Resumen
Objetivo: Realizar una revisión integrada para analizar las evidencias científicas referentes a la identificación de los microorganismos comunmente aislados en lesiones tisulares contaminadas y a los principales productos utilizados en las mismas.
Método: Revisión integrada a partir de una búsqueda usando los descriptores Úlcera de Pierna, Infección, Bactéria y Enfermería, en las bases de datos LILACS, IBECS, MEDLINE, Cochrane y SciELO, incluyendo artículos publicados entre 2003 y 2013.
Resultados: Fueron seleccionados 14 artículos, siendo siete de observación y siete estudios experimentales.
Discusión: Staphylococcus aureus y Pseudomonas aeruginosa fueron los microorganismos más imperantes en las lesiones tisulares evaluadas, seguidos por Enterobacter, Klebsiella pneumoniae y Acinetobacter. Los principales productos utilizados fueron alginato de plata, sulfadiazina de plata, luz ultravioleta y papaína, efectivos en la diminución de la carga bacteriana de lesiones contaminadas.
Conclusión: La identificación precoz de la presencia de microorganismos en las lesiones permite la decisión de la propedéutica adecuada a ser realizada.
Descriptores: Úlcera de la Pierna; Infección; Bacterias; Enfermería.
Citas
Martins MA, Tipple AFV, Reis C, Santiago SB, Bachion MM. Úlcera crônica de perna de pacientes em tratamento ambulatorial: análise microbiológica e de suscetibilidade antimicrobiana. Cienc Cuid Saude (Online) [Internet]. 2010 [Cited 2014 Oct 3] 9(3):464-70. Available from: http://periodicos. uem.br/ojs/index.php/CiencCuidSaude/article/view/8178/6635. [included in the review]
Zaho G, Hochwalt PC, Usui ML, et al. Delayed Wound Healing in Diabetic (db/db) Mice with Pseudomonas aeruginosa Biofilm Challenge – A Model for the Study of Chronic Wounds. Wound Repair Regen. (Online) [Internet] 2010 [Cited 2014 Oct 3] 18(5):467-77. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1524-475X.2010.00608.x/pdf
Silva RCL, Figueiredo NBA, Meireles IB, et al. Feridas, fundamentos e atualizações em enfermagem. 3ª edição. São Paulo: Yendis editora; 2011.
Tuttle MS, Mostow E, Mukherjee P, et al. Characterization of Bacterial Communities in Venous Insufficiency Wounds by Use of Conventional Culture and Molecular Diagnostic Methods. Journal of Clinical Microbiology. (Online) [Internet] 2011 [Cited 2014 Oct 3] 49(11):3812-19. Available from: http://jcm.asm.org/content/49/11/3812.long
Turhan V et al. Increasing incidence of Gram-negative organisms in bacterial agents isolated from diabetic foot ulcers. J Infect Dev Ctries. (Online) [Internet] 2013 [Cited 2014 Oct 3] 7(10):707-712. Available from: file:///C:/Users/Win/Downloads/2967-24527-1-PB.pdf
Rhoads DD, Cox SB, Rees EJ, Sun Y, Wolcott RD. Clinical identification of bacteria in human chronic wound infections: culturing vs. 16S ribosomal DNA sequencing. BMC Infectious Diseases. (Online) [Internet] 2012 [Cited 2014 Oct 3] 12(321):1-8. Available from: http://www.biomedcentral.com/ content/pdf/1471-2334-12-321.pdf
Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. J Clin Epidemiol. (Online) [Internet] 2008 [Cited 2014 Oct 3] 61(4):344-9. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2034723/pdf/bmj-335-7624-ac-00806.pdf
Taminato M, Fram D, Torloni MR, Belasco AGS, Saconato H, Barbosa DA. Rastreamento de Streptococcus do grupo B em gestantes: revisão integrativa e metanálise. Revista Latino Americana de Enfermagem. (Online) [Internet] 2011 [Cited 2014 Oct 3] 19(6):[9 telas]. Available from: http://www.scielo.br/pdf/rlae/v19n6/26.pdf
Gjødsbøl K, Skindersoe ME, Christensen JJ, Karlsmark T, Jørgensen B, Jensen AM, Klein BM, Sonnested MK, Krogfelt KA. No need for biopsies: comparison of three sample techniques for wound microbiota determination. Int Wound J. 2012 [Cited 2014 Oct 8] 9(3): 295-302. [included in the review]
Cantarelli VV, Brodt TCZ, Secchi C, Inamine E, Pereira FS. Cutaneous infection caused by Corynebacterium pseudodiphtheriticum. A microbiological report. Rev. Inst. Med. trop. S. Paulo. (Online) [Internet] 2008 [Cited 2014 Oct 8] 50(1): 51-52. Available from: http://www.scielo.br/pdf/rimtsp/v50n1/a11v50n1.pdf [included in the review]
