Hutchinson J J, Lawrence J C
Wound Healing Research Institute, Deeside, Clwyd.
J Hosp Infect. 1991 Feb;17(2):83-94. doi: 10.1016/0195-6701(91)90172-5.
It is often supposed that occlusive dressings potentiate wound infection. However, even though heavy colonization by skin and wound flora is often seen under certain types of occlusion, clinical infection is not a frequent occurrence. Commensal wound flora consists of a variety of Gram-positive and Gram-negative organisms and fungi which do not appear to be detrimental to healing. Certain aspects of wound healing may in fact be promoted by bacterial colonization, although clinical infection can lead to wound breakdown and systemic infection. Wounds compromised by devitalized tissue, drains or sutures are more susceptible than clean wounds to clinical infection. Occlusive dressings may help prevent infection by presenting a barrier to potential pathogens, and hydrocolloid occlusive dressings have been shown to prevent dissemination of methicillin-resistant Staphylococcus aureus. The rate of clinical infection as deduced from published trials of dressings is lower under occlusion than when non-occlusive dressings are used, and this is likely to be a result of normal activity of the host defences under occlusive dressings.
人们常常认为封闭性敷料会增加伤口感染的风险。然而，尽管在某些类型的封闭环境下，皮肤和伤口菌群的大量定植很常见，但临床感染并不经常发生。共生的伤口菌群由各种革兰氏阳性菌、革兰氏阴性菌以及真菌组成，这些菌群似乎对伤口愈合并无损害。实际上，细菌定植可能会促进伤口愈合的某些方面，尽管临床感染会导致伤口破溃和全身感染。因失活组织、引流管或缝线而受损的伤口比清洁伤口更容易发生临床感染。封闭性敷料可以通过对潜在病原体形成屏障来帮助预防感染，并且水胶体封闭性敷料已被证明可以防止耐甲氧西林金黄色葡萄球菌的传播。从已发表的敷料试验推断，封闭环境下的临床感染率低于使用非封闭性敷料时，这可能是由于封闭性敷料下宿主防御系统正常发挥作用的结果。
