[Preventing nosocomial infections. Dressings soaked in polyhexamethylene biguanide (PHMB)]

Polyhexamethlene biguanide (PHMB) is an antibacterial agent included in the chlorhexidine group which is active against a wide number of microorganisms including Staphylococcus Aureus Methycilin Resistant (MRSA), Vancomycin Resistant Enterococcus Faecalis (VRE) and Acinetobacter baumannii which all cause antibiotic-resistant infections. Traditionally gauze dressings have been used to cover and protect wounds although their porous structure does not constitute an efficient barrier against bacterial penetration, especially when a dressing becomes wet due to the effects of a wound oozing and draining. Recently the use of a dressing soaked in a 0.2% PHMB solution which works as a biological barrier against pathogenic agents has been introduced in clinical practice. On the one hand, this PHMB soaked dressing inhibits bacterial growth in the areas where it is applied and, on the other hand, it prevents the penetration of microorganisms through the dressing itself. Simultaneously while a PHMB soaked dressing carries out these actions, it creates an environment favorable to the proliferation of the normal flora found in the epidermis. As opposed to porous gauze dressings, a PHMB dressing remains active during 72 hours even in wet environs. Its wide anti-micro-bacterial range prevents infections in surgical, acute or chronic wounds and in any type of intra-corporal access susceptible to infection, such as by means of intravascular catheters, tracheotomies, or thoracic tubes. A PHMB dressing can also be used as a primary covering to treat a chronic wound since it does not interfere in the process of tissue reepithelization.