Cooper RA, Ameen H, Price P, McCulloch DA, Harding KG. A clinical investigation into the microbiological status of 'locally infected' leg ulcers. Int Wound J. 2009 [Cited 2014 Oct 8] 6(6): 453-62. [included in the review]
Wolcott RD, Rhoads DD. A study of biofilm-based wound management in subjects with critical limb ichaemia. Journal of wound care. 2008 [Cited 2014 Oct 8] 17(4): 145-155. [included in the review]
Landsdown AB, Williams A. Bacterial resistance to silver in wound care and medical devices. J Wound Care. 2007 [Cited 2014 Oct 8] 16(1): 15-9. [included in the review]
Basu S, Ramchuran Panray T, Bali Singh T, Gulati AK, Shukla VK. A prospective, descriptive study to identify the microbiological profile of chronic wounds in outpatients. Ostomy Wound Manage. (Online) [Internet] 2009 [Cited 2014 Oct 8] 55(1): 14-20. Available from: http://www.o-wm.com/content/a-prospective-descriptive-study-identify-microbiological-profile-chronic-wounds-outpatients. [included in the review]
Woo KY, Coutts PM, Sibbald RG. A randomized controlled trial to evaluate an antimicrobial dressing with silver alginate powder for the management of chronic wounds exhibiting signs of critical colonization. Adv Skin Wound Care. 2012 [Cited 2014 Oct 8] 25(11): 503-8. [included in the review]
Steenvoorde P, Doorn LPV, Jacobi CE, Oskam J. An Unnexpected effect of Dermacyn on infected leg ulcer. Journal of wound care. 2007 [Cited 2014 Oct 15] 16(2): 60-61. [included in the review]
Meaume S, Vallet D. Evalluation of a silver-releasing hydroalginate dressing in chronic wounds with signals of local infection. Journal of wound care. 2005 [Cited 2014 Oct 15] 14(9): 411-419. [included in the review]
Brown S. Clinical antimicrobial photodynamic therapy: phase II studies in chronic wounds. J Natl Compr Canc Netw. (Online) [Internet] 2012 [Cited 2014 Oct 15] 10 Suppl 2: S80-3. Available from: http://www.jnccn.org/content/10/Suppl_2/S-80.full.pdf+html[included in the review]
Thai TP, Keast DH, Campbell KE, Woodbury MG, Houghton PE. Effect of ultraviolet light C on bacterial colonization in chronic wounds. Ostomy Wound Manage. (Online) [Internet] 2005 [Cited 2014 Oct 8] 51(10): 32-45. Available from: http://www.o-wm.com/content/effect-ultraviolet-light-c-bacterial-colonization-chronic-wounds [included in the review]
Downe A. Use of Urgotul SSD to reduce bacteria and promote healing in chronic wounds. Br J Community Nurs. 2013 [Cited 2014 Oct 8] Suppl: S32, S34-8. [included in the review]
Lazareth I, Meaume S, Sigal-Grinberg ML, Combemale P, Le Guyadec T, Zagnoli A. Efficacy of a silver lipidocolloid dressing on heavily colonised wounds: a republished RCT. J Wound Care. 2012 [Cited 2014 Oct 8] 21(2): 96-102. [included in the review]
Nasir NM, Halim AS, Singh KB, Dorai AA, Haneef MM. Antibacterial properties of tualang honey and its effect in burn wound management: a comparative study. BMC Complementary and Alternative Medicin. (Online) [Internet] 2010 [Cited 2014 Oct 8] 10(31). Available from: http://www.biomedcentral.com/1472-6882/10/31
Han A, Zenilman JM, Melendez JH, et al. The importance of a multi-faceted approach to characterizing the microbial flora of chronic wounds. Wound Repair Regen. (Online) [Internet] 2011 [Cited 2014 Oct 8] 19(5):532-541. Available from: http://onlinelibrary.wiley.com/doi/10.1111/j.1524-475X.2011.00720.x/p df
Hirsch T, Spielmann M, Zuhaili B, et al. Enhanced susceptibility to infections in a diabetic wound healing model. BMC Surgery. (Online) [Internet] 2008 [Cited 2014 Oct 8] 8(5). Available from: http://www.ncbi. nlm.nih.gov/pmc/articles/PMC2276479/pdf/1471-2482-8-5.pdf
Burkatovskaya M, Caetano AP, Demivoda-rice TN, Tegos GP, Hamblin MR. Effect of chitosan acetate bandage on wound healing in infected and noninfected wounds in mice. Wound Repair Regen. (Online) [Internet] 2008 [Cited 2014 Oct 8] 16(3). Available from: http://onlinelibrary.wiley.com/doi/10. 1111/j.1524-475X.2008.00382.x/pdf
Dantas ALM, Ferreira PC, Valença CN, Diniz KD, Nunes JP, Germano RM. Complications of pressure ulcers in severely ill patients: a descriptive-exploratory study. Online braz j nurs [Internet]. 2013 June [cited 2014 Nov 27] 12(2). Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/3794 . doi: