Actualización en el manejo de heridas

Abstract

Complicated acute wounds and chronic wounds have always been present in medical practice. Unfortunately, the care given to them is not adequate and is often empirical. The high costs in health services and the poor quality of life of the patients who suffer because of them, brought about the development of technologies for the rapid, optimal and cost-effective closure of these injuries in the last 20 years. The concept of a humid environment appeared, with which specialized dressings or bandages were developed. The development of this technology has grown by leaps and bounds; but, in our country, there is still resistance to its use, despite the existing scientific evidence. It is important that surgeons are aware of this therapeutic arsenal and approach wounds holistically, and not as isolated injuries in chronic patients. In addition, new generations of surgeons must be trained in their years of residency in the use of these dressings, as is already done in North America and Europe. One should go as far as consider this a subspecialty of surgical care. There are two types of healing: the traditional, which uses low-tech dressings (gauze) and the advanced, which uses dressings with active substances that interact with the wound's microenvironment, such as: hydrocolloids, alginates, or collagen, among others. The objective of this review is to identify all the materials we have, from organic products to state-of-the-art devices for wound healing and when to use them.