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Co zamiast antybiotyku na ranę zakażoną? Walka z infekcją bez zwiększania oporności bakterii

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Leczenie ran zakażonych to wciąż duże wyzwanie w procesie terapeutycznym. Ze względu na obecność biofilmu, który chroni drobnoustroje przed aktywnością antybiotyków, zwalczanie infekcji jest utrudnione, a terapia się wydłuża. Odpowiedź na ten problem stanowią nie antybiotykowe środki przeciwdrobnoustrojowe, takie jak maść SutriHeal® Forte 5% z formułą kwasów żywicznych i lignanów.

Antybiotykooporność to rosnący problem współczesnej opieki zdrowotnej i jedno z największych zagrożeń zdrowia publicznego. W wyniku zakażeń lekoopornymi patogenami rocznie umiera na świecie 700 tysięcy osób. Do 2050 roku liczba ta może wzrosnąć nawet ponad dziesięciokrotnie. Jedną z przyczyn wzrastającej oporności drobnoustrojów na antybiotyki jest ich nieprawidłowe i nadmierne stosowanie w leczeniu ran zakażonych.

Zakażenie rany a proces gojenia

Według szacunków struktura biofilmu jest obecna w 60-100% przypadków ran trudno gojących się. Obecność biofilmu bakteryjnego prowadzi do opóźnienia lub całkowitego zahamowania procesu gojenia, podwyższenia poziomu pH, hipoksji tkanek, a także do uszkodzenia białek i rozpadu tkanek poprzez podwyższenie poziomu proteaz oraz wolnych rodników (ang. reactive oxygen species, ROS).

U pacjentów z zespołem stopy cukrzycowej obecność nieleczonej rany zakażonej z biofilmem może doprowadzić do powikłań takich jak m.in. zapalenie szpiku czy zapalenie kości, a w konsekwencji do amputacji kończyny. Możliwym następstwem nieleczonej infekcji w ranie jest również zakażenie ogólnoustrojowe i wstrząs septyczny.

Antybiotyki w miejscowym leczeniu ran

Według literatury naukowej brak jest dowodów na skuteczność miejscowego stosowania antybiotyków w leczeniu ran zakażonych. Wielowarstwowa struktura biofilmu obecna w ranach zakażonych uniemożliwia osiągnięcie w ranie stężenia terapeutycznego antybiotyku. Ekspozycja ran na antybiotyki prowadzi więc do wykształcenia przez drobnoustroje oporności przy jednoczesnym braku pozytywnego efektu terapeutycznego.

Wytyczne postępowania z ranami trudno gojącymi się z aktywnym procesem infekcji

Struktura biofilmu ma zdolność do szybkiego odtwarzania się (nawet już w ciągu 24h) i rozprzestrzeniania, w związku z czym jej skuteczna i trwała eradykacja stanowi wyzwanie terapeutyczne.

Według aktualnych wytycznych towarzystw naukowych postępowanie z raną zakażoną z obecnością biofilmu powinno uwzględniać:

  • dokładne, regularne oczyszczanie mechaniczne prowadzące do usunięcia biofilmu oraz tkanek martwiczych,
  • oczyszczanie za pomocą produktu antyseptycznego dostosowanego do stanu rany przy każdej zmianie opatrunku,
  • zastosowanie opatrunków specjalistycznych i produktów pomocniczych o działaniu przeciwbakteryjnym i przeciwbiofilmowym.

Jednym z nieantybiotykowych, miejscowo działających środków przeciwdrobnoustrojowych, które znajdują zastosowanie w leczeniu ran z toczącym się procesem infekcji, jest maść SutriHeal Forte 5% z formułą kwasów żywicznych i lignanów.

Produkt ten może być stosowany zarówno w leczeniu zakażonych ran przewlekłych z wysiękiem małym do średniego (odleżyny, owrzodzenia, oparzenia, zespół stopy cukrzycowej, rany nowotworowe), ran ostrych (rany chirurgiczne, pooperacyjne, zadrapania, skaleczenia), jak i schorzeń podologicznych.

