Lavanid® to sterylny, izoosmotyczny roztwór do miejscowego nawadniania ran ostrych i przewlekłych o zróżnicowanej etiologii. Produkt nadaje się również do stosowania śródoperacyjnego, a także do nawilżania wymazów, okładów i opatrunków.
Sprawdź najważniejsze informacje o produkcie Lavanid®:
-
- Jak działa produkt?
- Na jakie rany można go stosować?
- Przeciwwskazania w stosowaniu
- Opinia eksperta o produkcie
- W jaki sposób używać produktu?
- Jak długo można używać produktu?
- Skuteczność produktu – case study
- Jakie rodzaje produktu są dostępne?
- Czy na produkt przysługuje refundacja?
- Gdzie kupić produkt?
Jak działa produkt Lavanid®?
Płyn do irygacji ran Lavanid® to sterylny, izoosmotyczny roztwór na bazie płynu Ringera z dodatkiem poliheksanidu (PHMB). Płyn występuje w dwóch rodzajach: roztwór Lavanid 1 zawiera poliheksanid w stężeniu 0,02%, natomiast płyn Lavanid 2 zawiera 0,04% poliheksanidu.
Dzięki izotonicznym właściwościom płynu podczas stosowania nie zachodzi wymiana płynu ani elektrolitów z wydzielinami organizmu, co zapobiega powstawaniu obrzęków wokół rany oraz podrażnieniom. Połączenie płynu Ringera i 0,04% poliheksanidu, które zostało wykorzystane w roztworze, zapewnia produktowi bardzo dobrą tolerancję tkankową. Produkt nie ma działania cytotoksycznego. Znacznie redukuje lub całkowicie znosi dolegliwości bólowe pacjenta. Wpływa pozytywnie na regenerację tkanek i tworzącą się ziarninę, przyspieszając tym samym gojenie rany. Poliheksanid działa dużo korzystniej w ranie przewlekłej niż PVP-jod i dichlowodorek octenidyny.[1]
Zawarty w składzie produktu poliheksanid wpływa na zmniejszenie napięcia powierzchniowego roztworu, dzięki czemu możliwe jest skuteczne dotarcie do tkanek w obszarze rany i oczyszczenie ich.
Ponadto poliheksanid hamuje namnażanie się drobnoustrojów w opatrunkach oraz w roztworze, dzięki czemu zapobiega zakażeniom. Działanie poliheksanidu polega na selektywnym oddziaływaniu na cytoplazmę i błonę cytoplazmatyczną oraz uszkadzaniu DNA drobnoustrojów. Poliheksanid wykazuje skuteczność przeciwko szerokiemu spektrum mikroorganizmów. Zwalcza bakterie Gram-ujemne i Gram-dodatnie, w tym również szczepy oporne takie jak MRSA i VRE, bakterie przetrwalnikujące i wewnątrzkomórkowe, grzyby oraz wirusy. Poliheksanid jest także skuteczny w niszczeniu biofilmu. Według najnowszych wytycznych PHMB to środek antyseptyczny pierwszego wyboru w leczeniu ran krytycznie skolonizowanych i zakażonych oraz oparzeń.[2]
PHMB jest również skuteczną alternatywą dla antybiotyków działających miejscowo oraz prowadzi do redukcji bólu. [1,3]
Stosowanie płynu pozwala ponadto na zmniejszenie ilości włóknika i wysięku w łożysku rany, poprawę mikrokrążenia oraz skuteczne nawilżenie rany, dzięki czemu wspiera procesy gojenia. Dzięki właściwościom odkażającym i przeciwdrobnoustrojowym Lavanid® skutecznie eliminuje brzydki zapach z rany.
Lavanid® nie powoduje reakcji alergicznych i anafilaktycznych oraz rozwijania się odporności bakteryjnej. Płyn nadaje się do użytku przez 2 miesiące od pierwszego otwarcia opakowania, natomiast żel przez 1 miesiąc od otwarcia.
Na jakie rany można stosować płyn Lavanid®?
