In Spain, the annual cost of treating pressure ulcers is 461 million euros. The cost of treatment increases as the severity of the injury increases, as the healing time and the number of complications increases, being infection one of the most common complication.
The correct management of this bacterial load requires the use of antibiotics or antiseptics, taking into account the cost-benefit ratio and their side effects. Within the research line dependence-related skin injuries and chronic wounds, our research group has carried out an exploratory review of scientific literature on the different antiseptic dressings and topical local antibiotics used in chronic infected wounds to determine their different effects on healing, cicatrization, management of bacterial load and/or signs of infection, side effects and/or cost-benefit.
In the articles found, 7 different products have been used as treatment for these wounds; among the antiseptics: silver, cadexomer iodine, biguanide polyhexanide, honey and dialkylcarbamoyl chloride, and among the antibiotics: silver sulphadiazine and mupirocin.
Silver is the most effective product in healing or reducing the size of wounds, the management of bacterial load and/or signs of infection. However, it is the product that produces the most side effects, being the most frequent eczema, pain, maceration, erythema and burning. Dialkylcarbamoyl chloride can be a valid alternative for antimicrobial treatment, since it obtains excellent results and does not produce side effects. Silver is also the most cost-effective product, followed by cadexomer iodine and silver sulphadiazine, while the most expensive treatments are those using honey.
The full report of the review has been published in:
- Ruiz Prieto D, García Fernández FP. Use of antiseptics and antibiotics in the management of the bacterial load of chronic wounds. Gerokomos. 2020;31(4):261-267.
- Ruiz-Prieto D, García-Fernández FP. Efficacy against bacterial load and side effects of antiseptics and antibiotics in people with chronic wounds. Enferm Dermatol. 2020; 14(41): e01-e12. DOI: 10.5281/zenodo.4563189