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Preparación del lecho de la herida: limpieza segura y eficaz con ácido hipocloroso pH 5.5

01 January 2022

Abstract

Sinopsis:

El objetivo de la limpieza del lecho de la herida es favorecer la remoción de materia extraña, rehidratar el lecho y acelerar el proceso de cicatrización, considerando siempre una evaluación holística del paciente. La limpieza es un paso fundamental en la preparación del lecho de la herida. En los últimos años, se ha intensificado la búsqueda y elaboración de soluciones limpiadoras con el potencial de promover la curación mediante la eliminación de barreras locales para la curación, sin comprometer el tejido sano y/o en formación. Entre ellas, el ácido hipocloroso (HOCl) puro pH 5.5 cumple con los objetivos de la preparación del lecho de la herida y de limpieza terapéutica de forma biocompatible, segura, eficaz y natural. Este artículo tiene por objetivo realizar una revisión de la evidencia existente en relación con las soluciones limpiadoras y los beneficios del HOCl puro pH 5.5.

Conflicto de interés:

CRC declara no tener conflicto de interés. BAD y CLG son empleadas de Laboratorio UrgoMedical Chile.

Hay diferencias bioquímicas entre las heridas en proceso de cicatrización y las de difícil cicatricación (o crónicas). En aquellas que cicatrizan de manera esperada, la mitosis celular aumenta mientras que las citoquinas proinflamatorias y las metaloproteinasas de la matriz disminuyen.1 En las heridas crónicas, en cambio, se produce el proceso inverso. Siguiendo el mismo patrón, en las primeras, los factores de crecimiento aumentan y la respuesta celular es rápida, mientras que en las segundas, los niveles de factores de crecimiento son subóptimos y la respuesta celular senescente.2

La infección es la complicación más frecuente en las heridas con un proceso de cicatrización tórpido, ya que puede prolongar el tiempo de tratamiento y eventualmente derivar en la amputación de una extremidad o el fallecimiento del paciente, sumado a un aumento del uso de los recursos disponibles.3

Este artículo posiciona la preparación del lecho de la herida (WBP, por sus siglas en inglés) como una herramienta fundamental en el manejo de las heridas de todo tipo, destacando la importancia del proceso de limpieza del lecho y de la piel perilesional, así como su transversalidad en el proceso de valoración y tratamiento de una persona con una herida (Figura 1). El análisis de la evidencia disponible permitirá a enfermeras/os y médicas/os dedicados al manejo avanzado de heridas aplicar un enfoque crítico y reflexivo en la toma de decisiones vinculadas a los cuidados de la piel.

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