Sample records for wound infection

  1. Infection in conflict wounded

    PubMed Central

    Eardley, W. G. P.; Brown, K. V.; Bonner, T. J.; Green, A. D.; Clasper, J. C.

    2011-01-01

    Although mechanisms of modern military wounding may be distinct from those of ancient conflicts, the infectious sequelae of ballistic trauma and the evolving microbial flora of war wounds remain a considerable burden on both the injured combatant and their deployed medical systems. Battlefield surgeons of ancient times favoured suppuration in war wounding and as such Galenic encouragement of pus formation would hinder progress in wound care for centuries. Napoleonic surgeons eventually abandoned this mantra, embracing radical surgical intervention, primarily by amputation, to prevent infection. Later, microscopy enabled identification of microorganisms and characterization of wound flora. Concurrent advances in sanitation and evacuation enabled improved outcomes and establishment of modern military medical systems. Advances in medical doctrine and technology afford those injured in current conflicts with increasing survivability through rapid evacuation, sophisticated resuscitation and timely surgical intervention. Infectious complications in those that do survive, however, are a major concern. Addressing antibiotic use, nosocomial transmission and infectious sequelae are a current clinical management and research priority and will remain so in an era characterized by a massive burden of combat extremity injury. This paper provides a review of infection in combat wounding from a historical setting through to the modern evidence base. PMID:21149356

  2. JAMA Patient Page: Wound Infections

    MedlinePLUS

    ... through punctures (like a nail or a thorn), abrasions (scrapes or scratches), or lacerations (rips in the ... increases risk for infection by organisms that are resistant to antibiotics COMPLICATIONS OF WOUND INFECTIONS • Death of ...

  3. [Prevention of chronic wound infection].

    PubMed

    Kucisec-Tepes, Nastja

    2013-10-01

    An integral follow-up of the patient starting with medical history, present status and the wound itself will lead us to decide which plan of prevention, care and treatment will be efficient. The interaction of host immune abnormalities and growth of the microbial population invading the wound have a significant impact on the clinical presentation and direction of the development of the wound. Infection of a chronic wound is a consequence of a large number and composition of microbe populations in the tissue, along with the presence of virulence factors depending on the type and representation in the biofilm as a factor of greatest importance, the synergy of various microbial communities of aerobes-anaerobes in various combinations, and the host immune response. The basic procedures in preventing the development of infection from the colonization status are reduction of the total mass of microbes along with necrotic tissue, removal or destruction of virulent factors such as the biofilm, destruction of the synergy of various microbial communities, and increasing the level and quality of the host immune response. Prevention of the chronic wound infection demands numerous strategies or procedures, which should be applied simultaneously, but must rapidly and frequently follow each other in succession. Therefore, various methods are being applied depending on the indications, such as mechanical washing and cleaning, application of antiseptics, debridement, vacuum-assisted closing of the wound, oxygenation, moist wound healing - active and passive compresses, methods of removal or destruction of the biofilm, application of specific cells, i.e. factors of growth, and removal of mechanical stress. Antibiotics are not used in the prevention of chronic wound infection. They are used only in a targeted fashion when infection has been proven and the agent identified, as well as its sensitivity to antibiotics obtained from target samples. An ideal prevention would be a method that would prevent the development of the wound and be applied while the skin is still intact. Irrespective of all knowledge accumulated so far, the good clinical practice has not yet fully defined preventive measures for the care and prevention of chronic wound infection, and, likewise, these measures are not universally accepted. The aim of preventive procedures is at the same time the battle against microbes and the underlying disease that caused the development of chronic wound, with the aim of preventing the development of infection. PMID:24371976

  4. Bacterial isolates from infected wounds and their antibiotic susceptibility pattern: some remarks about wound infection.

    PubMed

    Bessa, Lucinda J; Fazii, Paolo; Di Giulio, Mara; Cellini, Luigina

    2015-02-01

    Wound infection plays an important role in the development of chronicity, delaying wound healing. This study aimed to identify the bacterial pathogens present in infected wounds and characterise their resistance profile to the most common antibiotics used in therapy. Three hundred and twelve wound swab samples were collected from 213 patients and analysed for the identification of microorganisms and for the determination of their antibiotic susceptibility. Patients with diverse type of wounds were included in this retrospective study, carried out from March to September 2012. A total of 28 species were isolated from 217 infected wounds. The most common bacterial species detected was Staphylococcus aureus (37%), followed by Pseudomonas aeruginosa (17%), Proteus mirabilis (10%), Escherichia coli (6%) and Corynebacterium spp. (5%). Polymicrobial infection was found in 59 (27·1%) of the samples and was mainly constituted with two species. The most common association was S. aureus/P. aeruginosa. All Gram-positives were susceptible to vancomycin and linezolid. Gram-negatives showed quite high resistance to the majority of antibiotics, being amikacin the most active against these bacteria. This study is mostly oriented to health care practitioners who deal with wound management, making them aware about the importance of wound infection and helping them to choose the adequate treatment options to control microbial infection in wounds. PMID:23433007

  5. Microbiology of Animal Bite Wound Infections

    PubMed Central

    Abrahamian, Fredrick M.; Goldstein, Ellie J. C.

    2011-01-01

    Summary: The microbiology of animal bite wound infections in humans is often polymicrobial, with a broad mixture of aerobic and anaerobic microorganisms. Bacteria recovered from infected bite wounds are most often reflective of the oral flora of the biting animal, which can also be influenced by the microbiome of their ingested prey and other foods. Bacteria may also originate from the victim's own skin or the physical environment at the time of injury. Our review has focused on bite wound infections in humans from dogs, cats, and a variety of other animals such as monkeys, bears, pigs, ferrets, horses, sheep, Tasmanian devils, snakes, Komodo dragons, monitor lizards, iguanas, alligators/crocodiles, rats, guinea pigs, hamsters, prairie dogs, swans, and sharks. The medical literature in this area has been made up mostly of small case series or case reports. Very few studies have been systematic and are often limited to dog or cat bite injuries. Limitations of studies include a lack of established or inconsistent criteria for an infected wound and a failure to utilize optimal techniques in pathogen isolation, especially for anaerobic organisms. There is also a lack of an understanding of the pathogenic significance of all cultured organisms. Gathering information and conducting research in a more systematic and methodical fashion through an organized research network, including zoos, veterinary practices, and rural clinics and hospitals, are needed to better define the microbiology of animal bite wound infections in humans. PMID:21482724

  6. Prevalence of 90-days postoperative wound infections after cardiac surgery

    Microsoft Academic Search

    Daisy Jonkers; Ted Elenbaas; Peter Terporten; Fred Nieman; Ellen Stobberingh

    2003-01-01

    Objective: Postoperative wound infections generally cause considerable extra morbidity, mortality and costs. As nowadays length of hospitalization shortens, post-discharge surveillance is important to get reliable information on the prevalence of postoperative wound infections. In this study, the prevalences of sternal wound (SWI) and donor site infections (DSI) during hospitalization as well as, 30 and 90 days after cardiac surgery were

  7. Incisional Negative Pressure Wound Therapy for Prevention of Postoperative Infections Following Caesarean Section

    ClinicalTrials.gov

    2014-10-15

    Surgical Wound Infection; Infection; Cesarean Section; Cesarean Section; Dehiscence; Complications; Cesarean Section; Complications; Cesarean Section, Wound, Dehiscence; Wound; Rupture, Surgery, Cesarean Section

  8. Risk factors for wound infection after lower segment cesarean section

    PubMed Central

    Al Jama, Fathia E.

    2012-01-01

    The incidence of post caesarean wound infection and independent risk factors associated with wound infection were retrospectively studied at a tertiary care hospital. A retrospective case controlled study of 107 patients with wound infection after lower segment caesarean section (LSCS) was undertaken between January 1998 and December 2007. The control group comprised of 340 patients selected randomly from among those who had LSCS during the study period with no wound infection. Chart reviews of patients with wound infection were identified using the definitions from the Centers for Disease Control and Prevention's National Nosocomial Infections Surveillance Systems. Comparisons for categorical variables were performed using the X 2 or Fisher exact test. Continuous variables were compared using the 2-tailed Student t test. P < 0.05 was considered significant. Logistic regression determined the independent risk factors. The overall wound infection rate in the study was 4.2% among 2 541 lower transverse CS. The independent risk factors identified for wound infection were, obesity, duration of labor >12 hours, and no antenatal care. Patients' age and parity, diabetes mellitus, premature rupture of membranes (PROM) >8 hours and elective vs. emergency surgery was not found to be significantly associated with wound infection. Conclusion: The independent risk factors could be incorporated into the policies for surveillance and prevention of wound infection. Antibiotic prophylaxis may be utilized in high risk patients such as PROM, obese patients and prolonged labor. PMID:25003037

  9. Level of training, wound care practices, and infection rates

    Microsoft Academic Search

    Adam J Singer; Judd E Hollander; Guy Cassara; Sharon M Valentine; Henry C Thode; Mark C Henry

    1995-01-01

    This prospective, nonrandomized descriptive study compares the traumatic wound infection rates in patients based on level of training of emergency department (ED) practitioners. Wounds were evaluated in 1,163 patients. A wound registry data sheet was prospectively completed on all patients sutured in the ED. All practitioners were assigned a unique identification number. Follow-up data was obtained at the time of

  10. Carboxymethylcellulose film for bacterial wound infection control and healing.

    PubMed

    Wong, Tin Wui; Ramli, Nor Amlizan

    2014-11-01

    Infection control and wound healing profiles of sodium carboxymethylcellulose (SCMC) films were investigated as a function of their anti-bacterial action, physical structures, polymer molecular weights and carboxymethyl substitution degrees. The films were prepared with in vitro polymer/film and in vivo microbe-colonized wound healing/systemic infection profiles examined. Adhesive high carboxymethyl substituted SCMC films aided healing via attaching to microbes and removing them from wound. Pseudomonas aeruginosa was removed via encapsulating in gelling low molecular weight SCMC film, whereas Staphylococcus aureus was trapped in tight folds of high molecular weight SCMC film. Incomplete microbe removal from wound did not necessary translate to inability to heal as microbe remnant at wound induced fibroblast migration and aided tissue reconstruction. Using no film nonetheless will cause systemic blood infection. SCMC films negate infection and promote wound healing via specific polymer-microbe adhesion, and removal of S. aureus and P. aeruginosa requires films of different polymer characteristics. PMID:25129756

  11. Profiling wound healing with wound effluent: Raman spectroscopic indicators of infection

    NASA Astrophysics Data System (ADS)

    Crane, Nicole J.; Elster, Eric A.

