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Percepción y manejo del dolor durante el desbridamiento químico con un agente desecante tópico: un análisis de la
Polina Shabes1, Waseem Garabet1, Sven Tilhein2
1Department of Vascular and Endovascular Surgery, University Hospital of Duesseldorf (UKD), Heinrich-Heine University Duesseldorf (HHU), Duesseldorf, Germany.
Journal of wound care
|September 4, 2025
Resumen
El dolor durante la aplicación de un agente desecante tópico (TDA) para el desbridamiento de heridas puede controlarse eficazmente con anestesia local. Este método de desbridamiento químico mostró niveles de dolor comparables o incluso más bajos que el desbridamiento agudo tradicional.
Área de la Ciencia:
- Cuidado y tratamiento de heridas
- Dermatología
- Farmacología
Sus antecedentes:
- El agente desecante tópico (TDA), una combinación de ácido metanesulfónico (MSA) y sulfóxido de dimetilo (DMSO), es una opción efectiva para eliminar el biofilm y la necrosis en el cuidado de las heridas.
- La aplicación de TDA puede causar dolor agudo temporal en algunos pacientes, lo que requiere estrategias de control del dolor.
Objetivo del estudio:
- Para evaluar el dolor asociado con la aplicación de TDA.
- Evaluar la eficacia de dos estrategias anestésicas locales en el tratamiento del dolor asociado a la ADT.
Principales métodos:
- Un estudio retrospectivo de la serie de casos en el que participaron 20 pacientes tratados con TDA.
- El dolor se evaluó utilizando la Escala Análoga Visual (EAV) antes, durante y después de la aplicación de TDA.
- Se emplearon dos estrategias para el control del dolor: crema anestésica y anestesia local tumescente (TLA).
Principales resultados:
- El desbridamiento químico con TDA se asoció con niveles variables de dolor (VAS 0-10) durante la aplicación.
- El manejo eficaz del dolor redujo significativamente el malestar, sin diferencias significativas en las calificaciones de dolor en comparación con el desbridamiento agudo.
- Los pacientes experimentaron niveles de dolor comparables o más bajos con TDA bajo un manejo anestésico adecuado.
Conclusiones:
- El dolor experimentado durante el desbridamiento químico TDA se puede controlar eficazmente con enfoques anestésicos fácilmente disponibles.
- El tratamiento con TDA, cuando se administra con anestesia local, no aumenta la percepción general del dolor en comparación con el desbridamiento agudo.
- Este estudio apoya la TDA como una opción de desbridamiento viable y bien tolerada con un control efectivo del dolor.
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