Firdoose Nyer, Hasoon Umer
Department of Oral and Maxillofacial Surgery, Ministry of Health, Riyadh 13226, India.
East Riyadh Specialized Centre Ishbiliya, Ministry of Health, Riyadh 13226, Kingdom of Saudi Arabia.
Natl J Maxillofac Surg. 2018 Jan-Jun;9(1):78-81. doi: 10.4103/njms.NJMS_69_17.
A number of dressings containing silver have been recently introduced into the wound care market as increased resistance to antibiotics has become a problem in treating infected wounds. A 54-year-old male, with adenoid cystic carcinoma treated by segmental resection and reconstruction of mandible using reconstruction plate with concomitant radiotherapy, resulted in a deep extraoral nonhealing necrotic, exuding, malodorous, and painful wound. Erythema, eczema, and trophic changes were surrounding the skin. Previous treatment was removal of exposed reconstruction plate and primary closure. Culture samples reported methicillin-resistant positive and sensitivity to linezolid. Repeated failed attempts to approximate the wound, prompted the use of Calgigraf Ag foam as dressing for the wound. Evidence of new tissue growth and subsequent reduction in wound area and exudate were significant. Chronic nonhealing wounds involving progressive tissue loss give rise to the biggest challenge to wound-care researchers. Despite proper care, some wounds fail to heal in normally and become chronic. The use of ionic silver with negative pressure therapy is safe and effective in difficult nonhealing wounds. This case illustrates the potential benefit of ionic silver combined with negative pressure and moist wound healing as management of a patient with long-standing, nonhealing, and osteoradionecrosis wound. Calgigraf Ag Foam a silver alginate dressing is optimal for maintaining moist environment vital to promote wound healing. It needs less frequent dressing changes with additional benefits such management of excessive exudate minimising malodour and maintaining a moist wound environment.
由于在治疗感染伤口时抗生素耐药性增加已成为一个问题,最近有多种含银敷料被引入伤口护理市场。一名54岁男性,患有腺样囊性癌,接受了下颌骨节段性切除并使用重建钢板进行重建,同时进行了放射治疗,结果导致口腔外有一个深部不愈合的坏死、渗出、有异味且疼痛的伤口。伤口周围皮肤出现红斑、湿疹和营养性改变。先前的治疗是取出暴露的重建钢板并进行一期缝合。培养样本报告为耐甲氧西林阳性,对利奈唑胺敏感。多次尝试闭合伤口均失败,促使使用Calgigraf Ag泡沫敷料来处理该伤口。新组织生长的证据以及随后伤口面积和渗出物的减少都很显著。涉及渐进性组织损失的慢性不愈合伤口给伤口护理研究人员带来了最大的挑战。尽管给予了适当的护理,但一些伤口仍无法正常愈合而变成慢性伤口。在处理困难的不愈合伤口时,使用离子银负压疗法是安全有效的。本病例说明了离子银联合负压和湿性伤口愈合在治疗长期不愈合且伴有放射性骨坏死伤口患者中的潜在益处。Calgigraf Ag泡沫敷料是一种藻酸盐银敷料,对于维持促进伤口愈合至关重要的湿润环境是最佳选择。它需要较少频繁更换敷料,还有额外的益处,如管理过多的渗出物、减少异味以及维持伤口湿润环境。