Antimicrobial Dressings for Improving Wound Healing

Abstract

Wound healing occurs by a series of interrelated molecular events which work together to restore tissue integrity and cellular function. These physiological events occur smoothly in normal healthy individual and/or under normal conditions. However, in certain cases, these molecular events are retarded resulting in hard-to-heal or chronic wounds arising from several factors such as poor venous return, underlying physiological or metabolic conditions such as diabetes as well as external factors such as poor nutrition. In most cases, such wounds are infected and infection also presents as another complicating phenomenon which triggers inlammatory reactions, therefore delaying wound healing. There has therefore been recent interests and signiicant eforts in preventing and actively treating wound infections by directly targeting infection causative agents through direct application of antimicrobial agents either alone or loaded into dressings (medicated). These have the advantage of overcoming challenges such as poor circulation in diabetic and leg ulcers when administered systemically and also require lower amounts to be applied compared to that required via oral or iv administration. This chapter will review and evaluate various antimicrobial agents used to target infected wounds, the means of delivery, and current state of the art, including commercially available dressings. Data sources will include mainly peer-reviewed literature, clinical trials and reports, patents as well as government reports where available.

Effectiveness of Modern Wound Dressing on the Growth of Staphylococcus Aureus Bacteria

“…Luka diklasifikasikan sebagai akut dan kronis (Güneş & Tıhmınlıoğlu, 2017). Luka akut bisa sembuh dalam waktu terbatas, tidak menunjukkan komplikasi, dan ditandai dengan hilangnya integritas kulit (cedera) secara tiba-tiba (Sarheed, Ahmed, Shouqair, & Boateng, 2016). Luka kronis adalah cedera jaringan yang tidak sembuh dalam jangka waktu 12 minggu dan sering terulang kembali (Boateng & Catanzano, 2015).…”

“…Tahap awal pembentukan luka kronis ditandai dengan munculnya organisme Grampositif seperti Staphylococcus Aureus dan Escherichia coli. Pada tahap selanjutnya, Gram-negatif spesies Pseudomonas yang umum dan cenderung menyerang lapisan yang lebih dalam pada luka (Sarheed et al, 2016).…”

“…Namun, modern wound dressing berjenis hidrogel memiliki beberapa polimer yang telah dikembangkan dalam beberapa tahun terakhir untuk diaplikasikan dalam perawatan luka (Martin et al, 2013). polimer alam dan sintetis yang banyak digunakan dalam perawatan luka akut dan kronis karena memiliki aktivitas antimikroba (Sarheed et al, 2016). Kombinasi polimer chitosan (Abdelgawad, Hudson, & Rojas, 2014), alginate (Catanzano et al, 2015), gelatine (Kavoosi, Dadfar, & Purfard, 2013), glucan dan poly (Kamoun, Chen, Mohy Eldin, & Kenawy, 2015), serta antimikroba dalam modern wound dressing efektif untuk meningkatkan dalam penyembuhan luka akut dan kronis (Mogoşanu & Grumezescu, 2014).…”

“…Dressing ini juga memiliki mekanisme pembekuan yang seimbang karena kehadiran ion kalsium selama tahap pertama dari penyembuhan luka (Borda et al, 2016). Dengan demikian, alginat berbasis hidrogel yang mengandung nanosilver dapat menyerap cairan pada luka dan dan memiliki aktivitas antimikroba yang kuat terhadap mikroorganisme (Sarheed et al, 2016). Selain itu, Alginat juga digunakan untuk luka yang dalam (Dissemond et al, 2014).…”

Ciprofloxacin-loaded calcium alginate wafers prepared by freeze-drying technique for potential healing of chronic diabetic foot ulcers

“…Chronic wounds arise from tissue injuries or disruption to anatomical structures that heal beyond 12 weeks [1]. They are associated with predisposing factors that might disturb the balance between wound bioburden and the patient's immune system or hinder the wound healing cycle [2]. The incidence of chronic wounds including diabetic foot, leg, pressure, venous and arterial ulcers as well as trauma, has increased significantly in recent years due to obesity, aging, high alcohol consumption, smoking, stress, poor nutrition, diabetic mellitus, ischemia, venous stasis disease, and high blood pressure [3].…”