Estudo clínico da prata iônica associada à microbiota de feridas de membros inferiores

Abstract

Silver, a topical antimicrobial originally used for water purification, has been used for hundreds of years to heal wounds due to its broad action spectrum against a wide variety of bacteria, fungi and viruses, including many antibiotic resistant bacteria such as Staphylococcus aureus (MRAS) and Vancomycin Resistant Enterococci (ERV). Objective: To analyze the patients wound bed microbiota with venous ulcers who who had been using topical Aquacel AG Extra (™) for 15 days. Methods: This a cross-sectional study through field research, presenting qualitative and quantitative variables that verified the venous ulcers microbiota through tissue biopsy (punch) before and after the usage Aquacel AG Extra (™) in patients with venous ulcers in Hospital de Base’s vascular ambulatory in São José do Rio Preto, SP. Results: During the two month period, nine patients were evaluated. Results showed that 11 different bacteria types were found in 18 piglets: 81.81% gram negative and 18.18% gram positive. The biopsy has qualitatively identified the microrganisms present in the wound, however, quantitative information is very important when using an antimicrobial coverage, since the microrganism may be present in numbers of reduced colonies. There was a predominance of people over 60 years old, male, mostly retired and neither alcoholics nor smokers. Pain was a factor that revealed an promising result and we could associate this with the coverage studied. Pseudomonas aeruginosa was the most frequently found gram negative microrganism and Staphylococcus aureus the gram positive one. Conclusion It is of fundamental importance the reliable identification of the microrganisms to conduct the drug treatment and the choice of the antimicrobial coverage, since the microorganism can be present in the wound in a smaller quantity of number of colonies. The results also pointed to the importance of zeal in the indication of antimicrobials, monitoring their effects, and supervising patient adherence, in order to minimize the possibilities of microbial resistance due to indiscriminate or inadequate use of coverages and medications.