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Use of chlorhexidine in wound healing and granulation tissue formation
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AbstrAct Introduction: Wounds with dressing defects pose a great challenge when choosing a good treatment that may reduce the risk of infection and promote granulation tissue formation. Objective: To demonstrate the usefulness of chlorhexidine digluconate (CHG) for granulation tissue formation. Materials and methods: Eighteen wounds (16 patients) that met the inclusion criteria were included. Wound cleansing was performed in outpatients with 20% CHG-impregnated cloths every 48-72 h, until the proper tissue granulation was achieved. Photographs of the clinical evolution of the wounds were taken. results: The adequate wound granulation mean was of 9.2 days (4-25 days) regardless of wound size or presence of comorbidities. There were no clinical signs of infection in any wound during the healing period. conclusions: CHG treatment is an appropriate method to be considered for outpatient injuries, which reduces the hospital costs borne by the health-care system. Level of Evidence: III. Key words: chlorhexidine, wounds, granulation tissue, skin dressing defect.
Uso del gluconato de clorhexidina en la curación de heridas y su potencial formación de tejido de granulación
rEsUMEn Introducción: Las heridas con defectos de coberturas suponen un gran desafío a la hora de elegir un buen tratamiento que reduzca el riesgo de infección e incremente la capacidad de granulación del tejido. El objetivo de este estudio fue demostrar la utilidad del digluconato de clorhexidina para la granulación de tejidos. Materiales y Métodos: Se incluyeron 18 heridas de 16 pacientes que cumplían con los criterios de inclusión. Se realizaron curaciones ambulatorias con gasas embebidas en digluconato de clorhexidina al 20%, cada 48-72 h, hasta lograr la adecuada granulación de tejido y se tomaron fotografías de la evolución clínica de las heridas. resultados: Se observó una adecuada granulación de las heridas en una media de 9.2 días (rango 4- días), independientemente del tamaño o de la comorbilidades. Ninguna herida presentó signos clínicos de infección durante el período de curación. conclusiones: El uso de digluconato de clorhexidina es un adecuado método por tener en cuenta para tratar heridas, de forma ambulatoria, y así disminuir los costos hospitalarios del sistema de salud. Palabras claves: Clorhexidina; heridas; tejido de granulación; defecto de cobertura. nivel de Evidencia: IV
Edgar G. Wagner, Juan M. sala Orthopedics Department, Hospital Regional de Comodoro Rivadavia, Chubut, Argentina
InVEstIGAcIÓn cLÍnIcA
Esta Revista está bajo una Licencia Creative Commons Atribución-NoComercial-CompartirObras Derivadas Igual 4.0 Internacional. (CC-BY-NC-SA 4.0). Rev Asoc Argent Ortop Traumatol 2020; 85 (2): 139-146 • ISSN 1852-7434 (online)
Received on April 21st, 2019. Accepted after evaluation on November 30th^ , 2019 • Edgar G. Wagner, MD • edgar.gw@hotmail.com ‘https://orcid.org/0000-0001-9472- How to cite this paper: Wagner EG, Sala JM. Use of chlorhexidine in wound healing and granulation tissue formation. Rev Asoc Argent Ortop Traumatol 2020;85(2):139-146. https://doi. org/10.15417/issn.1852-7434.2020.85.2.
ID
E. G. Wagner and J. M. sala
E. G. Wagner and J. M. sala
Figure 1. 20% chlorhexidine digluconate soap used in this studt (Laclorhex, 4g chlorhexidine digluconate 20% solution, Laboratorio Sertex S.R.L, Rosario, Santa Fe, Argentina).
Figure 2. Traumatic amputation wound. a. Foot wound due to a motor vehicle accident with hallux amputation. B. Day 9 after 20% chlorhexidine digluconate treatment, case eligible for an epithelialization procedure, a skin flap or graft or a referral to a plastic surgery specialist.
Use of chlorhexidine in wound healing and granulation tissue formation
Figure 3. Morel-Lavallée injury. a. Postoperative Escharotomy, beginning of the chlorhexidine wound dressing change treatment. B. Day 8 after chlorhexidine digluconate treatment, case eligible for an epithelialization procedure, a skin flap or graft or a referral to a plastic surgery specialist.
Figure 4. Hand wound due to a crushing injury in a bakery bread-making machine. a. Day 1 after Escharotomy, beginning of the wound dressing change treatment. B. Day 6 after chlorhexidine digluconate treatment, case eligible for an epithelialization procedure, a skin flap or graft or a referral to a plastic surgery specialist.
Use of chlorhexidine in wound healing and granulation tissue formation
ORCID de J. M. Salas: https://orcid.org/0000-0002-8942-
–––––––––––––––––– Conflict of interests: Authors claim they do not have any conflict of interests.
E. G. Wagner and J. M. sala