Płyn Lavanid® może być stosowany do oczyszczania i irygacji ran trudno gojących się takich jak owrzodzenia na podłożu cukrzycowym, odleżyny, owrzodzenia podudzi na tle niewydolności żylnej. Można go również stosować na rany o wysokim poziomie wrażliwości, takie jak oparzenia I i II stopnia.
Lavanid® może być również stosowany do przemywania ran ostrych, w tym również ran chirurgicznych. Produkt nadaje się także do stosowania śródoperacyjnego, a także w zapobieganiu zakażeniu miejsca operowanego.
Produkt jest również odpowiedni do leczenia ran zakażonych lub zagrożonych zakażeniem, w tym do zakażeń w obrębie endoprotezy oraz ostrych zakażeń kostnych i tkanek miękkich.
Do leczenia początkowego, ran ostrych i silnie zainfekowanych zaleca się płyn Lavanid 2 (0,04 proc. poliheksanidu). W ranach z rozwiniętym procesem gojenia, do płukania jam ciała, w miejscach zagrożonych infekcją oraz w terapii podciśnieniowej stosuje się natomiast płyn Lavanid 1 (0,02% poliheksanidu).
Przeciwwskazania w stosowaniu
Płyn Lavanid® nie powinien być stosowany w obrębie centralnego układu nerwowego oraz opon mózgowych. Nie zaleca się również stosowania produktu na rany i tkankę chrzęstną, a także w obrębie oczu oraz ucha środkowego i wewnętrznego.
Płyn nie powinien być stosowany we wlewach dootrzewnowych. Nie zaleca się również stosowania produktu u pacjentów ze stwierdzoną nadwrażliwością na poliheksanid.
Opinia eksperta o produkcie Lavanid® – Andrzej Przewięźlikowski, magister pielęgniarstwa chirurgicznego, specjalista w leczeniu ran przewlekłych, prowadzący własną działalność leczenia ran przewlekłych
Lavanid jest preparatem o szerokim zastosowaniu. Jest sterylnym, izoosmotycznym roztworem. W leczeniu ran przewlekłych należy pamiętać, że nie tylko rodzaj substancji czynnej ma znaczenie, ale również jej stężenie. Lavanid jest tego doskonałym przykładem. Dostępne stężenia PHMB w Lavanidzie to: Lavanid 1 – 0,02% i Lavanid 2 – 0,04%. Według badań poliheksanid w tych stężeniach jest antyseptykiem niepodrażniającym. Dzięki temu możliwe jest długotrwałe stosowanie tego preparatu na ranie.
W jaki sposób używać płynu Lavanid®?
Płyn Lavanid® może być dozowany na dwa sposoby: poprzez odkręcenie butelki lub wkłucie w nakrętkę specjalnego kolca. Aby skorzystać z drugiej metody, należy zdjąć folię aluminiową i zdezynfekować miejsce wkłucia kolca. Następnie należy włożyć kolec. W ten sposób butelka z płynem zostaje przygotowana do dozowania aseptycznego.
W celu mechanicznego oczyszczenia rany należy przepłukać ją preparatem Lavanid®. Produkt nadaję się do wielokrotnego i długotrwałego leczenia ran trudno gojących się.
Płyn można również wykorzystywać do nawilżania wymazów, okładów i opatrunków, tamponad i serwet operacyjnych. Stosuje się go także do dekontaminacji pacjentów zakażonych MRSA.
Płyn Lavanid® może być stosowany w terapii podciśnieniowej.
Produkt Lavanid® występuje również w formie żelu na rany, który może być stosowany wspólnie z płynem dla poprawy efektów leczenia.
Jak długo można używać produktu?
Ze względu na swój skład produkty Lavanid nie mają ograniczenia czasowego w ich zastosowaniu. Ich wskazaniem jest długoterminowa terapia ran.
Skuteczność produktu Lavanid® – case study
Chory, lat 27, aktywny zawodowo (kucharz), leczony z powodu owrzodzenia od 6 lat, obciążony otyłością olbrzymią i przewlekłą niewydolnością żylną w stopniu C6 wg klasyfikacji CEAP.