    2012-01-01

    The care of modern traumatic war wounds remains a significant challenge for clinicians. Many of the extremity wounds inflicted during Operation Enduring Freedom and Operation Iraqi Freedom are colonized or infected with multi-drug resistant organisms, particularly Acinetobacter baumannii. Biofilm formation and resistance to current treatments can significantly confound the wound healing process. Accurate strain identification and targeted drug administration for the treatment of wound bioburden has become a priority for combat casualty care. In this study, we use vibrational spectroscopy to examine wound exudates for bacterial load. Inherent chemical differences in different bacterial species and strains make possible the high specificity of vibrational spectroscopy.

  12. The risk of wound infection after simple hand laceration

    PubMed Central

    Roodsari, Gholamreza S; Zahedi, Farhad; Zehtabchi, Shahriar

    2015-01-01

    BACKGROUND: This prospective observational study aimed to determine the infection rate of simple hand laceration (SHL), and to compare infection rates between patients who were prescribed antibiotics and those who were not. METHODS: The study was performed at two urban hospitals enrolling 125 emergency department (ED) patients with SHL. Exclusion criteria included patients with lacerations for more than 12 hours, immunocompromized patients, patients given antibiotics, and patients with gross contamination, bites or crush injuries. Wound infection was defined as clinical infection at a follow-up visit (10–14 days) or wound was treated with antibiotics. Patient satisfaction was also measured using a visual analogue scale 1–10, asking the patients about wound appearance. Demographic data and wound characteristics were compared between the infected and non-infected wounds. The infection rates were also compared between patients who received prophylactic antibiotics and those who did not. The results were presented with medians and quartiles or percentages with 95% confidence intervals (CI). RESULTS: In the 125 patients SHL [median age: 28 (18, 43); range: 1–102 years old; 36% female], 44 (35%, 95% CI: 27%–44%) were given antibiotics in the ED. Wound infection was reported in 6 patients (4.8%, 95% CI: 2%–10%). Age, gender, history of diabetes and wound closure were not associated with wound infection (P>0.05). The infection rate was not significantly different between patients with or without antibiotic prophylaxis [7% (3/44), 95% CI: 2%–10% vs. 4% (3/81), 95% CI: 1%–11%, P=0.66]. Patient’s satisfaction with appearance of infected and non-infected wounds were significantly different [7.5 (6, 8) vs. 9 (8, 10), P=0.01]. CONCLUSION: Approximately 5% of simple hand lacerations become infected. Age, gender, diabetes, prophylactic antibiotics and closure technique do not affect the risk of infection.

  13. The laparoscopically harvested omental flap for deep sternal wound infection

    Microsoft Academic Search

    Jan J. van Wingerden; Matijn E. H. Coret; Christianne A. van Nieuwenhoven; Eric R. Totté

    2010-01-01

    Objective: To report our experience with the laparoscopically harvested omental flap in the treatment of deep sternal wound infection, and to present a modification and introduce two supportive techniques in the perioperative management. Methods: Between June 2005 and September 2007, six patients with grade IV (El Oakley–Wright classification) deep sternal wound infection following a median sternotomy for coronary artery bypass

  14. Targeted photodynamic therapy for infected wounds in mice

    NASA Astrophysics Data System (ADS)

    Hamblin, Michael R.; O'Donnell, David A.; Zahra, Touqir; Contag, Christopher H.; McManus, Albert T.; Hasan, Tayyaba

    2002-06-01

    Although many workers have used photodynamic therapy to kill bacteria in vitro, the use of this approach has seldom been reported in vivo in animal models of infection. We report on the use of a targeted polycationic photosensitizer conjugate between poly-L-lysine and chlorin(e6) that can penetrate the Gram (-) outer membrane together with red laser light to kill Escherichia coli and Pseudomonas aeruginosa infecting excisional wounds in mice. We used genetically engineered luminescent bacteria that allowed the infection to be imaged in mouse wounds using a sensitive CCD camera. Wounds were infected with 5x106 bacteria, followed by application of the conjugate in solution and illumination. There was a light-dose dependent loss of luminescence as measured by image analysis in the wound treated with conjugate and light, not seen in control wounds. This strain of E coli is non-invasive and the infection in untreated wounds spontaneously resolved in a few days and all wounds healed equally well showing the photodynamic treatment did not damage the host tissue. P aeruginosa is highly invasive and mice with untreated or control wounds all died while 90% of PDT treated mice survived. PDT may have a role to play in the rapid treatment of infected wounds in view of the worldwide rise in antibiotic resistance.

  15. Toxic shock syndrome associated with surgical wound infections.

    PubMed

    Bartlett, P; Reingold, A L; Graham, D R; Dan, B B; Selinger, D S; Tank, G W; Wichterman, K A

    1982-03-12

    In 13 cases of toxic shock syndrome (TSS) associated with postoperative wound infections, clinical findings were similar to those observed in cases of TSS in menstruating women. While local signs of a surgical wounds infection were minimal, Staphylococcus aureus was recovered from cultures of wounds in 12 of 12 patients; multiple blood cultures were negative for 11 of 11 patients. Toxic shock syndrome due to surgical wound infections accompanied a wide variety of surgical procedures in both men and women and was not necessarily associated with menstruation in women. The median interval between surgery and onset of TSS was two days. Toxic shock syndrome can develop in association with surgical wound infections caused by S aureus and should be considered in the differential diagnosis of postoperative fever and hypotension. PMID:7057535

  16. Wound infection in the obese pregnant woman.

    PubMed

    Tipton, Amanda M; Cohen, Stephen A; Chelmow, David

    2011-12-01

    Obesity has been linked as a risk factor for wound complications and is becoming a more common occurrence. We reviewed the risk factors, preventive strategies, and recommended management of wound complications in obese women undergoing cesarean delivery. The limited available data support the use of prophylactic antibiotic before cesarean delivery, closure of subcutaneous space >2 cm, and maintaining normothermia intraoperatively to help reduce the incidence of postoperative wound complications. Data regarding management of cesarean wound complications in the obese patient are sparse, but they do suggest either primary or secondary closure of wounds is preferred to healing by secondary intention. Antibiotics should be administered in the presence of cellulitis or systemic toxicity. Use of vacuum-assisted wound closure devices may be useful in wound management. There is a need for randomized controlled trials which evaluate the prevention and management of wound complications in obese women undergoing cesarean delivery. PMID:22108085

  17. Negative-pressure wound therapy enhances local inflammatory responses in acute infected soft-tissue wound.

    PubMed

    Liu, Daohong; Zhang, Lihai; Li, Tongtong; Wang, Guoqi; Du, Hailong; Hou, Hongping; Han, Li; Tang, Peifu

    2014-09-01

    Clinical studies found that negative-pressure wound therapy (NPWT) displayed significant clinical benefits in the healing of infected wounds. However, the effect of NPWT on local inflammatory responses in acute infected soft-tissue wound has not been investigated thoroughly. The purpose of this study was to test the impact of NPWT on local expression of proinflammatory cytokines, amount of neutrophils, and bacterial bioburden in wound from acute infected soft-tissue wounds. Full-thickness wounds were created on the back of rabbits, and were inoculated with Staphylococcus aureus strain ATCC29213. The wounds were treated with sterile saline-moistened gauze dressings and NPWT with continuous negative pressure (-125 mmHg). Wound samples were harvested on days 0 (6 h after bacterial inoculation), 2, 4, 6, and 8 at the center of wound beds before irrigation for real-time PCR analysis of gene expression of IL-1?, IL-8, and TNF-?. Wound biopsies were examined histologically for neutrophil quantification in different layers of tissue. Quantitative bacterial cultures at the same time point were analyzed for bacterial clearance. Application of NPWT to acute infected wounds in rabbits was compared with treatment with sterile saline-moistened gauze, over an 8-day period. NPWT-treated wounds exhibited earlier and greater peaking of IL-1? and IL-8 expression and decrease in TNF-? expression over the early 4 days (P < 0.05). Furthermore, histologic examination revealed that significantly increased neutrophil count was observed in the shallow layer in wound biopsies of NPWT treatment at day 2 (P < 0.001). In addition, there was a statistically significant decrease of bacteria load from baseline (day 0) at days 2 and 8 in NPWT group (P < 0.05). In conclusion, this study demonstrates that NPWT of acute infected soft-tissue wounds leads to increased local IL-1? and IL-8 expression in early phase of inflammation, which may trigger accumulation of neutrophils and thus accelerate bacterial clearance. Meanwhile, the success of NPWT in the treatment of acute wounds can attenuate the expression of TNF-?, and the result may partly explain how NPWT can avoid significantly impairing wound healing. PMID:24748178

  18. Dermal wound transcriptomic responses to Infection with Pseudomonas aeruginosa versus Klebsiella pneumoniae in a rabbit ear wound model

    PubMed Central

    2014-01-01

    Background Bacterial infections of wounds impair healing and worsen scarring. We hypothesized that transcriptome analysis of wounds infected with Klebsiella pneumoniae (K.p.) or Pseudomonas aeruginosa (P.a.) would indicate host-responses associated with the worse healing of P.a.- than K.p.-infected wounds. Methods Wounds created on post-operative day (POD) 0 were infected during the inflammatory phase of healing on POD3 and were harvested on POD4 for microarray and transcriptome analysis. Other wounds received topical antibiotic after infection for 24 hours to promote biofilm development, and were harvested on POD6 or POD12. Results Wounds infected for 24 hours, relative to uninfected wounds, elevated transcripts of immune-response functions characteristic of infiltrating leukocytes. But P.a.-infected wounds elevated many more transcripts and to higher levels than K.p.-infected wounds. Coincidently, suppressed transcripts of both wounds enriched into stress-response pathways, including EIF2 signaling; however, this was more extensive for P.a.-infected wounds, including many-fold more transcripts enriching in the ‘cell death’ annotation, suggesting resident cutaneous cell toxicity in response to a more damaging P.a. inflammatory milieu. The POD6 wounds were colonized with biofilm but expressed magnitudes fewer immune-response transcripts with no stress-response enrichments. However, elevated transcripts of P.a.-infected wounds were inferred to be regulated by type I interferons, similar to a network unique to P.a.-infected wounds on POD4. On POD12, transcripts that were more elevated in K.p.-infected wounds suggested healing, while transcripts more elevated in P.a.-infected wounds indicated inflammation. Conclusions An extensive inflammatory response of wounds was evident from upregulated transcripts 24 hours after infection with either bacterium, but the response was more intense for P.a.- than K.p.-infected wounds. Coincidently, more extensive down-regulated transcripts of P.a.-infected wounds indicated a stronger “integrated stress response” to the inflammatory milieu that tipped more toward cutaneous cell death. Unique to P.a.-infected wounds on POD4 and POD6 were networks inferred to be regulated by interferons, which may result from intracellular replication of P.a. These data point to specific downregulated transcripts of cells resident to the wound as well as upregulated transcripts characteristic of infiltrating leukocytes that could be useful markers of poorly healing wounds and indicators of wound-specific treatments for improving outcomes. PMID:25035691

