Senevirathne Samitha, Ekanayake Gayan, Samarathunge Dishan, Basnayke Oshan
Professorial Surgical Unit, National Hospital of Sri Lanka, Colombo, LKA.
Plastic and Reconstructive Surgery, National Hospital of Sri Lanka, Colombo, LKA.
Cureus. 2024 Aug 20;16(8):e67274. doi: 10.7759/cureus.67274. eCollection 2024 Aug.
Biofilm formation over burn wounds has led to persistent wound infection, poor wound healing, and resistance to antimicrobial therapy. This process ultimately leads to prolonged hospital stays and increased cost of burn wound care, especially in developing countries. Hence, large-area biofilm-targeted therapy should be a mainstay in burn wound care. Polyhexanide is a polymer used as a disinfectant, and betaine is a surfactant. We report a patient managed with a combined preparation of the above two substances. A 44-year-old patient sustained a 22% superficial partial-thickness and mid-dermal burns on the back and right arm after a high-voltage electrocution injury. The patient was treated with dressings containing the above preparation and closely monitored for the healing stages of the burn wound. Complete wound epithelialization with healthy granulation tissue was achieved within 15 days. No surface wound swab culture became positive during the treatment. The patient did not develop any fever spikes, and the white blood cell count was maintained at less than 12,000 mm with a C-reactive protein level below 50 mg/L. No surgical intervention was needed for further management of the wound. Polyhexanide and betaine combined preparation may be used effectively on the superficial partial-thickness and mid-dermal burns to prevent wound infection and improve granulation and epithelialization. However, high-quality comparative evidence is needed for the confirmation.
烧伤创面生物膜的形成会导致创面持续感染、愈合不良以及对抗菌治疗产生耐药性。这一过程最终会导致住院时间延长以及烧伤创面护理成本增加,在发展中国家尤其如此。因此,大面积生物膜靶向治疗应成为烧伤创面护理的主要手段。聚己缩胍是一种用作消毒剂的聚合物,而甜菜碱是一种表面活性剂。我们报告了一例使用上述两种物质的联合制剂进行治疗的患者。一名44岁患者在遭受高压电击伤后,背部和右臂有22%的浅Ⅱ度和深Ⅱ度烧伤。该患者接受了含有上述制剂的敷料治疗,并密切监测烧伤创面的愈合阶段。在15天内实现了创面完全上皮化,并有健康的肉芽组织。治疗期间,创面表面拭子培养均未呈阳性。患者未出现任何体温峰值,白细胞计数维持在12,000/mm以下,C反应蛋白水平低于50mg/L。无需进行手术干预来进一步处理创面。聚己缩胍和甜菜碱联合制剂可有效用于浅Ⅱ度和深Ⅱ度烧伤,以预防创面感染并促进肉芽组织生长和上皮化。然而,需要高质量的比较证据来证实这一点。