Abstract
BackgroundThe presence of infections is one of the main factors that leads to delays in healing or non-closure of cutaneous wounds. Although the goal of antibiotic use is to treat or prevent infection, there is currently no agreement on the effectiveness of these products.AimThe aim of this study was to evaluate the efficacy of antibiotic use during the healing process of skin wounds in animal models not intentionally infected, as well as to analyze the advances and limitations of the studies carried out in this field.Main methodsThis systematic review was performed according to the PRISMA guidelines, using a structured search on the MedLine (PubMed) and Scopus platforms to retrieve studies published until August 29, 2018, 13:35p.m. The studies included were limited to those that used excision or incision wound models and that were not intentionally infected. The data for the animal models, antibiotic used, and the main results of the studies were extracted, and compared where possible. Bias analysis and methodological quality assessments were examined through the SYRCLE’s Risk of Bias tool.Key findingsTwenty-seven studies were selected. Overall, the effects of the antibiotic on the wound decreased inflammatory cell infiltration and promoted an increased number of fibroblasts, extracellular matrix constituents, re-epithelialization and tissue strength. A great deal of important information about the methodology was not presented, such as: the statistical analysis used, the animal model (sex and age), antibiotic dosage, blinding and randomization of the animals chosen.SignificanceBased on the results found, we believe that antibiotic therapy can be considered a viable alternative for the treatment of cutaneous wounds. However, current evidence obtained from the methodological quality analysis points towards a high risk of bias. This is due to the incomplete characterization of the experimental design and treatment protocol, which compromises the reproducibility of the studies.
Highlights
Skin plays an important role in protecting the body against aggressive agents, forming a barrier that prevents the entry and proliferation of pathogens [1]
Our results showed that antibiotic use can Lycosamide Nitrofuran Tetracycline Glycopeptide Ansamycin Steroid antibacterial Cyclic polypeptides Cyclic polypeptides + Aminoglycoside + Polymyxim teroid antibacterial
Our results showed that antibiotic use, mainly in a curative application based on hydrogel formulations, are important to speed up cutaneous healing
Summary
Skin plays an important role in protecting the body against aggressive agents, forming a barrier that prevents the entry and proliferation of pathogens [1]. Platelets aggregate at the site of the lesion and initiate the process of blood coagulation, which promotes vascular hemostasis and releases chemotactic factors that stimulate the migration and activation of immune cells that will be important for the phase of the process [3]. The phase is known as proliferative, characterized by the formation of granulation tissue, rich in blood vessels and collagen type III fibers [6]. This tissue is fragile and poorly resistant to traction, but it is the necessary basis for definitive tissue deposition. The goal of antibiotic use is to treat or prevent infection, there is currently no agreement on the effectiveness of these products
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