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      Uso de apósitos en quemaduras Translated title: Dressing options in burns

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          Abstract

          Resumen Además de la naturaleza y el alcance de las lesiones que influyen en las infecciones, el tipo y la cantidad de microorganismos que colonizan la herida por quemadura parecen influir en el riesgo futuro de infección invasiva de la misma. Por esta razón, en el presente artículo analizamos algunas de las diferentes opciones de apósitos utilizados más frecuentemente en el manejo de la lesión por quemadura, con mayor énfasis en los empleados personalmente y considerando que el conocimiento adecuado de estos productos favorece el manejo ambulatorio de los pacientes que sufren quemaduras, puesto que son herramientas efectivas siempre y cuando se utilicen en la manera y tiempo adecuados.

          Translated abstract

          Abstract In addition to the nature and extent of the lesions influencing infections, the type and number of microorganisms that colonize the burn wound appear to influence the future risk of invasive wound infection. For this reason, this article discusses some of the different dressing options most frequently used in the management of burn injury, more emphatically in those used personally, considering that the appropriate knowledge of these products promote the outpatient management of patients suffering burns; dressings provide effective tools as long as they are used in an appropriate manner and time.

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          Most cited references13

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          Silver. I: Its antibacterial properties and mechanism of action.

          Silver products have two key advantages: they are broad-spectrum antibiotics and are not yet associated with drug resistance. This article, the first in a two-part series, describes the main mechanism of action of this metallic element.
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            Dressings for superficial and partial thickness burns.

            An acute burn wound is a complex and evolving injury. Extensive burns produce systemic consequences, in addition to local tissue damage. Treatment of partial thickness burn wounds is directed towards promoting healing and a wide variety of dressings are currently available. Improvements in technology and advances in understanding of wound healing have driven the development of new dressings. Dressing selection should be based on their effects on healing, but ease of application and removal, dressing change requirements, cost and patient comfort should also be considered. To assess the effects of burn wound dressings on superficial and partial thickness burns. For this first update we searched The Cochrane Wounds Group Specialised Register (searched 8 November 2012); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 10); Ovid MEDLINE (2008 to October Week 4 2012); Ovid MEDLINE (In-Process & Other Non-Indexed Citations, November 07, 2012); Ovid EMBASE (2008 to 2012 Week 44); AND EBSCO CINAHL (1982 to 2 November 2012). All randomised controlled trials (RCTs) that evaluated the effects of burn wound dressings on the healing of superficial and partial thickness burns. Two authors extracted the data independently using standardised forms. We assessed each trial for internal validity and resolved differences by discussion. A total of 30 RCTs are included in this review. Overall both the quality of trial reporting and trial conduct were generally poor and meta analysis was largely precluded due to study heterogeneity or poor data reporting. In the context of this poor quality evidence, silver sulphadiazine (SSD) was consistently associated with poorer healing outcomes than biosynthetic (skin substitute) dressings, silver-containing dressings and silicon-coated dressings. Burns treated with hydrogel dressings appear to heal more quickly than those treated with usual care. There is a paucity of high-quality evidence regarding the effect of different dressings on the healing of superficial and partial thickness burn injuries. The studies summarised in this review evaluated a variety of interventions, comparators and clinical endpoints and all were at risk of bias. It is impossible to draw firm and confident conclusions about the effectiveness of specific dressings, however silver sulphadiazine was consistently associated with poorer healing outcomes than biosynthetic, silicon-coated and silver dressings whilst hydrogel-treated burns had better healing outcomes than those treated with usual care.
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              Wound management in an era of increasing bacterial antibiotic resistance: a role for topical silver treatment.

              Antibiotic-resistant bacteria represent an increasing concern in wound infections. Wound colonization with these organisms normally results in aggressive management of the wound complicated by a greatly limited choice of therapeutic antibiotics. Silver and other noble metals are recognized as potential allies in combating these organisms in wounds. Three types of topical silver applications were tested to determine their bactericidal efficacies against clinical isolates of antibiotic-resistant organisms. The silver-based applications represent 3 methods of applying silver to wounds: as a liquid (silver nitrate), incorporated in a cream (silver sulfadiazine) and as a dressing coating (silver-coated dressings). The reduction in the viable bacterial population recovered from test articles after exposure to silver provided a comparative measure of the bactericidal efficacies of these silver applications. All of the products demonstrated an ability to reduce the number of viable bacteria. However, the methods varied in their efficacy against antibiotic-resistant bacteria, with the silver-coated dressing being the most efficacious and silver nitrate the least efficacious. Silver was demonstrated to be effective at killing the antibiotic-resistant strains tested. The silver-coated dressing was particularly rapid at killing the tested bacteria and was effective against a broader range of bacteria. Silver may be a useful prophylactic or therapeutic agent for the prevention of wound colonization by organisms that impede healing, including antibiotic-resistant bacteria.
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                Author and article information

                Journal
                cpil
                Cirugía Plástica Ibero-Latinoamericana
                Cir. plást. iberolatinoam.
                Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE) (Madrid, Madrid, Spain )
                0376-7892
                1989-2055
                2020
                : 46
                : suppl 1
                : 31-38
                Affiliations
                [1] orgnameHospital Civil de Guadalajara orgdiv1Unidad de Atención Integral a Niños con Quemaduras México
                Article
                S0376-78922020000200031 S0376-7892(20)04600000031
                10.4321/s0376-78922020000200008
                f84a5ef5-3a77-4f2c-8db4-1b4fce967f0b

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

                History
                : 10 January 2020
                : 27 September 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 8
                Product

                SciELO Spain

                Categories
                Quemados

                Burns infections,Wound infections,Wound dressings,Burns,Infección quemaduras,Infección heridas,Apósitos

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