Avaliação da atividade antimicrobiana, citotóxica, antibiofilme e de cicatrização do polihexametileno biguanida (PHMB) em feridas complexas

Abstract

Introduction: Complex wounds are acute or chronic injuries that are found with external loss of skin tissue, the presence of infections, ischemia, necrosis or systemic diseases. In this context, an urgent search for better treatments in the care of patients with wounds becomes necessary. Polyhexamethylene biguanide (PHMB) is a substance commonly used in the treatment of skin lesions and has shown a promising action in the control of bacteria, elimination of biofilms, healing, pain and odor control. Objective: To identify published scientific evidence on antimicrobial, cytotoxic, antibiofilm and PHMB healing activities in complex wounds. Methodology: This is a bibliographic, descriptive, integrative review (IR) study, developed in six stages, in the months of September and October 2020 in search of primary articles on the subject in question. Eight databases BDENF, CINAHL, LILACS, MEDLINE, Embase, Scifinder, Scopus, Web of Scince and two electronic libraries SciELO and Scince Direct were used. In the search, the controlled descriptors “Healing”, “Wound infection”, “Biofilms” and “Polyhexamethylene Biguanide” were used, associated with the Boolean operators “AND” and “OR”. Results: The sample consisted of 26 primary articles, published in 19 international journals, between the years 2013 to 2020. The synthesis of the evidence revealed various pharmaceutical forms, concentrations and antimicrobial, cytotoxic, antibiofilm and PHMB healing effects. 18 (69.2%) of the articles reported antimicrobial activity of PHMB, in 12 different concentrations, all with antimicrobial effect in at least one study. Four (15.4%) of the studies reported cytotoxic action on gels, membranes and solutions of varying concentrations. Nine (34.6%) identified antibiofilm action in solutions of 0.1 and 0.5%. Eight (30.8%) expressed a healing effect, of these 6 (23%) act on wound healing factors. Conclusion: There is still no universal consensus on the most appropriate composition and concentration of PHMB. New well-designed clinical studies are necessary to establish the efficacy of this substance in the treatment of wounds.