  19. Innate defense regulator peptide 1018 in wound healing and wound infection.

    PubMed

    Steinstraesser, Lars; Hirsch, Tobias; Schulte, Matthias; Kueckelhaus, Maximilian; Jacobsen, Frank; Mersch, Evgenija A; Stricker, Ingo; Afacan, Nicole; Jenssen, Havard; Hancock, Robert E W; Kindrachuk, Jason

    2012-01-01

    Innate defense regulators (IDRs) are synthetic immunomodulatory versions of natural host defense peptides (HDP). IDRs mediate protection against bacterial challenge in the absence of direct antimicrobial activity, representing a novel approach to anti-infective and anti-inflammatory therapy. Previously, we reported that IDR-1018 selectively induced chemokine responses and suppressed pro-inflammatory responses. As there has been an increasing appreciation for the ability of HDPs to modulate complex immune processes, including wound healing, we characterized the wound healing activities of IDR-1018 in vitro. Further, we investigated the efficacy of IDR-1018 in diabetic and non-diabetic wound healing models. In all experiments, IDR-1018 was compared to the human HDP LL-37 and HDP-derived wound healing peptide HB-107. IDR-1018 was significantly less cytotoxic in vitro as compared to either LL-37 or HB-107. Furthermore, administration of IDR-1018 resulted in a dose-dependent increase in fibroblast cellular respiration. In vivo, IDR-1018 demonstrated significantly accelerated wound healing in S. aureus infected porcine and non-diabetic but not in diabetic murine wounds. However, no significant differences in bacterial colonization were observed. Our investigation demonstrates that in addition to previously reported immunomodulatory activities IDR-1018 promotes wound healing independent of direct antibacterial activity. Interestingly, these effects were not observed in diabetic wounds. It is anticipated that the wound healing activities of IDR-1018 can be attributed to modulation of host immune pathways that are suppressed in diabetic wounds and provide further evidence of the multiple immunomodulatory activities of IDR-1018. PMID:22879874

  20. Negative Pressure Wound Therapy of Chronically Infected Wounds Using 1% Acetic Acid Irrigation

    PubMed Central

    Lee, Byeong Ho; Lee, Hye Kyung; Kim, Hyoung Suk; Moon, Min Seon; Suh, In Suck

    2015-01-01

    Background Negative-pressure wound therapy (NPWT) induces angiogenesis and collagen synthesis to promote tissue healing. Although acetic acid soaks normalize alkali wound conditions to raise tissue oxygen saturation and deconstruct the biofilms of chronic wounds, frequent dressing changes are required. Methods Combined use of NPWT and acetic acid irrigation was assessed in the treatment of chronic wounds, instilling acetic acid solution (1%) beneath polyurethane membranes twice daily for three weeks under continuous pressure (125 mm Hg). Clinical photographs, pH levels, cultures, and debrided fragments of wounds were obtained pre- and posttreatment. Tissue immunostaining (CD31, Ki-67, and CD45) and reverse transcription-polymerase chain reaction (vascular endothelial growth factor [VEGF], vascular endothelial growth factor receptor [VEGFR]; procollagen; hypoxia-inducible factor 1 alpha [HIF-1-alpha]; matrix metalloproteinase [MMP]-1,-3,-9; and tissue inhibitor of metalloproteinase [TIMP]) were also performed. Results Wound sizes tended to diminish with the combined therapy, accompanied by drops in wound pH (weakly acidic or neutral) and less evidence of infection. CD31 and Ki-67 immunostaining increased (P<0.05) post-treatment, as did the levels of VEGFR, procollagen, and MMP-1 (P<0.05), whereas the VEGF, HIF-1-alpha, and MMP-9/TIMP levels declined (P<0.05). Conclusions By combining acetic acid irrigation with negative-pressure dressings, both the pH and the size of chronic wounds can be reduced and infections be controlled. This approach may enhance angiogenesis and collagen synthesis in wounds, restoring the extracellular matrix. PMID:25606491

  1. MRSA and diabetic foot wounds: Contaminating or infecting organisms?

    Microsoft Academic Search

    Frank L. Bowling; Edward B. Jude; Andrew J. M. Boulton

    2009-01-01

    Although infection is a well-recognized barrier to healing, evidence has emerged that wound colonization with methicillin-resistant\\u000a Staphylococcus aureus (MRSA) has the same effect, which has been quantified as increasing the time to healing twofold. MRSA is a concern for those\\u000a with diabetic foot ulcers based on evidence of impaired healing when it is present in the wound. However, many studies

  2. Reducing wound infections. Improved gown and drape barrier performance.

    PubMed

    Moylan, J A; Fitzpatrick, K T; Davenport, K E

    1987-02-01

    A 21-month study involving 2181 clean and clean-contaminated general surgical procedures was performed to evaluate the effectiveness of a commercially available disposable gown and drape system vs a cotton system in reducing wound infection. The series in which the disposable spun-laced fiber system was used had a significantly lower overall infection rate (2.83% vs 6.5%) as well as better rates in clean (1.8% vs 3.8%) and clean-contaminated (4.8% vs 11.4%) procedures. This effect was independent of all other factors. The odds of developing a wound infection was 2 1/2 times higher with a cotton system than with a disposable system. Actual cost analysis from three types of hospitals showed lower costs with utilization of disposable gown and drape systems. Hospital charges were significantly higher for those patients developing wound infections. The results of the study demonstrated not only significant reduction in wound infection rates but also major cost savings when a disposable gown and drape system was used in the operating room. PMID:3813865

  3. Deep Sternal Wound Infection: Risk Factors and Outcomes

    Microsoft Academic Search

    Michael A Borger; Vivek Rao; Richard D Weisel; Joan Ivanov; Gideon Cohen; Hugh E Scully; Tirone E David

    1998-01-01

    Background. Deep sternal wound infection (DSWI) is a serious complication of cardiac operations performed by median sternotomy. We attempted to define the predictors of DSWI and to describe the outcomes of two treatment strategies used at our institution.Methods. Retrospective review was performed using prospectively gathered data on 12,267 consecutive cardiac surgical patients from 1990 to 1995. Chart review was performed

  4. Pseudomonas syringae pv. syringae Uses Proteasome Inhibitor Syringolin A to Colonize from Wound Infection

    E-print Network

    Pseudomonas syringae pv. syringae Uses Proteasome Inhibitor Syringolin A to Colonize from Wound of plants by bacterial leaf pathogens at wound sites is common in nature. Plants defend wound sites. The molecular mechanisms used by pathogens to suppress containment at wound infection sites are poorly

  5. Wound infections caused by Vibrio vulnificus and other marine bacteria.

    PubMed Central

    Oliver, J. D.

    2005-01-01

    Infections caused by Vibrio vulnificus were first reported in 1979 by Blake et al. of the US Centers for Disease Control. At that time described as a 'rare, unnamed halophilic lactose-fermenting Vibrio species', V. vulnificus has emerged as the most virulent foodborne pathogen in the United States with a hospitalization rate of 0.910 and a case-fatality rate of 0.390. It is in addition a significant cause of potentially life-threatening wound infections. Infections following ingestion of raw or undercooked seafood, commonly raw oysters, can lead to a primary septicaemia with a fatality rate of 50-60%. An unusual symptom, occurring in 69% of 274 cases reviewed by Oliver, is the development of secondary lesions, typically on the extremities, which are generally severe (often a necrotizing fasciitis) and require tissue debridement or amputation. These cases occur almost exclusively in males over the age of 50 years. Interestingly, this gender specificity has been found to be due to the female hormone oestrogen, which in some manner provides protection against the lethal V. vulnificus endotoxin. Further, most cases occur in persons with certain underlying diseases which are either immunocompromising or which lead to elevated serum iron levels (e.g. liver cirrhosis, chronic hepatitis, haemochromatosis). V. vulnificus infections resulting in primary septicaemia have been extensively studied, and the subject of several reviews. This review concentrates on the wound infections caused by this marine bacterial pathogen, including the more recently described biotypes 2 and 3, with brief discussions of those caused by other marine vibrios, and the increasingly reported wound/skin infections caused by Mycobacterium marinum, Erysipelothrix rhusiopathiae, and Aeromnonas hydrophila. PMID:15962544

  6. Wound infection after elective laparoscopic surgery for colorectal carcinoma

    Microsoft Academic Search

    Seiichiro Yamamoto; Shin Fujita; Takayuki Akasu; Seiji Ishiguro; Yutaka Kobayashi; Yoshihiro Moriya

    2007-01-01

    Background  The aim of this study was to evaluate various clinical parameters that would influence the occurrence of wound infection (WI)\\u000a in elective laparoscopic surgery (LS) for colorectal carcinoma.\\u000a \\u000a \\u000a \\u000a Methods  The study included 290 patients who underwent LS between June 2001 and December 2005. WI was diagnosed within 30 days of the\\u000a operation, and both superficial and deep incision surgical site infection

  7. Supplemental Intravenous Crystalloid Administration Does Not Reduce the Risk of Surgical Wound Infection

    PubMed Central

    Kabon, Barbara; Akça, Ozan; Taguchi, Akiko; Nagele, Angelika; Jebadurai, Ratnaraj; Arkilic, Cem F.; Sharma, Neeru; Ahluwalia, Arundhathi; Galandiuk, Susan; Fleshman, James; Sessler, Daniel I.; Kurz, Andrea

    2005-01-01

    Wound perfusion and oxygenation are important determinants of the development of postoperative wound infections. Supplemental fluid administration significantly increases tissue oxygenation in surrogate wounds in the subcutaneous tissue of the upper arm in perioperative surgical patients. We tested the hypothesis that supplemental fluid administration during and after elective colon resections decreases the incidence of postoperative wound infections. Patients undergoing open colon resection were randomly assigned to small (n=124, 8 mL·kg-1·h-1) or large volume (n=129, 16-18 mL·kg-1·h-1) fluid management. Our major outcomes were two distinct criteria for diagnosis of surgical wound infections: 1) purulent exudate combined with a culture positive for pathogenic bacteria and 2) Center for Disease Control criteria for diagnosis of surgical wound infections. All wound infections diagnosed using either criterion by a blinded observer in the 15 days following surgery were considered in the analysis. Wound healing was evaluated with the ASEPSIS scoring system. Of the patients given small fluid administration, 14 had surgical wound infections; 11 given large fluid therapy had infections, P=0.46. ASEPSIS wound healing scores were similar in both groups: 7±16 (small volume) vs. 8±14 (large volume), P=0.70. Our results suggest that supplemental hydration in the range tested does not impact wound infection rate. PMID:16244030

  8. Ceftriaxone versus povidone iodine in preventing wound infections following biliary surgery.

    PubMed Central

    Kiff, R. S.; Lomax, J.; Fowler, L.; Kingston, R. D.; Hoare, E. M.; Sykes, P. A.

