Oleh Admin Kalbe Medical pada June 06, 2017 07:30

PolyHexaMethylene Biguanide Bermanfaat dalam Penyembuhan Luka Kronik

Apabila terjadi luka, maka luka tersebut akan sembuh secara fisiologis melalui 4 tahap, yaitu: hemostasis (6 jam), inflamasi (1 minggu), proliferasi (3 sampai 4 minggu), dan maturasi (2 tahun). Jika luka mengalami komplikasi, maka penyembuhan luka akan mengalami perlambatan, sehingga lebih lambat dari jadwal penyembuhan luka tersebut. Salah satu komplikasi yang paling banyak terjadi adalah infeksi luka. Infeksi terjadi apabila ada bakteri yang masuk ke luka kemudian bakteri tersebut berkembang biak dan berakibat pada respons inflamasi dari tubuh. Karena infeksi tersebut, luka akan terus tertahan pada fase inflamasi dan tidak bisa masuk ke fase proliferasi. Padahal, penyembuhan luka paling banyak terjadi pada fase proliferasi.

Oleh karena itu, pada luka kronik, penting untuk mencegah dan mengobati infeksi dengan mengontrol beban bakteri pada luka. Beban bakteri (bacterial load) adalah parameter yang menunjukkan banyaknya koloni bakteri pada luka. Mengontrol beban bakteri dapat dilakukan dengan memberikan dressing antimikroba pada luka. Salah satu antimikroba yang telah dievaluasi penggunaannya pada luka kronik adalah PHMB (PolyHexaMethylene Biguanide). Telah ada beberapa uji klinik yang mengevaluasi efektivitas penggunaan PHMB pada luka kronik, dengan hasil yang bervariasi. Oleh karena itu, dr. Eliot To dan tim dari Kanada melakukan sebuah systematic review dari uji klinik – uji klinik yang telah meneliti penggunaan PHMB pada luka kronik. Systematic review ini mengevaluasi 3 parameter utama, yaitu kecepatan penyembuhan luka, kontrol beban bakteri, dan nyeri luka.


Parameter pertama, yaitu penyembuhan luka, didapatkan 5 uji klinik yang mengevaluasi kecepatan penyembuhan luka dibandingkan dressing standar. Namun, hanya 1 dari 5 uji klinik tersebut yang menunjukkan hasil bahwa PHMB berdampak positif pada kecepatan penyembuhan luka, hasil ini tidak bermakna secara statistik. Parameter yang kedua, yaitu beban bakteri, didapatkan 5 uji klinik yang mengevaluasi kemampuan mengontrol beban bakteri dibandingkan dressing standar. Pada 5 uji klinik ini, didapatkan bahwa penggunaan PHMB secara bermakna menurunkan beban bakteri dari luka kronik dibandingkan dressing standar. Parameter yang ketiga, yaitu rasa nyeri, didapatkan 5 uji klinik yang mengevaluasi rasa nyeri dibandingkan dengan dressing standar. Pada 5 uji klinik ini, didapatkan bahwa penggunaan PHMB secara bermakna mengurangi rasa nyeri dibandingkan dengan dressing standar.


Kesimpulan:
Pada luka kronik, penggunaan PHMB (PolyHexaMethylene Biguanide) bermanfaat pada beberapa hal penyembuhan luka, yaitu: memperbaiki kontrol beban bakteri dan mengurangi rasa nyeri secara bermakna dibandingkan dressing standar. (NNO)

Image : Ilustrasi
Referensi:
1.Halim AS, Khoo TL, Saad AZM. Wound bed preparation from a clinical perspective. Indian J Plast Surg Off Publ Assoc Plast Surg India. 2012;45(2):193–202.
2.To E, Dyck R, Gerber S, Kadavil S, Woo KY. The effectiveness of topical polyhexamethylene biguanide (PHMB) agents for the treatment of chronic wounds: A systematic review. Surg Technol Int. 2016;XXIX:45–51.

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