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新型技术治疗皮肤和软组织感染。

Novel techniques in the treatment of skin and soft tissue infection.

机构信息

Hampshire Hospitals Foundation NHS Trust, Winchester.

University of Southampton, Faculty of Medicine, Southampton, UK.

出版信息

Curr Opin Infect Dis. 2022 Apr 1;35(2):72-78. doi: 10.1097/QCO.0000000000000818.

Abstract

PURPOSE OF REVIEW

Global antibiotic resistance is compromising the management of soft tissue infection and Acute Bacterial Skin and Skin Structure Infection (ABSSI). This review describes a novel topical treatment Reactive Oxygen (RO) gel which could compliment and in some situations replace systemic antibiotics.

RECENT FINDINGS

A novel topical treatment RO gel could have an important role in treatment, infection prevention and antimicrobial stewardship. RO is highly antimicrobial against Gram positive and negative bacteria, by slow release of oxygen radicals over a prolonged period of up to 72 h. It prevents and breaks down biofilm and may support healing by cellular signalling. Much clinical investigation remains to be delivered on RO therapy but there seem few disadvantages in its use and early clinical evaluations are extremely promising.

SUMMARY

Managing complicated skin and soft tissue infections require more than just antibiotic treatment. Soft tissue infection healing is often compromised by underlying comorbidities and pathology and increasingly the presence of highly antimicrobial-resistant bacteria. This has been highlighted particularly in war and trauma soft tissue infection. The fundamentals of soft tissue infection repair require early surgical drainage and debridement, correction of compromised physiology and treatment of underlying conditions and appropriate antimicrobial treatment. RO therapy could be an important advance.

摘要

目的综述

全球抗生素耐药性正在影响软组织感染和急性细菌性皮肤和皮肤结构感染(ABSSI)的治疗。本综述描述了一种新型局部治疗活性氧(RO)凝胶,它可以补充并在某些情况下替代全身抗生素。

最近的发现

一种新型的局部治疗 RO 凝胶在治疗、感染预防和抗菌药物管理方面可能具有重要作用。RO 通过缓慢释放氧自由基在长达 72 小时的时间内具有高度抗革兰氏阳性和革兰氏阴性细菌的作用。它可以防止和分解生物膜,并通过细胞信号支持愈合。关于 RO 治疗仍有许多临床研究有待开展,但它的使用似乎几乎没有缺点,早期临床评估非常有希望。

总结

管理复杂的皮肤和软组织感染需要的不仅仅是抗生素治疗。软组织感染的愈合常常受到潜在的合并症和病理学以及越来越多的高度抗微生物耐药细菌的影响。这在战争和创伤软组织感染中尤为突出。软组织感染修复的基础需要早期手术引流和清创、纠正受损的生理机能以及治疗潜在疾病和适当的抗菌治疗。RO 治疗可能是一个重要的进展。

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