    1988-01-01

    The effect of either prophylactic antibiotic or wound antiseptic on bile bacteriology, wound and other postoperative sepsis has been studied in a controlled prospective randomised trial of 243 patients undergoing biliary surgery at a district general hospital. Wound infection rates were significantly less in patients given intravenous ceftriaxone (1%) at induction of anaesthesia when compared to povidone iodine sprayed into the wound at the completion of surgery (9%) (P = 0.02). In all but one patient infected wounds grew organisms identical to those cultured from the bile. There were also fewer chest and urinary infections in the ceftriaxone group but this was not statistically significant. PMID:3056208

  9. An In Vivo Polymicrobial Biofilm Wound Infection Model to Study Interspecies Interactions

    PubMed Central

    Dalton, Trevor; Dowd, Scot E.; Wolcott, Randall D.; Sun, Yan; Watters, Chase; Griswold, John A.; Rumbaugh, Kendra P.

    2011-01-01

    Chronic wound infections are typically polymicrobial; however, most in vivo studies have focused on monospecies infections. This project was designed to develop an in vivo, polymicrobial, biofilm-related, infected wound model in order to study multispecies biofilm dynamics and in relation to wound chronicity. Multispecies biofilms consisting of both Gram negative and Gram positive strains, as well as aerobes and anaerobes, were grown in vitro and then transplanted onto the wounds of mice. These in vitro-to-in vivo multi-species biofilm transplants generated polymicrobial wound infections, which remained heterogeneous with four bacterial species throughout the experiment. We observed that wounded mice given multispecies biofilm infections displayed a wound healing impairment over mice infected with a single-species of bacteria. In addition, the bacteria in the polymicrobial wound infections displayed increased antimicrobial tolerance in comparison to those in single species infections. These data suggest that synergistic interactions between different bacterial species in wounds may contribute to healing delays and/or antibiotic tolerance. PMID:22076151

  10. The effects of Panafil when using topical negative pressure to heal an infected sternal wound.

    PubMed

    Melano, E; Rodriguez, H L; Carrillo, R; Dillon, L

    2004-11-01

    A wound that became infected a few weeks after bypass surgery responded well to a treatment regimen combining TNP with application of an enzymatic agent. The patient had diabetes mellitus, which slows healing and increases infection risk. PMID:15575570

  11. Risk factors for sternal wound infection and mid-term survival following coronary artery bypass surgery

    Microsoft Academic Search

    John C. Y Lu; Antony D Grayson; Pankaj Jha; Arun K Srinivasan; Brian M Fabri

    2003-01-01

    Objective: To identify risk factors for sternal wound infection following coronary artery bypass surgery (CABG), and to compare early and mid-term survival outcome. Methods: Data were prospectively collected for 4228 patients who underwent CABG surgery between April 1997 and March 2001. One hundred and nine (2.6%) patients developed sternal wound infection. We used logistic regression to identify independent risk factors

  12. Incidence and risk factors for caesarean wound infection in Lagos Nigeria

    Microsoft Academic Search

    Oliver C Ezechi; Asuquo Edet; Hakim Akinlade; Chidinma V Gab-Okafor; Ebiere Herbertson

    2009-01-01

    BACKGROUND: Post caesarean wound infection is not only a leading cause of prolonged hospital stay but a major cause of the widespread aversion to caesarean delivery in developing countries. In order to control and prevent post caesarean wound infection in our environment there is the need to access the relative contribution of each aetiologic factor. Though some studies in our

  13. Antimicrobial Activity of Artemisia absinthium Against Surgical Wounds Infected by Staphylococcus aureus in a Rat Model.

    PubMed

    Moslemi, Hamid Reza; Hoseinzadeh, Hesamoddin; Badouei, Mahdi Askari; Kafshdouzan, Khatereh; Fard, Ramin Mazaheri Nezhad

    2012-12-01

    The wound infection is one of the frequent complications in patients undergoing surgical operations. Staphylococcus aureus is the most common cause of surgical wounds. Artemisia absinthium has been shown to bear strong antimicrobial activity, especially against Gram-positive pathogens. This study was designed to investigate the antimicrobial effects of A. absinthium against surgical wounds infected by S. aureus in a rat model. Twenty male Sprague-Dawley rats were divided randomly into two equal groups of treated and control rats. A circular incision was created on the dorsal inter-scapular region of each rat. After skin wounding, rats were inoculated locally with 1 × 10(4) CFU of S. aureus at sites of skin wounds. The extract was applied topically twice a day throughout the experiment. Animals of the control group were left untreated. Results have revealed that topical application of A. absinthium extract on the infected wound sites produced significant antibacterial activity against S. aureus. PMID:24293717

  14. Experimental phage therapy of burn wound infection: difficult first steps

    PubMed Central

    Rose, Thomas; Verbeken, Gilbert; Vos, Daniel De; Merabishvili, Maya; Vaneechoutte, Mario; Lavigne, Rob; Jennes, Serge; Zizi, Martin; Pirnay, Jean-Paul

    2014-01-01

    Antibiotic resistance has become a major public health problem and the antibiotics pipeline is running dry. Bacteriophages (phages) may offer an ‘innovative’ means of infection treatment, which can be combined or alternated with antibiotic therapy and may enhance our abilities to treat bacterial infections successfully. Today, in the Queen Astrid Military Hospital, phage therapy is increasingly considered as part of a salvage therapy for patients in therapeutic dead end, particularly those with multidrug resistant infections. We describe the application of a well-defined and quality controlled phage cocktail, active against Pseudomonas aeruginosa and Staphylococcus aureus, on colonized burn wounds within a modest clinical trial (nine patients, 10 applications), which was approved by a leading Belgian Medical Ethical Committee. No adverse events, clinical abnormalities or changes in laboratory test results that could be related to the application of phages were observed. Unfortunately, this very prudent ‘clinical trial’ did not allow for an adequate evaluation of the efficacy of the phage cocktail. Nevertheless, this first ‘baby step’ revealed several pitfalls and lessons for future experimental phage therapy and helped overcome the psychological hurdles that existed to the use of viruses in the treatment of patients in our burn unit. PMID:25356373

  15. Preventing Deep Wound Infection after Coronary Artery Bypass Grafting

    PubMed Central

    Bryan, Charles S.; Yarbrough, William M.

    2013-01-01

    The consequences of deep wound infections before, during, and after coronary artery bypass grafting have prompted research to clarify risk factors and explore preventive measures to keep infection rates at an irreducible minimum. An analysis of 42 studies in which investigators used multivariate logistic regression analysis revealed that diabetes mellitus and obesity are by far the chief preoperative risk factors. A 4-point preoperative scoring system based on a patient's body mass index and the presence or absence of diabetes is one practical way to determine the risk of mediastinitis, and other risk-estimate methods are being refined. Intraoperative risk factors include prolonged perfusion time, the use of one or more internal mammary arteries as grafts, blood transfusion, and mechanical circulatory assistance. The chief postoperative risk factor is reoperation, usually for bleeding. Unresolved issues include the optimal approach to Staphylococcus aureus nasal colonization and the choice of a prophylactic antibiotic regimen. We recommend that cardiac surgery programs supplement their audit processes and ongoing vigilance for infections with periodic, multidisciplinary reviews of best-practice standards for preoperative, intraoperative, and postoperative patient care. PMID:23678210

  16. Continuous intravenous insulin infusion reduces the incidence of deep sternal wound infection in diabetic patients after cardiac surgical procedures

    Microsoft Academic Search

    Anthony P Furnary; Kathryn J Zerr; Gary L Grunkemeier; Albert Starr

    1999-01-01

    Background. Diabetes mellitus is a risk factor for deep sternal wound infection after open heart surgical procedures. We previously showed that elevated postoperative blood glucose levels are a predictor of deep sternal wound infection in diabetic patients. Therefore, we hypothesized that aggressive intravenous pharmacologic control of postoperative blood glucose levels would reduce the incidence of deep sternal wound infection.Methods. In

  17. Triclosan-coated sutures do not reduce leg wound infections after coronary artery bypass grafting

    PubMed Central

    Seim, Bjørn Edvard; Tønnessen, Theis; Woldbaek, Per Reidar

    2012-01-01

    OBJECTIVES Leg wound infection is a common complication after coronary artery bypass grafting (CABG). Suture contamination has been suggested as a mechanism of surgical site infections. Vicryl Plus® is a polyglacitin suture coated with the antiseptic chemical substance Triclosan, which has been shown to inhibit the growth of Staphylococcus aureus in vitro. The first aim of the present study was to compare Vicryl Plus with conventional Vicryl® sutures with regard to leg wound infections following CABG. The second aim was to examine patient- and operative characteristics, which are assumed to predict leg wound infections. METHODS After statistical calculations a priori, 328 CABG patients were prospectively randomized to leg wound closure with Vicryl Plus (164 patients) or conventional Vicryl sutures (164 patients). Incidences of leg wound infection and predictors of infection related to patient- and operative characteristics were examined. RESULTS The incidence of leg wound infections was 10.4% (17/163) in the Vicryl group, and 10.0% (16/160) in the Vicryl Plus group (P = 1.00). Patients with leg wound infections had increased body mass index and prolonged extracorporeal circulation and aortic clamping time compared with patients without infections. CONCLUSIONS In the present study, we report for the first time that Vicryl Plus did not reduce the incidence of leg wound infections in patients undergoing CABG. Obesity and prolonged time of extracorporeal circulation were both associated with the increased risk of infections. Currently, the clinical role and indication for the use of Vicryl Plus have yet to be defined. PMID:22691378