W chwili objęcia opieką owrzodzenie okrężne podudzia lewego od linii kostek do 1/3 górnej jego wysokości, pokryte złogami włóknika wymieszanymi z martwicą rozpływną obficie sączyło, wydzielało przykry zapach. Z relacji chorego wynika, że 6 lat temu pojawiła się niewielka rana w okolicy kostki przyśrodkowej.
W tej fazie leczył się u dermatologa. Pomimo leczenia rana powiększała się i kiedy pojawiła się druga w okolicy kostki bocznej, pacjent został skierowany do chirurga. Stosował wg zaleceń opatrunki specjalistyczne. Mimo to owrzodzenie nadal się powiększało. Ranę chory pielęgnował sam.
Pacjent trudny do współpracy, ze względu na otyłość olbrzymią ograniczone możliwości samopielęgnacji, bardzo żywo reagujący przy próbach oczyszczania rany (wielokrotnie przerywano debridement z powodu silnych dolegliwości bólowych).
Stan rany uległ radykalnej poprawie po wprowadzeniu kompresjoterapii półsztywnej, niestety zrezygnowano z niej mimo dobrych efektów. Ból był nie do zniesienia. Natomiast każda próba wprowadzenia opatrunków aktywnych w połączeniu z kompresjoterapią powodowała nawroty zakażenia generującego duże obszary martwicy.
Zdecydowano o zastosowaniu antyseptyków w przymoczkach zmienianych 2 razy dziennie w połączeniu z kompresjoterapią. Zastosowano podchloryny. Po początkowej poprawie stanu rany po czasie dochodziło do pogorszenia. Wówczas po raz pierwszy zastosowano PHMB w preparacie o stężeniu 0,1%, niestety i tym razem scenariusz się powtórzył.
Radykalną poprawę stanu rany odnotowano dopiero od 06.05.2020 r., kiedy zastosowano Lavanid 2 w stężeniu 0,04% poliheksanidu. Zakażenia i martwica nie nawracają, owrzodzenie powoli, ale sukcesywnie się zmniejsza.
Historia leczenia tego pacjenta zdaje się potwierdzać tezę prof. Kramera, że najlepszym antyseptykiem nie jest ten o najszerszym zastosowaniu, ale ten, który będzie najodpowiedniejszy do danego przypadku. Tak jak nie ma identycznych ran przewlekłych, tak też nie ma idealnego opatrunku, którym można leczyć wszystkie rany. Tym razem Lavanid i kompresjoterapia okazały się najskuteczniejszą metodą leczenia tej konkretnej rany.
Jakie rodzaje produktu są dostępne?
Płyn Lavanid® jest dostępny w butelkach o pojemności 125 ml, 250 ml, 500 ml oraz 1000 ml.
Lavanid Żel na rany jest dostępny w tubach o pojemności: 40 g i 100 g oraz w strzykawkach o pojemności 10g.
Czy na produkt Lavanid® przysługuje refundacja?
Produkt Lavanid® nie jest refundowany.
Gdzie kupić produkt Lavanid®?
Preparat Lavanid® jest dostępny w aptekach stacjonarnych w większości aptek na terenie kraju oraz na stronie internetowej firmy Surg-Tech – przedstawiciela producenta produktów Lavanid i Lavanox (podchloryn sodowy) w Polsce.
Można go kupić tu:
Firma Surg-Tech posiada w swojej ofercie nie tylko stale rosnącą gamę produktów do leczenia i pielęgnacji ran, ale również wysokiej jakości sprzęt do chirurgii małoinwazyjnej.
Źródła:
[1] Elżbieta Szkiler, Poliheksanid w miejscowym leczeniu ran, „Forum Zakażeń „2018, 9(5), 291-297.
[2] Kramer A., Consensus on Wound Antisepsis: Update 2018.
[3] Gerli S., Rossetti D, Di Renzo G.C. A new approach for the treatment of bacterial vaginosis; use of polyhexamethylene biguanide, „European Review for Medical and Pharmacological Sciences” 2003, 7(5), 127-130.
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