Eardley William G P, Watts Sarah A, Clasper Jon C
Royal Centre for Defence Medicine, Birmingham, UK.
Int J Low Extrem Wounds. 2012 Sep;11(3):213-23. doi: 10.1177/1534734612450589. Epub 2012 Jun 21.
Extremity injury and contamination as consequence are features of high-energy wounding. A leading cause of disability and the commonest cause of late complications, prevention of wound infection determines the ultimate outcome in these populations. Multiple variables influence the development of infection, one of which is the dressing used on the wound. Antiseptic-soaked gauze dressings feature in the early management of limb trauma despite a lack of evidence to support this. Iodine and chlorhexidine are ubiquitous in other aspects of health care however, and a plethora of studies detail their role in skin antisepsis, the recommendations from which are often anecdotally applied to acute wounding. To contextualize the role for antiseptic dressing use in acute, significant limb injury this review explores the evidence for the use of chlorhexidine and iodine in skin antisepsis. The paucity of experimental data available for antiseptic use in early wound management and the need for further research to address this evidence void is highlighted.
肢体损伤及随之而来的污染是高能创伤的特征。伤口感染是导致残疾的主要原因和晚期并发症的最常见原因，预防伤口感染决定了这些人群的最终结局。多种因素会影响感染的发生，其中之一是伤口所使用的敷料。尽管缺乏证据支持，但浸有防腐剂的纱布敷料在肢体创伤的早期处理中较为常见。然而，碘和洗必泰在医疗保健的其他方面广泛使用，大量研究详细阐述了它们在皮肤消毒中的作用，这些研究的建议常常被经验性地应用于急性创伤。为了阐明在急性严重肢体损伤中使用抗菌敷料的作用，本综述探讨了洗必泰和碘在皮肤消毒中应用的证据。强调了在早期伤口处理中使用防腐剂的实验数据匮乏，以及需要进一步研究来填补这一证据空白。