  18. Combined treatment with chlorhexidine and 0·9% saline in a newborn infant with an infected surgical wound.

    PubMed

    Tekgündüz, Kadir ?erafettin; Kepenekli, Eda; Demirelli, Ya?ar; Caner, Ibrahim; Kara, Mustafa

    2014-12-01

    Newborns are more susceptible to infection; this makes proper wound care extremely important in them. Unfortunately, in spite of successful surgery, patients can die as a result of wound area infections. Herein, we report a case in which a combined therapy of chlorhexidine (a disinfectant) and saline (a cleansing agent used in wound care) was used effectively to treat the wound in a newborn infant with an antibiotic-resistant, Gram-negative, bacteria-related surgical site infection. PMID:25483281

  19. Noncontact, low-frequency ultrasound as an effective therapy against Pseudomonas aeruginosa-infected biofilm wounds.

    PubMed

    Seth, Akhil K; Nguyen, Khang T; Geringer, Matthew R; Hong, Seok J; Leung, Kai P; Mustoe, Thomas A; Galiano, Robert D

    2013-01-01

    Bacterial biofilms, a critical chronic wound mediator, remain difficult to treat. Energy-based devices may potentially improve healing, but with no evidence of efficacy against biofilms. This study evaluates noncontact, low-frequency ultrasound (NLFU) in the treatment of biofilm-infected wounds. Six-millimeter dermal punch wounds in rabbit ears were inoculated with 10(7) colony-forming units of Pseudomonas aeruginosa or left as sterile controls. A biofilm was established in vivo using our published model. NLFU treatment was carried out every other day or every day, with contralateral ear wounds acting as internal, untreated controls. Wounds were harvested for several quantitative endpoints and scanning electron microscopy to evaluate the biofilm structure. The P.?aeruginosa biofilm consistently impaired wound epithelialization and granulation. NLFU, both every other day and every day, improved healing and reduced bacterial counts relative to untreated controls (p?wound biofilm. This represents the first in vivo evidence of energy-based modalities' impact on wound biofilm, setting the foundation for future mechanistic studies. Continued wound care technology research is essential to improving our understanding, and treatment, of biofilm-infected chronic wounds. PMID:23421692

  20. A Rat Model of Diabetic Wound Infection for the Evaluation of Topical Antimicrobial Therapies

    PubMed Central

    Mendes, João J; Leandro, Clara I; Bonaparte, Dolores P; Pinto, Andreia L

    2012-01-01

    Diabetes mellitus is an epidemic multisystemic chronic disease that frequently is complicated by complex wound infections. Innovative topical antimicrobial therapy agents are potentially useful for multimodal treatment of these infections. However, an appropriately standardized in vivo model is currently not available to facilitate the screening of these emerging products and their effect on wound healing. To develop such a model, we analyzed, tested, and modified published models of wound healing. We optimized various aspects of the model, including animal species, diabetes induction method, hair removal technique, splint and dressing methods, the control of unintentional bacterial infection, sampling methods for the evaluation of bacterial burden, and aspects of the microscopic and macroscopic assessment of wound healing, all while taking into consideration animal welfare and the ‘3Rs’ principle. We thus developed a new wound infection model in rats that is optimized for testing topical antimicrobial therapy agents. This model accurately reproduces the pathophysiology of infected diabetic wound healing and includes the current standard treatment (that is, debridement). The numerous benefits of this model include the ready availability of necessary materials, simple techniques, high reproducibility, and practicality for experiments with large sample sizes. Furthermore, given its similarities to infected-wound healing and treatment in humans, our new model can serve as a valid alternative for applied research. PMID:22330650

  1. Novel technique for avoidance of pressure competition between a negative pressure wound therapy device and chest drains in the management of deep sternal wound infections.

    PubMed

    Davis, James S; Kourliouros, Antonios; Deshpande, Ranjit; Cavale, Naveen

    2015-02-01

    In recent years, the use of negative pressure wound therapy (NPWT) devices has changed the way sternal wound infections are being managed. It is not uncommon for deep sternal wound infections to occur together with mediastinal or even pleural collections requiring underwater seal drainage. In these patients in whom there is a communication between the pleural and mediastinal cavities, the concomitant use of an NPWT device negates the pressure gradient within the pleural and mediastinal drains, allowing suppurative fluid to stagnate. We present a novel technique to address this limitation of NPWT devices in patients with sternal wound infections that communicate with a pleural collection. PMID:25415315

  2. First case of Chlorella wound infection in a human in Australia

    PubMed Central

    Hart, J; Mooney, L; Arthur, I; Inglis, T J J; Murray, R

    2014-01-01

    A 30-year-old man developed an infected knee wound 2 days after jumping his bicycle into a freshwater dam. He required repeated debridement and tissue grew bright green colonies typical of the alga Chlorella plus Aeromonas hydrophila. This, and one previously reported case, responded to surgical debridement and careful wound management. PMID:25356359

  3. A prospective study of wound infections after laparotomy in obstetrics and gynaecology department.

    PubMed

    Suwal, A; Shrivastava, V R; Giri, A

    2012-12-01

    Postoperative wound infection is of great importance to both surgeon and patient. All surgeons know that postoperative wound infection means morbidity, anxiety, longer hospitalization, higher cost; not to forget the embarrassment to the surgeons. However, it is still a common surgical complication despite other advances in modern medicine. This study was conducted to find out the incidence of postoperative wound infection and to survey the risk factors for wound infection in obstetrics and gynaecology department of Nepal medical college teaching hospital (NMCTH). A prospective study of all the cases with infected wound after laparotomy and lower segment cesarean section done in NMCTH in obstetrics and gynaecology department was carried out in this study from Chaitra 2068 to Falgun 2069. The frequency of wound infection was 5.87%. Most of the wound infection after lower segment cesarean section occurred in emergency cases (16 out of 19). Seventy percent of patients had preoperative hospital stay range of 0-2 days whereas the range was 3-18 days for the rest 30%. The range of blood loss was 150-300 ml in nearly 75.7 % of patients. Duration of operation was 1-2 hours in 89.2% cases. Only 48.6% of wound infection was identified within 8th postoperative day. Number of infected cases getting prophylactic antibiotic was 25 (67.6%). BMI was >25 in 62.2% of patients. Type of skin incision was pfannenstiel in 94.6%. Skin was closed subcuticularly with vicryl no. 1 in 81.1%. Staphylococcus aureus was isolated in swab culture in 24.3%. Resuturing was required in 18.9% of cases. PMID:24579531

  4. The Healing Effect of Scrophularia Striata on Experimental Burn Wounds Infected to Pseudomonas Aeruginosa in Rat

    PubMed Central

    Tanideh, Nader; Haddadi, Mohammad Hossein; Rokni-Hosseini, Mohammad Hossein; Hossienzadeh, Masood; Mehrabani, Davood; Sayehmiri, Kourosh; Koohi-Hossienabadi, Omid

    2015-01-01

    BACKGROUND The cause of death in burn patients after 48 hours of hospitalization has been reported to be bacterial infections. Recently, due to the compounds accelerating the healing process and the intense reduction of treatment side effects, medicinal plants are used to cure burn wound infections. This study aims to investigate the medicinal effect of the ethanolic extract of Scrophularia striata on burn wound infection in in-vivo and in-vitro in comparison with silver sulfadiazine (SSD). METHODS One hundred and fifty male Sprague Dawley rats were divided into 3 equal groups. A hot plate of 1×1cm was used to create second degree burn wounds. The ethanolic extract of S. striata was provided through percolation method. Group 1 was treated with SSD, group 2 with S. striata, and group 3 was considered as control group. All animals were infected to Pseudomonas aeruginosa. On days 3, 7, 10, 14, and 21 after burn wound injury, the animals were euthanized and were evaluated histologically. The MIC and MBC were determined using the micro dilution method. RESULTS The rate of wound healing was significantly greater in S. striata group in comparison to SSD and control groups. CONCLUSION S. striata contains was shown to have anti-bacterial and wound healing effects while this effect was significantly more than SSD denoting to its use when needed for burn wounds infected to P. aeruginosa. PMID:25606472

  5. Understanding the host inflammatory response to wound infection: an in vivo study of Klebsiella pneumoniae in a rabbit ear wound model.

    PubMed

    Seth, Akhil K; Geringer, Matthew R; Gurjala, Anandev N; Abercrombie, Johnathan A; Chen, Ping; You, Tao; Hong, Seok J; Galiano, Robert D; Mustoe, Thomas A; Leung, Kai P

    2012-01-01

    Wound infection development is critically dependent on the complex interactions between bacteria and host. Klebsiella pneumoniae has become an increasingly common wound pathogen, but its natural history within wounds has never been studied. Using a validated, in vivo rabbit ear model, wounds were inoculated with K.?pneumoniae at different concentrations (10²-10? colony-forming units) with measurement of viable and nonviable bacterial counts, histological wound-healing parameters, and host inflammatory gene expression at multiple time points postinoculation (48, 96, and 240 hours). Bacteria and wound morphologies were evaluated with scanning electron microscopy. Comparable experiments were performed in ischemic ears to model immune response impairment. All wounds, despite different inoculants, equilibrated to similar bacterial concentrations by 96 hours. With a 10? colony-forming units inoculant, wounds at 240 hours showed decreased bacterial counts (p?wounds revealed impaired inflammatory gene expression (p?wound infection. An impaired host cannot control this bacterial burden, preventing adequate healing while allowing bacteria to establish a chronic presence. Our novel study quantitatively validates the host immune response as integral to wound infection dynamics. PMID:22332606

  6. Burn Wound Infections and Antibiotic Susceptibility Patterns at Pakistan Institute of Medical Sciences, Islamabad, Pakistan

