skin. Wound healing is accomplished in three stages in healthy individuals, including inflammatory, proliferative, and remodeling stages. Healing of wounds normally starts from the inflammatory phase and ends up in the remodeling phase, but chronic wounds remain in an inflammatory stage and do not show progression due to some specific reasons. Chronic wounds are classified in different categories, such as diabetic foot ulcer (DFU), venous leg ulcers (VLU) and pressure ulcer (PU), surgical site infection (SSI), abscess, or trauma ulcers. Globally, the incidence rate of DFU is 1-4 % and prevalence rate is 5.3-10.5 %. However, colonization of pathogenic bacteria at the wound site is associated with wound chronicity. Most chronic wounds contain more than one bacterial species and produce a synergetic effect that results in previously non-virulent bacterial species becoming virulent and causing damage to the host. While investigating bacterial diversity in chronic wounds, Staphylococcus, Pseudomonas, Peptoniphilus, Enterobacter, Stenotrophomonas, Finegoldia, and Serratia were found most frequently in chronic wounds. Recently, it has been observed that bacteria in chronic wounds develop biofilms that contribute to a delay in healing. In a mature biofilm, bacteria grow slowly due to deficiency of nutrients that results in the resistance of bacteria to antibiotics. The present review reflects the reasons why acute wounds become chronic. Interesting findings include the bacterial load, which forms biofilms and shows high-level resistance toward antibiotics, which is a threat to human health in general and particularly to some patients who have acute wounds.
                Bookmark

                Author and article information

                Journal
                geroko
                Gerokomos
                Gerokomos
                Sociedad Española de Enfermería Geriátrica y Gerontológica (Barcelona, Barcelona, Spain )
                1134-928X
                2022
                : 33
                : 2
                : 111-118
                Affiliations
                [5] orgnameGNEAUPP orgdiv1Comité Director
                [4] orgnameGNEAUPP orgdiv1Comité Consultivo
                [3] Figueres orgnameABS Ernest Lluch España
                [1] Girona Cataluña orgnameUniversitat de Girona orgdiv2Facultad de Enfermería Spain
                [2] Alicante Valencia orgnameUniversidad de Alicante orgdiv1Facultad de Ciencias de la Salud orgdiv2Grupo WINTER-Heridas-UA Spain
                Article
                S1134-928X2022000200010 S1134-928X(22)03300200010
                b4ed1163-a8d0-44c0-a8cb-e2006d545f56

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 28 February 2022
                : 28 February 2022
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 55, Pages: 8
                Product

                SciELO Spain

                Categories
                Helcos

                biofilms,Anti-bacterial agents,anti-infective agents,wound infection,Antibacterianos,antiinfecciosos,biopelículas,infección de heridas

                Comments

                Comment on this article