Silver dressings – do they work?

doi:10.1136/dtb.2010.02.0014

Cited by 17 publications

(1 citation statement)

References 19 publications

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“…Sin embargo, para quemaduras y otras heridas donde la infección es un riesgo alto, se pueden usar apósitos antimicrobianos (AMD). Típicamente, el agente antimicrobiano (AMD) está contenido dentro de un apósito para heridas, que puede usarse tanto profilácticamente (para evitar la colonización de la herida y posterior formación de biofilm) así como en el tratamiento de la infección establecida (Anon, 2010).…”

Section: Marco Teóricounclassified

Desarrollo de un apósito biodegradable con potencial actividad protectora para el tratamiento de infecciones

Rodríguez¹,

Alfaro²,

Madrigal‐Carballo

et al. 2019

Memorias Del I Congreso Internacional De Ciencias Exactas Y Naturales

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Se obtuvieron apósitos biodegradables para tratamiento de heridas, con potencial actividad protectora contra infecciones. Las muestras se sintetizaron a partir de los residuos generados durante el procesamiento del camarón camello (Heterocarpus vicarius) y se cargaron con un antibiótico modelo. Los apósitos de quitosano cargados con antibiótico se formularon con concentraciones de antibióticos entre 0,65 y 4 mg/ml. Los apósitos obtenidos tenían un tamaño de poro entre 317 y 180 µm, mostraron un porcentaje de hinchamiento de 83 a 92% y el mecanismo de liberación del fármaco siguió a una cinética de primer orden, que se relaciona con un mecanismo de liberación de la inflamación por erosión del fármaco. Además, la evaluación de la actividad antimicrobiana in vitro mostró que el apósito para heridas cargado con antibióticos inhibe el crecimiento bacteriano de las cepas Staphylococcus aureus y Pseudomonas aeruginosa. Las muestras desarrolladas permiten la liberación de antibióticos, poros para el crecimiento celular, capacidad de absorción de líquidos y protección antimicrobiana efectiva en el tratamiento de infecciones bacterianas.

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Section: Marco Teóricounclassified

Desarrollo de un apósito biodegradable con potencial actividad protectora para el tratamiento de infecciones

Rodríguez¹,

Alfaro²,

Madrigal‐Carballo

et al. 2019

Memorias Del I Congreso Internacional De Ciencias Exactas Y Naturales

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Expert opinion on the management of infections in the diabetic foot

Lipsky

Peters

Senneville

et al. 2012

Diabetes Metabolism Res

177

155

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SummaryThis update of the International Working Group on the Diabetic Foot incorporates some information from a related review of diabetic foot osteomyelitis (DFO) and a systematic review of the management of infection of the diabetic foot. The pathophysiology of these infections is now well understood, and there is a validated system for classifying the severity of infections based on their clinical findings. Diagnosing osteomyelitis remains difficult, but several recent publications have clarified the role of clinical, laboratory and imaging tests. Magnetic resonance imaging has emerged as the most accurate means of diagnosing bone infection, but bone biopsy for culture and histopathology remains the criterion standard. Determining the organisms responsible for a diabetic foot infection via culture of appropriately collected tissue specimens enables clinicians to make optimal antibiotic choices based on culture and sensitivity results. In addition to culture-directed antibiotic therapy, most infections require some surgical intervention, ranging from minor debridement to major resection, amputation or revascularization. Clinicians must also provide proper wound care to ensure healing of the wound. Various adjunctive therapies may benefit some patients, but the data supporting them are weak. If properly treated, most diabetic foot infections can be cured. Providers practising in developing countries, and their patients, face especially challenging situations.

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IWGDF guidance on the diagnosis and management of foot infections in persons with diabetes

Lipsky

Aragón‐Sánchez

Diggle

et al. 2016

Diabetes Metabolism Res

494

561

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Recommendations Classification/diagnosis Diabetic foot infection must be diagnosed clinically, based on the presence of local or systemic signs or symptoms of inflammation (strong; low). Assess the severity of any diabetic foot infection using the Infectious Diseases Society of America/International Working Group on the Diabetic Foot classification scheme (strong; moderate). Osteomyelitis For an infected open wound, perform a probe‐to‐bone test; in a patient at low risk for osteomyelitis, a negative test largely rules out the diagnosis, while in a high‐risk patient, a positive test is largely diagnostic (strong; high). Markedly elevated serum inflammatory markers, especially erythrocyte sedimentation rate, are suggestive of osteomyelitis in suspected cases (weak; moderate). A definite diagnosis of bone infection usually requires positive results on microbiological (and, optimally, histological) examinations of an aseptically obtained bone sample, but this is usually required only when the diagnosis is in doubt or determining the causative pathogen's antibiotic susceptibility is crucial (strong; moderate). A probable diagnosis of bone infection is reasonable if there are positive results on a combination of diagnostic tests, such as probe‐to‐bone, serum inflammatory markers, plain X‐ray, magnetic resonance imaging (MRI) or radionuclide scanning (strong; weak). Avoid using results of soft tissue or sinus tract specimens for selecting antibiotic therapy for osteomyelitis as they do not accurately reflect bone culture results (strong; moderate). Obtain plain X‐rays of the foot in all cases of non‐superficial diabetic foot infection (strong; low). Use MRI when an advanced imaging test is needed for diagnosing diabetic foot osteomyelitis (strong; moderate). When MRI is not available or contraindicated, consider a white blood cell‐labelled radionuclide scan, or possibly single‐photon emission computed tomography (CT) and CT (SPECT/CT) or fluorine‐18‐fluorodeoxyglucose positron emission tomography/CT scans (weak; moderate). Assessing severity At initial evaluation of any infected foot, obtain vital signs and appropriate blood tests, debride the wound and probe and assess the depth and extent of the infection to establish its severity (strong; moderate). At initial evaluation, assess arterial perfusion and decide whether and when further vascular assessment or revascularization is needed (strong; low). Microbiological considerations Obtain cultures, preferably of a tissue specimen rather than a swab, of infected wounds to determine the causative microorganisms and their antibiotic sensitivity (strong; high). Do not obtain repeat cultures unless the patient is not clinically responding to treatment, or occasionally for infection control surveillance of resistant pathogens (strong; low). Send collected specimens to the microbiology laboratory promptly, in sterile transport containers, accompanied by clinical information on the type of specimen and location of the wound (strong; low). Surgical treatment Consult...

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Silver dressings – do they work?

Cited by 17 publications

References 19 publications

Desarrollo de un apósito biodegradable con potencial actividad protectora para el tratamiento de infecciones

Desarrollo de un apósito biodegradable con potencial actividad protectora para el tratamiento de infecciones

Expert opinion on the management of infections in the diabetic foot

IWGDF guidance on the diagnosis and management of foot infections in persons with diabetes

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