Sains Malaysiana 52(9)(2023): 2633-2643
http://doi.org/10.17576/jsm-2023-5209-13
Perkembangan Terkini
dalam Rawatan Topikal Ulser Tekanan: Suatu Tinjauan
Sistematik
(Recent Development in
the Topical Treatments of Pressure Ulcers: A Systematic Review)
MOHD HANIF ZULFAKAR* &
GRACE TING ENG CHI
Pusat
Teknologi Penghantaran Dadah dan Vaksin, Fakulti Farmasi, Universiti Kebangsaan
Malaysia, 50300 Kuala Lumpur, Malaysia
Diserahkan: 10 April
2023/Diterima: 8 Ogos 2023
Abstrak
Ulser tekanan adalah kecederaan
setempat pada kulit atau tisu lembut yang mendasari bahagian tulang yang
menonjol. Walaupun terdapat pelbagai rawatan topikal (agen topikal dan pembalut
luka) yang tersedia untuk merawat ulser tekanan, rawatan ulser tekanan tetap
mencabar. Ini telah mendorong penyelidikan untuk mengembangkan rawatan topikal
yang baharu dan lebih berkesan untuk pengurusan dan penyembuhan ulser tekanan.
Oleh itu, kajian ini akan memberi tumpuan kepada kajian terdahulu mengenai
perkembangan rawatan topikal dalam tempoh 10 tahun kebelakangan ini untuk mengenal pasti
agen topikal dan formulasinya serta pembalut luka yang telah dibangunkan selama
tempoh ini. Selain tu, kajian ini juga akan mengkaji kesan agen topikal dan
pembalut luka terhadap rawatan bagi semua tahap ulser tekanan (Tahap I - IV).
Dengan melakukan kajian ini, rawatan topikal bagi rawatan setiap tahap ulser
tekanan boleh dikenal pasti. Carian sistematik melalui PubMed, MEDLINE,
EBSCOHost, Science Direct dan Google Scholar telah dilakukan. Kata kunci
‘pressure ulcer’, ‘bedsore’, ‘decubitus ulcer’ ‘dressings’, ‘bandages’,
‘topical agents’, ‘topical treatment’ dan gabungannya telah digunakan. Sinonim
perkataan juga akan digunakan untuk memperluas pencarian. Sejumlah 18 artikel
dikenal pasti memenuhi kriteria inklusi dan eksklusi. Hasil daripada tinjauan
ini membuktikan bahawa formulasi salap adalah lebih berkesan berbanding jenis
formulasi lain, manakala formulasi gel bukan pilihan yang baik untuk rawatan
luka tekanan. Dari aspek keberkesanan rawatan topikal, kesemua formulasi
topikal yang dikenalpasti adalah berkesan, kecuali gel sukralfat 15%. Akhir
sekali, berdasarkan tahap luka tekanan, agen topikal adalah didapati berkesan
dan paling banyak diindikasikan untuk ulser tahap I dan II, manakala pembalut
pula untuk ulser tahap II dan III.
Kata kunci: Agen topikal; pembalut luka; rawatan
topikal; ulser tekanan
Abstract
Pressure ulcers are localized injuries to the skin
or underlying soft tissue over a bony prominence. Although there are a variety
of topical treatments available (topical agents and dressings) to treat
pressure ulcers, pressure ulcer treatments remain challenging. This has
prompted research to develop new and more effective topical treatments for
pressure ulcers. Therefore, this review summarizes all the the topical
treatments developed over the last 10 years in RCTs and animal studies to study the most suitable
type of topical formulation in the delivery of topical agents for pressure
ulcers, to evaluate the effectiveness of each topical treatments developed and
to identify the topical treatments that are mostly indicated and effective for
different stages of pressure ulcers (Phase I-IV). A systematic search through PubMed, Ovid and
EBSCOHost was performed. The keywords ‘pressure ulcer’, ‘bedsore’, ‘decubitus
ulcer’ ‘dressings’, ‘bandages’, ‘topical agents’, ‘topical treatment’ and combination of them were used.
The synonyms of the words were used to extend the search. A total of 18
articles that met the inclusion and exclusion criteria were identified. Findings from this review have demonstrated that ointment formulation is
superior to other formulations while gel formulation is not a good option for the treatment of pressure ulcers.
In terms of effectiveness, all the topical treatments identified except topical
sucralfate 15% gel are effective in the treatment of pressure ulcers. Lastly,
in terms of stage of pressure ulcers, topical agents are shown to be mostly
indicated and effective for stage I and II pressure ulcers while topical
dressings are shown to be mostly indicated and effective for stage II and III
pressure ulcers.
Keywords: Dressings; pressure ulcer; topical agents; topical treatment
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*Pengarang untuk surat-menyurat;
email: hanifzulfakar@ukm.edu.my
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