    PubMed Central

    Saaiq, Muhammad; Ahmad, Shehzad; Zaib, Muhammad Salman

    2015-01-01

    BACKGROND Burn wound infections carry considerable mortality and morbidity amongst burn injury victims who have been successfully rescued through the initial resuscitation. This study assessed the prevalent microrganisms causing burn wound infections among hospitalized patients; their susceptibility pattern to commonly used antibiotics; and the frequency of infections with respect to the duration of the burn wounds. METHODS This study was carried out at Burn Care Centre, Pakistan Institute of Medical Sciences (PIMS), Islamabad, Pakistan over a period of two years (i.e. from June 2010 to May 2012). The study included all wound-culture-positive patients of either gender and all ages, who had sustained deep burns and underwent definitive management with wound excisions and skin auto-grafting. Patients with negative cultures of the wounds were excluded. Tissue specimens for culture and sensitivity were collected from burn wounds using standard collection techniques and analyzed at microbiological laboratory. RESULTS Out of a total of 95 positive microbial growths, 36 were Pseudomonas aeruginosa (35.29%) as the most frequent isolate found, followed by 21 Klebsiella pneumoniae (20.58%), 19 Staphylococcus aureaus (18.62%), 10 Proteus (9.80%), 7 E. coli (6.86%), 7 Acinetobacter (6.86%), and 4 Candida (3.92%). A variable antibiotic susceptibility pattern was observed among the grown microbes. Positive cultures were significantly more frequent among patients with over two weeks duration of burn wounds. CONCLUSION P. aeruginosa, K. pneumoniae and S. aureus constituted the most common bacterial microbes of burn wounds in our in-patients cases. Positive cultures were more frequent among patients with over two weeks duration of burn wounds. Early excision and skin grafting of deep burns and adherence to infection control measures can help to effectively reduce the burden of these infections. PMID:25606471

  7. Effect of Honey on Healing of Pseudomonas aeruginosa Infected Burn Wounds in Rat

    Microsoft Academic Search

    M. Hazrati; D. Mehrabani; A. Japoni; H. Montasery; N. Azarpira; A. R. Hamidian-shirazi; N. Tanideh

    2010-01-01

    Hazrati, M., Mehrabani, D., Japoni, A., Montasery, H., Azarpira, N., Hamidian-shirazi, A.R. and Tanideh, N. 2010. Effect of honey on healing of Pseudomonas aeruginosas infected burn wounds in rat. J. Appl. Anim. Res., 37: 161–165.To determine the effect of honey on healing of burn wounds infected with Pseudomonas aeruginosa, 57 male Sprague-Dawley 180–220 g rats were randomly divided into 3

  8. Glucose Control Lowers the Risk of Wound Infection in Diabetics After Open Heart Operations

    Microsoft Academic Search

    1997-01-01

    Background. Elevated blood glucose levels in the postoperative period are associated with an increased risk of deep wound infection in diabetic individuals undergoing open heart operations at Providence St. Vincent Hospital.Methods. Of 8,910 patients who underwent cardiac operations between 1987 and 1993, 1,585 (18%) were diabetic. The rate of deep sternal wound infections in diabetic patients was 1.7%, versus 0.4%

  9. Wound Healing and Care

    MedlinePLUS

    ... stitches or a hospital stay? Different Types of Wounds Most of us think of wounds happening because ... into the wound and cause infection. Closing Serious Wounds If a wound is clean, a doctor will ...

  10. The Human Cathelicidin Antimicrobial Peptide LL-37 as a Potential Treatment for Polymicrobial Infected Wounds

    PubMed Central

    Duplantier, Allen J.; van Hoek, Monique L.

    2013-01-01

    Diabetic patients often have ulcers on their lower-limbs that are infected by multiple biofilm-forming genera of bacteria, and the elimination of the biofilm has proven highly successful in resolving such wounds in patients. To that end, antimicrobial peptides have shown potential as a new anti-biofilm approach. The single human cathelicidin peptide LL-37 has been shown to have antimicrobial and anti-biofilm activity against multiple Gram-positive and Gram-negative human pathogens, and have wound-healing effects on the host. The combination of the anti-biofilm effect and wound-healing properties of LL-37 may make it highly effective in resolving polymicrobially infected wounds when topically applied. Such a peptide or its derivatives could be a platform from which to develop new therapeutic strategies to treat biofilm-mediated infections of wounds. This review summarizes known mechanisms that regulate the endogenous levels of LL-37 and discusses the anti-biofilm, antibacterial, and immunological effects of deficient vs. excessive concentrations of LL-37 within the wound environment. Here, we review recent advances in understanding the therapeutic potential of this peptide and other clinically advanced peptides as a potential topical treatment for polymicrobial infected wounds. PMID:23840194

  11. Effect of surgical incision management on wound infections in a poststernotomy patient population.

    PubMed

    Grauhan, Onnen; Navasardyan, Artashes; Tutkun, Baris; Hennig, Felix; Müller, Peter; Hummel, Manfred; Hetzer, Roland

    2014-06-01

    Skin breakdown and infiltration of skin flora are key causative elements in poststernotomy wound infections. We hypothesised that surgical incision management (SIM) using negative pressure wound therapy over closed surgical incisions for 6-7?days would reduce wound infections in a comprehensive poststernotomy patient population. 'All comers' undergoing median sternotomy at our institution were analysed prospectively from 1 September to 15 October 2013 (study group, n?=?237) and retrospectively from January 2008 to December 2009 (historical control group, n?=?3508). The study group had SIM (Prevena™ Therapy) placed immediately after skin suturing and applied at -125 mmHg for 6-7?days, whereas control group received conventional sterile wound tape dressings. Primary endpoint was wound infection within 30 days. Study group had a significantly lower infection rate than control group: 1·3% (3 patients) versus 3·4% (119 patients), respectively (P?wound infection after median sternotomy. Based on these data SIM may be cost-effective in patients undergoing cardiac surgery. PMID:24851729

  12. Pseudomonas syringae pv. syringae uses proteasome inhibitor syringolin A to colonize from wound infection sites.

    PubMed

    Misas-Villamil, Johana C; Kolodziejek, Izabella; Crabill, Emerson; Kaschani, Farnusch; Niessen, Sherry; Shindo, Takayuki; Kaiser, Markus; Alfano, James R; van der Hoorn, Renier A L

    2013-03-01

    Infection of plants by bacterial leaf pathogens at wound sites is common in nature. Plants defend wound sites to prevent pathogen invasion, but several pathogens can overcome spatial restriction and enter leaf tissues. The molecular mechanisms used by pathogens to suppress containment at wound infection sites are poorly understood. Here, we studied Pseudomonas syringae strains causing brown spot on bean and blossom blight on pear. These strains exist as epiphytes that can cause disease upon wounding caused by hail, sand storms and frost. We demonstrate that these strains overcome spatial restriction at wound sites by producing syringolin A (SylA), a small molecule proteasome inhibitor. Consequently, SylA-producing strains are able to escape from primary infection sites and colonize adjacent tissues along the vasculature. We found that SylA diffuses from the primary infection site and suppresses acquired resistance in adjacent tissues by blocking signaling by the stress hormone salicylic acid (SA). Thus, SylA diffusion creates a zone of SA-insensitive tissue that is prepared for subsequent colonization. In addition, SylA promotes bacterial motility and suppresses immune responses at the primary infection site. These local immune responses do not affect bacterial growth and were weak compared to effector-triggered immunity. Thus, SylA facilitates colonization from wounding sites by increasing bacterial motility and suppressing SA signaling in adjacent tissues. PMID:23555272

  13. Pseudomonas syringae pv. syringae Uses Proteasome Inhibitor Syringolin A to Colonize from Wound Infection Sites

    PubMed Central

    Misas-Villamil, Johana C.; Kolodziejek, Izabella; Crabill, Emerson; Kaschani, Farnusch; Niessen, Sherry; Shindo, Takayuki; Kaiser, Markus; Alfano, James R.; van der Hoorn, Renier A. L.

    2013-01-01

    Infection of plants by bacterial leaf pathogens at wound sites is common in nature. Plants defend wound sites to prevent pathogen invasion, but several pathogens can overcome spatial restriction and enter leaf tissues. The molecular mechanisms used by pathogens to suppress containment at wound infection sites are poorly understood. Here, we studied Pseudomonas syringae strains causing brown spot on bean and blossom blight on pear. These strains exist as epiphytes that can cause disease upon wounding caused by hail, sand storms and frost. We demonstrate that these strains overcome spatial restriction at wound sites by producing syringolin A (SylA), a small molecule proteasome inhibitor. Consequently, SylA-producing strains are able to escape from primary infection sites and colonize adjacent tissues along the vasculature. We found that SylA diffuses from the primary infection site and suppresses acquired resistance in adjacent tissues by blocking signaling by the stress hormone salicylic acid (SA). Thus, SylA diffusion creates a zone of SA-insensitive tissue that is prepared for subsequent colonization. In addition, SylA promotes bacterial motility and suppresses immune responses at the primary infection site. These local immune responses do not affect bacterial growth and were weak compared to effector-triggered immunity. Thus, SylA facilitates colonization from wounding sites by increasing bacterial motility and suppressing SA signaling in adjacent tissues. PMID:23555272

  14. Biofilms and persistent wound infections in United States military trauma patients: a case–control analysis

    PubMed Central

    2014-01-01

    Background Complex traumatic injuries sustained by military personnel, particularly when involving extremities, often result in infectious complications and substantial morbidity. One factor that may further impair patient recovery is the persistence of infections. Surface-attached microbial communities, known as biofilms, may play a role in hindering the management of infections; however, clinical data associating biofilm formation with persistent or chronic infections are lacking. Therefore, we evaluated the production of bacterial biofilms as a potential risk factor for persistent infections among wounded military personnel. Methods Bacterial isolates and clinical data from military personnel with deployment-related injuries were collected through the Trauma Infectious Disease Outcomes Study. The study population consisted of patients with diagnosed skin and soft-tissue infections. Cases (wounds with bacterial isolates of the same organism collected 14 days apart) were compared to controls (wounds with non-recurrent bacterial isolates), which were matched by organism and infectious disease syndrome. Potential risk factors for persistent infections, including biofilm formation, were examined in a univariate analysis. Data are expressed as odds ratios (OR; 95% confidence interval [CI]). Results On a per infected wound basis, 35 cases (representing 25 patients) and 69 controls (representing 60 patients) were identified. Eight patients with multiple wounds were utilized as both cases and controls. Overall, 235 bacterial isolates were tested for biofilm formation in the case–control analysis. Biofilm formation was significantly associated with infection persistence (OR: 29.49; CI: 6.24-infinity) in a univariate analysis. Multidrug resistance (OR: 5.62; CI: 1.02-56.92), packed red blood cell transfusion requirements within the first 24 hours (OR: 1.02; CI: 1.01-1.04), operating room visits prior to and on the date of infection diagnosis (OR: 2.05; CI: 1.09-4.28), anatomical location of infected wound (OR: 5.47; CI: 1.65-23.39), and occurrence of polymicrobial infections (OR: 69.71; CI: 15.39-infinity) were also significant risk factors for persistent infections. Conclusions We found that biofilm production by clinical strains is significantly associated with the persistence of wound infections. However, the statistical power of the analysis was limited due to the small sample size, precluding a multivariate analysis. Further data are needed to confirm biofilm formation as a risk factor for persistent wound infections. PMID:24712544