Maść SutriHeal® Forte 5% w leczeniu ran zakażonych

Struktura biofilmu ma w zdecydowanej większości przypadków charakter wielogatunkowy. Najczęściej występującymi w strukturze biofilmu patogenami są gronkowiec złocisty (S. aureus) oraz pałeczka ropy błękitnej (P. aeruginosa). Współistnienie tych patogenów wiąże się z istotnym pogorszeniem stanu rany.

Maść SutriHeal® Forte 5% wykazuje skuteczność przeciwbakteryjną  zarówno wobec szczepów S. aureus, jak i P. aeruginosa. Maść ma również zdolność do istotnej redukcji biofilmu tworzonego przez wymienione patogeny przy jednoczesnym braku działania cytotoksycznego na komórki pacjenta tworzące łożysko rany. Maść nie prowadzi również do indukcji stanu zapalnego.

 

 

Działanie przeciwdrobnoustrojowe maści SutriHeal® Forte 5% wynika z wykorzystania innowacyjnej formuły kwasów żywicznych i lignanów pozyskanych z ekstraktu świerku norweskiego. W skład tego ekstraktu wchodzą substancje takie jak  diterpenoidy (m.in. kwas abietynowy, kwas dehydroabietynowy), kwas p-kumarowy, których działanie jest analogiczne do działania nowoczesnych antyseptyków.

Maść SutriHeal® Forte 5% wpływa również na stymulację procesu gojenia (średnio o 2 mm/doba). Z tego względu w opracowaniach eksperckich wskazuje się na jej wysoką przydatność kliniczną i szerokie spektrum zastosowania.

 

Przeczytaj więcej na temat maści SutriHeal® Forte 5%:

Bibliografia:

  1. M. Bartoszewicz, A. Junka, „Ocena aktywności in vitro maści Sutriheal® Forte 5% względem Staphylococcus aureus i Pseudomonas aeruginosa oraz linii komórkowych odpowiedzialnych za proces gojenia się rany”, „Forum Leczenia Ran” 2021, 2(2): 71-80.
  2. M. Kucharzewski, E. Szkiler i in., „Algorytmy i wytyczne postępowania terapeutycznego w ranach trudno gojących się”, „Forum Leczenia Ran” 2020, 1(3): 95-116.
  3. M. Bartoszewicz, T. Banasiewicz i in., „Zasady postępowania miejscowego i ogólnego w ranach/owrzodzeniach przewlekłych objętych procesem infekcji”, „Forum Zakażeń” 2019, 10(1): 1-30.
  4. U. Zielińska, A. Zdun, „Miejsce antybiotykoterapii w leczeniu ran”, „Pielęgniarstwo w Anestezjologii i Intensywnej Opiece” 2019, 5(4): 121-125.
  5. K. Bondarczuk, „Skutki antybiotykoodporności – co już wiemy, a czego możemy się spodziewać?”, „Forum Zakażeń” 2020, 11(6): 297-300.
  6. E. Szkiler, „Zakażenie ran i owrzodzeń – postępowanie w praktyce pielęgniarskiej”, „Pielęgniarstwo w Anestezjologii i Intensywnej Opiece” 2019, 5(2): 47-52.

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  44. تنظيف المنازل في المدينة هو عمل شاق ولا يزال يحتاج إلى الكثير من الوقت والجهد. يمكن أن يكون التنظيف الشامل للبيت أمرًا صعبًا، خاصة عندما يتعلق الأمر بمساحات كبيرة وأثاث كثير. تظهر المنظفات المحترفات في هذه الحالات كأفضل الخيارات لإنهاء العمل بفعالية وسرعة. يتم توفير خدمات تنظيف المنازل بأسعار معقولة، ويمكن الحصول على خدمات تنظيف متنوعة مثل تنظيف الأرضيات والنوافذ والستائر والحمامات والمطابخ. بالإضافة إلى ذلك، بعض الشركات تستخدم مواد تنظيف ذات جودة عالية وخالية من المواد الكيميائية الضارة بالإنسان والطبيعة. إذا كنت تريد العناية بمنزلك بطريقة صحيحة ودقيقة وتريد توفير الوقت والجهد، فإن تنظيف المنزل بالمدينة هو خيار جيد.
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