Topical Antimicrobial Therapy for Treating Chronic Wounds
Topical Antimicrobial Therapy for Treating Chronic Wounds
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DOI：
10.1086/644732
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发表时间：
2009-11-15
影响因子：
11.8
通讯作者：
Hoey, Christopher
中科院分区：
文献类型：
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作者：
Lipsky, Benjamin A.;Hoey, Christopher
数千年来，各种药物已被局部应用于治疗感染的伤口，但它们的适当作用仍不清楚。局部治疗提供了许多潜在的优点，但也有缺点。关于哪些临床体征定义伤口感染以及定量微生物学研究是否有用，意见不一。临床感染的伤口通常需要全身抗生素治疗，而临床未感染的伤口如预期愈合不需要抗菌剂。对于如何治疗愈合不良的伤口并伴有提示感染的“继发性”体征存在争议;这些可能受益于局部抗菌药物。一些证据支持使用局部药剂治疗恶臭或烧伤伤口。荟萃分析和系统评价表明，局部抗菌药物的适应症很少。使用更新的、相对无毒的抗菌剂（例如，卡地姆碘或银敷料）比使用局部抗生素更可取，尤其是可用于全身使用的药物。我们提供目前可用的局部抗菌药物的临床相关信息。
Various agents have been applied topically to treat infected wounds for millennia, but their proper role remains unclear. Topical therapy affords many potential advantages but also has disadvantages. Opinions differ on which clinical signs define wound infection and on whether quantitative microbiological studies are useful. Clinically infected wounds usually require systemic antibiotic therapy, whereas clinically uninfected wounds that are healing as expected do not require antimicrobials. There is controversy over how to treat poorly healing wounds with "secondary" signs suggesting infection; these may benefit from topical antimicrobial agents. Some evidence supports using topical agents for malodorous or burn wounds. Meta-analyses and systematic reviews suggest there are few proven indications for topical antimicrobials. Use of a newer, relatively nontoxic antiseptic (eg, cadexomer iodine or silver dressings) is preferable to use of topical antibiotics, especially agents that are available for systemic use. We provide clinically relevant information on currently available topical antimicrobial agents.