  15. Validation of a novel murine wound model of Acinetobacter baumannii infection.

    PubMed

    Thompson, Mitchell G; Black, Chad C; Pavlicek, Rebecca L; Honnold, Cary L; Wise, Matthew C; Alamneh, Yonas A; Moon, Jay K; Kessler, Jennifer L; Si, Yuanzheng; Williams, Robert; Yildirim, Suleyman; Kirkup, Benjamin C; Green, Romanza K; Hall, Eric R; Palys, Thomas J; Zurawski, Daniel V

    2014-01-01

    Patients recovering from traumatic injuries or surgery often require weeks to months of hospitalization, increasing the risk for wound and surgical site infections caused by ESKAPE pathogens, which include A. baumannii (the ESKAPE pathogens are Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species). As new therapies are being developed to counter A. baumannii infections, animal models are also needed to evaluate potential treatments. Here, we present an excisional, murine wound model in which a diminutive inoculum of a clinically relevant, multidrug-resistant A. baumannii isolate can proliferate, form biofilms, and be effectively treated with antibiotics. The model requires a temporary, cyclophosphamide-induced neutropenia to establish an infection that can persist. A 6-mm-diameter, full-thickness wound was created in the skin overlying the thoracic spine, and after the wound bed was inoculated, it was covered with a dressing for 7 days. Uninoculated control wounds healed within 13 days, whereas infected, placebo-treated wounds remained unclosed beyond 21 days. Treated and untreated wounds were assessed with multiple quantitative and qualitative techniques that included gross pathology, weight loss and recovery, wound closure, bacterial burden, 16S rRNA community profiling, histopathology, peptide nucleic acid-fluorescence in situ hybridization, and scanning electron microscopy assessment of biofilms. The range of differences that we are able to identify with these measures in antibiotic- versus placebo-treated animals provides a clear window within which novel antimicrobial therapies can be assessed. The model can be used to evaluate antimicrobials for their ability to reduce specific pathogen loads in wounded tissues and clear biofilms. Ultimately, the mouse model approach allows for highly powered studies and serves as an initial multifaceted in vivo assessment prior to testing in larger animals. PMID:24342634

  16. In vivo modeling of biofilm-infected wounds: a review.

    PubMed

    Seth, Akhil K; Geringer, Matthew R; Hong, Seok J; Leung, Kai P; Mustoe, Thomas A; Galiano, Robert D

    2012-11-01

    Chronic wounds continue to represent a difficult and complex problem for both patients and healthcare providers. Bacterial biofilms represent a critical component of nonhealing wounds, utilizing several different mechanisms to inhibit innate inflammatory pathways and resist traditional therapeutics. Although in vitro biofilm systems have been well described and studied, understanding the intricacies of wound biofilm pathology requires appropriate in vivo models to understand the interactions between bacteria and host. In an effort to clarify the available literature, this review describes and critically evaluates all of the in vivo wound biofilm models currently published to-date, including model advantages and clinical applicability. We will also address the need for continued therapeutic development and testing using these currently available in vivo models. PMID:22835953

  17. Multifocal cutaneous mucormycosis complicating polymicrobial wound infections in a tsunami survivor from Sri Lanka.

    PubMed

    Andresen, David; Donaldson, Annabelle; Choo, Lennart; Knox, Adrian; Klaassen, Michael; Ursic, Caesar; Vonthethoff, Leon; Krilis, Steven; Konecny, Pamela

    A man injured in the tsunami of Dec 26, 2004, returned to Sydney for management of his soft-tissue injuries. Despite broad-spectrum antibiotics, surgical wound debridement, and vigilant wound care, his condition worsened. Muscle and fat necrosis developed in a previously debrided thigh wound, and necrotising lesions arose from previous abrasions. Histological analysis showed mucormycosis in three non-contiguous sites, and Apophysomyces elegans was isolated from excised wound tissue. Wound infections, both bacterial and fungal, will undoubtedly add to the morbidity and mortality already recorded in tsunami-affected areas. Other cases [correction] of cutaneous mucormycosis might develop in survivors, but this disease can be difficult to diagnose and even harder to treat, particularly in those remaining in affected regions. PMID:15752532

  18. Strategies to reduce deep sternal wound infection after bilateral internal mammary artery grafting.

    PubMed

    Sajja, Lokeswara Rao

    2014-11-18

    Deep sternal wound infections (DSWI) continue to be an infrequent but potentially devastating complication after cardiac surgical procedures. Its prevalence is more after coronary artery bypass grafting using single internal mammary artery (IMA) graft. Bilateral internal mammary artery (BIMA) harvesting carries a higher risk of sternal infection than harvesting single IMA. Several risk factors have been identified with sternal wound infections and a few are modifiable. Strategies that reduce DSWI target the modifiable risk factors that include microbiological factors, appropriate antibiotic prophylaxis, tight glycemic control. Surgical strategies to reduce DSWI following BIMA harvest include techniques of IMA harvesting with lesser devascularization of sternum using skeletonized, semiskeletonized and modified pedicle harvest are associated with greater preservation of sternal blood supply and sternal closure and stability techniques. The various strategies to minimize sternal wound infections during preoperative, intra and postoperative periods are summarized in this article. PMID:25463763

  19. Chronic wound infections: the role of Pseudomonas aeruginosa and Staphylococcus aureus.

    PubMed

    Serra, Raffaele; Grande, Raffaele; Butrico, Lucia; Rossi, Alessio; Settimio, Ugo Francesco; Caroleo, Benedetto; Amato, Bruno; Gallelli, Luca; de Franciscis, Stefano

    2015-05-01

    Chronic leg ulcers affect 1-2% of the general population and are related to increased morbidity and health costs. Staphylococcus aureus and Pseudomonas aeruginosa are the most common bacteria isolated from chronic wounds. They can express virulence factors and surface proteins affecting wound healing. The co-infection of S. aureus and P. aeruginosa is more virulent than single infection. In particular, S. aureus and P. aeruginosa have both intrinsic and acquired antibiotic resistance, making clinical management of infection a real challenge, particularly in patients with comorbidity. Therefore, a correct and prompt diagnosis of chronic wound infection requires a detailed knowledge of skin bacterial flora. This is a necessary prerequisite for tailored pharmacological treatment, improving symptoms, and reducing side effects and antibiotic resistance. PMID:25746414

  20. Polypragmasia in the therapy of infected wounds – conclusions drawn from the perspectives of low temperature plasma technology for plasma wound therapy

    PubMed Central

    Kramer, Axel; Hübner, Nils-Olaf; Weltmann, Klaus-Dieter; Lademann, Jürgen; Ekkernkamp, Axel; Hinz, Peter; Assadian, Ojan

    2008-01-01

    As long as a wound is infected, the healing process cannot begin. The indication for wound antiseptic is dependent on the interaction between the wound, the causative micro-organisms, and the host immune system. An uncritical colonisation is a condition whereby micro-organisms on a wound will proliferate, yet the immune system will not react excessively. Wound antiseptic is most often not necessary unless for epidemiologic reasons like colonisation with multi-resistant organisms. In most instances of a microbial contamination of the wound and colonisation, thorough cleaning will be sufficient. Bacterial counts above 105 to 106 cfu per gram tissue (critical colonisation) might decrease wound healing due to release of toxins, particularly in chronic wounds. Traumatic and heavily contaminated wounds therefore will require anti-infective measures, in particular wound antiseptic. In such situations, even a single application of an antiseptic compound will significantly reduce the number of pathogens, and hence, the risk of infection. If a wound infection is clinically manifest, local antiseptics and systemic antibiotics are therapeutically indicated. The prophylactic and therapeutic techniques for treatment of acute and chronic wounds (chemical antiseptics using xenobiotics or antibiotics, biological antiseptic applying maggots, medical honey or chitosan, physical antiseptic using water-filtered infrared A, UV, or electric current) mostly have been empirically developed without establishing a fundamental working hypothesis for their effectiveness. The most important aspect in controlling a wound infection and achieving healing of a wound is meticulous debridement of necrotic material. This is achieved by surgical, enzymatic or biological means e.g. using maggots. However, none of these methods (with some exception for maggots) is totally gentle to vital tissue and particularly chemical methods possess cytotoxicity effects. Derived from the general principles of antiseptic wound treatment, the following working hypothesis is postulated: the most ideal constellation for treatment of wounds is the superficial destruction of microbial layers without deep tissue alteration, like it is caused by antiseptics, in order not to endanger the regenerative granulation tissue. At the same time, it is desirable to support and increase cell proliferation and granulation capacities. These two aspects might be achieved by using low temperature plasma technology. PMID:20204115

  1. Wound management with vacuum-assisted closure in postoperative infections after surgery for spinal stenosis

    PubMed Central

    Karaaslan, Fatih; Erdem, ?evki; Mermerkaya, Musa U?ur

    2015-01-01

    Objective To evaluate the results of negative-pressure wound therapy (NPWT) in the treatment of surgical spinal site infections. Materials and methods The use of NPWT in postoperative infections after dorsal spinal surgery (transforaminal lumbar interbody fusion plus posterior instrumentation) was studied retrospectively. From February 2011 to January 2012, six patients (females) out of 317 (209 females; 108 males) were readmitted to our clinic with surgical site infections on postoperative day 14 (range 9–19) and were treated with debridement, NPWT, and antibiotics. We evaluated the clinical and laboratory data, including the ability to retain the spinal hardware and recurrent infections. Results The incidence of deep postoperative surgical site infection was six (1.89%) patients (females) out of 317 patients (209 females; 108 males) at 1 year. All patients completed their wound NPWT regimen successfully. An average of 5.1 (range 3–8) irrigation and debridement sessions was performed before definitive wound closure. The mean follow-up period was 13 (range 12–16) months. No patient had a persistent infection requiring partial or total hardware removal. The hospital stay infection parameters normalized within an average of 4.6 weeks. Conclusion The study illustrates the usefulness of NPWT as an effective adjuvant treatment option for managing complicated deep spinal surgical wound infections. PMID:25565903

