USE of TOPICAL Antimicrobial THERAPY with Silver IN the TREATMENT of Wounds REFRACTORY

There are several causes that lead to chronic wounds. The local factors the high level of bacteria has been the fruit of many studies. The microclimate of this imbalance can cause elevation of metalloproteinases and senescent cells, reduced mitogenic activity and response to fotres growth. One way of restoring balance is the use of antimicrobial dressings. Of antimicrobial silver: it binds the protein of the cell wall of bacteria, enzymes and bacterial DNA or bacterial cell, preventing the execution of processes vital to the bacterial cell and its replication.Goal was to determine the response of the foam dressing with silver, combined with glycerine, surfactant in the treatment of chronic wounds. Methodology: Six clinical case studies, carried out from January to Jun/2010 a Private Hospital in the city of Sao Paulo. Data were collected through written records, laboratory data (previous crop more than 10⁵ colonies, leukocyte count, hemoglobin, C-Reactive Protein CRP and glucose), with systematic photographic terms of patient consent and ethics committee on research. It was 06 full-thickness wounds, three of them with bone exposure, refractory to numerous therapies. All patients were receiving systemic antibiotics for more than five days, abnormal smears, diabetic, hypertensive, with time of injury ranged from 10 to 120 days. The first seven were performed daily dressings and after the 8th. healing interval 72 hours until the end of treatment. Was repeated weekly culture, leukocyte count, CRP and glycemia.Results: All wounds healed without surgery, range 9-28 days. The laboratory results have identified a striking decrease of CRP and leukocytos in 5 patients in the first week. The tissue culture in 3 patients became negative in the 2nd. Weeks of treatment.Conclusion: The use of topical therapy in the cases studied showed a good therapeutic response, contributing to the elimination of the indicators of infection, avoiding invasive procedures.