Vol. 2 No. 1 (2023): infermieristica journal: it's TIME to care
Articles

Use of antimicrobial Dialkyl Carbamoyl Chloride (DACC) surface dressings for the treatment of infected post-surgical complications in neonates with low risk of adverse reactions: case series in the AOU Meyer NICU

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  • Biagio Nicolosi,
  • Eustachio Parente
Biagio Nicolosi
AOU Meyer IRCCS
DOI: https://doi.org/10.36253/if-2105

Published 2023-04-30

Keywords

  • post surgical wounds,
  • neonatal injury,
  • infected wounds
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Abstract

The skin of the child presents significant differences compared to that of the adult; this diversity is even more marked if the skin of the newborn is taken into consideration. In fact, this is immature, as is its immune response. This results in weak responses to microorganisms. Therefore, the use of antibacterial dressings is necessary to manage the microbial load at the skin surface level. To this end, international consensus documents suggest that the use of products with a physical and mechanical action to remove bacteria is indicated. Bacterial uptake dressings that exploit DACC technology are bacteriostatic and non-bactericidal dressings; this "passive" control of the bacterial load avoids the rupture of the bacterial cell wall and the consequent release of endotoxins, which worsen the inflammatory state and prevent the healing of the lesion. Thanks to its purely physical principle, it also does not release any antimicrobial agent, which could create the risk of bacterial resistance and allergies. This treatment proposal aims to highlight the advantage and benefit of advanced dressings with DACC technology, for the prevention and treatment of pediatric and neonatal infected wounds.

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References

  1. Teng J. M. C., Marqueling A. L., Benjamin L. T., Overview of Dermatologic Care in Children, Therapy in pediatric dermatology, Switzerland, Springer, 2017.
  2. Gleason C. A., Juul S. E., Newborn Skin Development: Structure and Function, Avery's deseas of newborn, X Ed., Philadelphia, Elsevier, 2018.
  3. Baharestani M. M., An overview of neonatal and pediatric wound care knowledge and considerations, Ostomy Wound Management, 2007; 53(6):34-55.
  4. Irving V., Caring for and protecting the skin of pre-term neonates, J Wound Care, 2001, 10:253.
  5. Polin R. A., Abman H. A., Rowitch D. H., Benitz W. E., Fox W. W., Physiologic Development of the Skin, Fetal
  6. and neonatal physiology, V Ed., Philadelphia, Elsevier, 2017.
  7. Isaacs D., Skin and soft tissue infections, Evidence-Based Neonatal Infections, I Ed., Wiley, 2014.
  8. Buganza Tepole A., Kuhl E., Systems-based approaches toward wound healing, Pediatr Res, 2013;73(4 Pt
  9. :553–563.
  10. McNamara S.A., Hirt P.A., Weigelt M.A., et al., Traditional and advanced therapeutic modalities for wounds
  11. in the paediatric population: an evidence-based review, J Wound Care. 2020;29(6):321–334.
  12. McCord S.S., Levy M.L., Practical guide to pediatric wound care, Semin Plast Surg, 2006;20(3):192–199.
  13. White R., Rodgers A., O’Connor L., Anthony D., Paediatric wound care: neonates and infants, Wounds UK,
  14. ;12(3):8–11.
  15. Ciprandi G., Crucianelli S., Pomponi M., et al., Physical approach to infected pressure ulcers in a pediatric
  16. population: impact of a DACC non-medicated technology in bioburden management. Presented at: The
  17. EPUAP Annual Conference, 2018, Rome.
  18. Visscher M.O., Utturkar R., Pickens W.L., et al., Neonatal skin maturation – vernix caseosa and free amino
  19. acids, Pediatr Dermatol. 2011;28(2):122–132.
  20. Ciprandi G., et al., Meeting the Challenges in Pediatric Wound Care: Our 15-Year Experience with
  21. Dialkylcarbamoyl Chloride-Coated Dressing Technology in Acute and Chronic Wounds, Chronic Wound
  22. Care Management and Research, 2022:9 23–33.
  23. Husmark J., Morgner B., Budi Susilo Y., Wiegand C., Antimicrobial effects of bacterial binding to a
  24. dialkylcarbamoyl chloride-coated wound dressing: an in vitro study, J Wound Care, 2022;31(7):560-570.
  25. EWMA Document, Antimicrobials and Non-healing Wounds: An Update, Journal of Wound Management,
  26. World Union of Wound Healing Societies, The role of non-medicated dressings for the management of
  27. wound infection, Wounds International, 2022.
  28. Mosti G., Magliaro A., Mattaliano V., Picerni P., Angelotti N., Comparative study of two antimicrobial
  29. dressings in infected leg ulcers: a pilot study, J Wound Care, 2015, 24(3):121-2; 124-7.