Totoraitis Kristin, Cohen Joel L, Friedman Adam
J Drugs Dermatol. 2017 Mar 1;16(3):209-212.
Surgical procedures are an important piece of a dermatologist's daily practice. Therefore, the optimization of post-surgical wound healing is an area of utmost importance and interest. Although low risk, one notable barrier to proper wound healing is surgical site infection.
In an attempt to mitigate this risk and improve surgical outcomes, multiple topical products continue to be used both pre- and postprocedure. Traditionally, this includes both topical antibiotics and antiseptics. However, these products are not without consequence.
The overuse of topical antibiotics as prophylaxis for infection has contributed to increased bacterial resistance, and in fact is no longer recommended by the American Academy of Dermatology in clean post surgical wounds. Topical antiseptics, including chlorhexidine and povidone-iodine, can have a cytotoxic effect on keratinocytes and may actually impede wound healing as a result. In addition, chlorhexidine in particular can produce both otologic and ocular toxic effects when used on the face. Emerging products, such as hypochlorous acid, may be a potential alternative to the more commonly used agents, as it has effective antimicrobial actions and minimal adverse effects. Therefore, the purpose of this review is to highlight several topical products used to optimize post-surgical wound healing and discuss both their efficacy and safety.
J Drugs Dermatol. 2017;16(3):209-212.
.手术操作是皮肤科医生日常工作的重要组成部分。因此,优化术后伤口愈合是一个极其重要且备受关注的领域。尽管风险较低,但手术部位感染是影响伤口正常愈合的一个显著障碍。
为了降低这种风险并改善手术效果,术前和术后都持续使用多种局部用产品。传统上,这包括局部用抗生素和防腐剂。然而,这些产品并非没有问题。
局部用抗生素作为感染预防药物的过度使用导致了细菌耐药性增加,事实上,美国皮肤科协会已不再推荐在清洁的术后伤口中使用。包括氯己定和聚维酮碘在内的局部用防腐剂可能对角质形成细胞产生细胞毒性作用,进而可能阻碍伤口愈合。此外,尤其是氯己定用于面部时,可能会产生耳毒性和眼毒性作用。新兴产品,如次氯酸,可能是更常用药物的潜在替代品,因为它具有有效的抗菌作用且不良反应最小。因此,本综述的目的是强调几种用于优化术后伤口愈合的局部用产品,并讨论它们的疗效和安全性。
《皮肤药物学杂志》2017年;16(3):209 - 212。