Pharm
Antimicrobial Dressing
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Antimicrobial Dressing
, Double Antibiotic Solution, DABS Solution, Dakin's Solution
Indications
Wound
Critical Colonization
Friable granulation tissue
Malodorous Wound
s
Altered wound drainage
Increased would pain
Preparations
Topical Antibiotics
May decrease infection in minor contaminated wounds
Do not decrease the risk of infection in clean wounds (surgical wounds)
Risk fo
Allergic Contact Dermatitis
and antibiotics resistance
Use only for short period and then transition to petroleum jelly or
Vaseline Gauze
Antimicrobial solutions
Double Antibiotic Solution (DABS, Gentamycin and Neomycin)
Applied 3-4 times per day
Risk of
Antibiotic Resistance
Dakin's Solution (Bleach,
Hydrogen Peroxide
,
Betadine
,
Alcohol
)
Cytotoxic agents and typically only recommended for frank infection or necrosis
Other agents are recommended after infection controlled
Acetic acid (vinegar and saline)
Effective for
Pseudomonas
(but risk of tissue cytotoxicity)
Hypochlorous acid (e.g. Puracyn Plus, Vashe)
Naturally occuring agents released by
White Blood Cell
s
May use to soak wounds to remove biofilm, then remove, dry and apply bandage
Dressings
Nanocrystalline Silver (e.g.
Tegaderm
Ag Mesh)
Broad spectrum antimicrobial activity and decreases biofilms
May stay in place for up to a week
Not cytotoxic
Cadexomer
Iodine
Time released
Iodine
0.9%
Highly absorptive gel
May stay in place up to 2-3 days (turns yellow-white when time to change)
Hydrofera Blue
Bacteriostatic dyes
Highly absorptive
Leptospermum Honey (e.g. Medihoney)
Antimicrobial activity, but avoid in critical colonization or infected wounds
Debrides wounds
References
Quisberg (2017)
Wound
Care Update, Park Nicollet Conference, St Louis Park, MN (attended 9/15/2017)
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