  2. A Bioengineered Human Skin Tissue for the Treatment of Infected Wounds

    PubMed Central

    Thomas-Virnig, Christina L.; Allen-Hoffmann, B. Lynn

    2012-01-01

    Background Complex skin defects resulting from acute skin trauma and chronic, nonhealing wounds are life-threatening injuries. Infection is one of the most common obstacles to the healing of these types of wounds. Host defense peptides (HDPs) possessing a broad spectrum of activity against microorganisms and serving as innate immune modulators have emerged as potential treatment strategies for infected wounds. The Problem The increase in multidrug-resistant clinical bacterial isolates highlights the need for new and innovative anti-infective therapies for the treatment of both acute and chronic skin wounds. Basic/Clinical Science To address the critical need for new therapeutic options to reduce infection and improve wound healing, a bioengineered skin substitute (BSS) tissue has been created to act as an anti-infective living human skin tissue that provides enhanced expression of the endogenous HDP, cathelicidin. To generate a BSS exhibiting these antimicrobial properties, the clinically tested NIKS progenitor cells were employed to provide a source of genetically uniform, nontumorigenic, pathogen-free human keratinocytes that are amenable to genetic engineering using nonviral means. Clinical Care Relevance Pathogenic bacterial strains are increasingly developing antibiotic resistance, thereby forcing the clinician to use potent antibiotics with deleterious effects on keratinocyte viability and migration. Therefore, an urgent need exists for new wound therapies that can circumvent many of the problems associated with current antibiotic treatments. Conclusion Enhanced expression of cathelicidin in a genetically engineered human BSS has been shown to inhibit the bacterial growth of a multidrug-resistant clinical strain of Acinetobacter baumannii in vivo, creating a new and innovative therapeutic option for combating these debilitating wound infections while also promoting healing. PMID:24527286

  3. Management of the infected median sternotomy wound with muscle flaps. The Emory 20-year experience.

    PubMed Central

    Jones, G; Jurkiewicz, M J; Bostwick, J; Wood, R; Bried, J T; Culbertson, J; Howell, R; Eaves, F; Carlson, G; Nahai, F

    1997-01-01

    OBJECTIVE: The purpose of the study is to define those patient variables that contribute to morbidity and mortality of median sternotomy wound infection and the results of treatment by debridement and closure by muscle flaps. BACKGROUND: Infection of the median sternotomy wound after open heart surgery is a devastating complication associated with significant mortality. Twenty years ago, these wounds were treated with either open packing or antibiotic irrigation, with a mortality approaching 50% in some series. In 1975, the authors began treating these wounds with radical sternal debridement followed by closure using muscle or omental flaps. The mortality of sternal wound infection has dropped to < 10%. METHODS: The authors' total experience with 409 patients treated over 20 years is described in relation to flap choices, hospital days after sternal wound closure, and incidence rates of morbidity and mortality. One hundred eighty-six patients treated since January 1988 were studied to determine which patient variables had impact on rates of flap closure complications, recurrent sternal wound infection, or death. Variables included obesity, history of smoking, hypertension, diabetes, poststernotomy septicemia, internal mammary artery harvest, use of intra-aortic balloon pump, and perioperative myocardial infarction and were analyzed using chi square tests. Fisher's exact tests, and multivariable logistic regression analysis. RESULTS: The mortality rate over 20 years was 8.1% (33/49). Additional procedures for recurrent sternal wound infection were necessary in 5.1% of patients. Thirty-one patients (7.6%) required treatment for hematoma, and 11 patients (2.7%) required hernia repair. Among patients treated since 1988, variables strongly associated with mortality were septicemia (p < 0.00001), perioperative myocardial infarction (p = 0.006), and intra-aortic balloon pump (p = 0.0168). Factors associated with wound closure complications were intra-aortic balloon pump (p = 0.0287), hypertension (p = 0.0335), and history of smoking (p = 0.0741). Factors associated with recurrent infection were history of sternotomy (p = 0.008) and patients treated for sternal wound infection from 1988 to 1992 (p = 0.024). Mean hospital stay after sternal wound reconstruction declined from 18.6 days (1988-1992) to 12.4 days (1993-1996) (p = 0.005). To clarify management decisions of these difficult cases, a classification of sternal wound infection is presented. CONCLUSIONS: Using the principles of sternal wound debridement and early flap coverage, the authors have achieved a significant reduction in mortality after sternal wound infection and have reduced the mean hospital stay after sternal wound closure of these critically ill patients. Further reductions in mortality will depend on earlier detection of mediastinitis, before onset of septicemia, and ongoing improvements in the critical care of patients with multisystem organ failure. PMID:9230817

  4. Carboxymethyl cellulose wafers containing antimicrobials: a modern drug delivery system for wound infections.

    PubMed

    Ng, Shiow-Fern; Jumaat, Nafisah

    2014-01-23

    Lyophilised wafers have been shown to have potential as a modern dressing for mucosal wound healing. The wafer absorbs wound exudates and transforms into a gel, thus providing a moist environment which is essential for wound healing. The objective of this study was to develop a carboxymethyl cellulose wafer containing antimicrobials to promote wound healing and treat wound infection. The pre-formulation studies began with four polymers, sodium carboxymethyl cellulose (NaCMC), methylcellulose (MC), sodium alginate and xanthan gum, but only NaCMC and MC were chosen for further investigation. The wafers were characterised by physical assessments, solvent loss, microscopic examination, swelling and hydration properties, drug content uniformity, drug release and efficacy of antimicrobials. Three of the antimicrobials, neomycin trisulphate salt hydrate, sulphacetamide sodium and silver nitrate, were selected as model drugs. Among the formulations, NaCMC wafer containing neomycin trisulphate exhibited the most desirable wound dressing characteristics (i.e., flexibility, sponginess, uniform wafer texture, high content drug uniformity) with the highest in vitro drug release and the greatest inhibition against both Gram positive and Gram negative bacteria. In conclusion, we successfully developed a NaCMC lyophilised wafer containing antimicrobials, and this formulation has potential for use in mucosal wounds infected with bacteria. PMID:24076463

  5. A Case of Continuous Negative Pressure Wound Therapy for Abdominal Infected Lymphocele after Kidney Transplantation

    PubMed Central

    Franchin, Marco; Tozzi, Matteo; Soldini, Gabriele; Piffaretti, Gabriele

    2014-01-01

    Lymphocele is a common complication after kidney transplantation. Although superinfection is a rare event, it generates a difficult management problem; generally, open surgical drainage is the preferred method of treatment but it may lead to complicated postoperative course and prolonged healing time. Negative pressure wound therapy showed promising outcomes in various surgical disciplines and settings. We present a case of an abdominal infected lymphocele after kidney transplantation managed with open surgery and negative pressure wound therapy. PMID:25374744

  6. Requirements for Pseudomonas aeruginosa Acute Burn and Chronic Surgical Wound Infection

    PubMed Central

    Turner, Keith H.; Everett, Jake; Trivedi, Urvish; Rumbaugh, Kendra P.; Whiteley, Marvin

    2014-01-01

    Opportunistic infections caused by Pseudomonas aeruginosa can be acute or chronic. While acute infections often spread rapidly and can cause tissue damage and sepsis with high mortality rates, chronic infections can persist for weeks, months, or years in the face of intensive clinical intervention. Remarkably, this diverse infectious capability is not accompanied by extensive variation in genomic content, suggesting that the genetic capacity to be an acute or a chronic pathogen is present in most P. aeruginosa strains. To investigate the genetic requirements for acute and chronic pathogenesis in P. aeruginosa infections, we combined high-throughput sequencing-mediated transcriptome profiling (RNA-seq) and genome-wide insertion mutant fitness profiling (Tn-seq) to characterize gene expression and fitness determinants in murine models of burn and non-diabetic chronic wound infection. Generally we discovered that expression of a gene in vivo is not correlated with its importance for fitness, with the exception of metabolic genes. By combining metabolic models generated from in vivo gene expression data with mutant fitness profiles, we determined the nutritional requirements for colonization and persistence in these infections. Specifically, we found that long-chain fatty acids represent a major carbon source in both chronic and acute wounds, and P. aeruginosa must biosynthesize purines, several amino acids, and most cofactors during infection. In addition, we determined that P. aeruginosa requires chemotactic flagellar motility for fitness and virulence in acute burn wound infections, but not in non-diabetic chronic wound infections. Our results provide novel insight into the genetic requirements for acute and chronic P. aeruginosa wound infections and demonstrate the power of using both gene expression and fitness profiling for probing bacterial virulence. PMID:25057820

  7. Quality of the surveillance of surgical wound infections: a 10-year prospective study of 12,364 wounds.

    PubMed

    Ibsen Sørensen, Allan; Sandberg Sørensen, Torben; Bremmelgaard, Annie

    2003-04-01

    We did a survey of postoperative wound infection rates in our department over a 10-year period. It was based on the results of forms completed by surgeons in the department after each operation and when an infection was diagnosed (primary registration). These forms were sent to the electronic data processing department for registration of data in a database. Every third month, detailed reports of the data were discussed with the surgeons. The quality of this routine survey was evaluated as follows: 1) Every year, the year's data in the surveys database were compared with those in the National Patient Register and, in case of discrepancies, the patient's records were checked and missing information about the operation and infections were recorded in the surveys database (secondary registration). 2) In case of a primary registered infection, the patient's record was carefully examined. Infections not fulfilling the criteria for an infection were called registration failures. The primary registration of operations reached an acceptable level (about 95%) after 5 years of the survey, but the recording of infections was unreliable throughout the study due to an unacceptably low registration rate (about 60%) and to a high rate of registration failures. PMID:12807325

  8. Analysis of blood flow and local expression of angiogenesis?associated growth factors in infected wounds treated with negative pressure wound therapy.

    PubMed

    Xia, Cheng-Yan; Yu, Ai-Xi; Qi, Baiwen; Zhou, Min; Li, Zong-Huan; Wang, Wei-Yang

    2014-05-01

    Angiogenesis is involved in the wound healing process. Increased angiogenesis and blood flow constitute a major mechanism of negative pressure wound therapy (NPWT), which has been shown to facilitate the healing of infected wounds. However, the effect on the expression of angiogensis?related growth factor remains unknown. The goal of the current study was to investigate the angiogenic factor levels prior to and following NPWT in infected wounds. A total of 20 patients with infected wounds treated with NPWT were included in the study. Patients acted as their own control; the postoperative measurements of patients were considered as the experimental group, while preoperative measurements were considered as the controlled group. Blood flow was recorded prior to and during NPWT. A total of 10 angiogensis?related growth factors were detected using a protein biochip array to analyze the change in protein levels prior to NPWT, and on the third day during NPWT. All wounds were successfully reconstructed by skin grafting or using local flaps following NPWT. NPWT resulted in significantly increased blood flow in the wound. There was a significant increase in vascular endothelial growth factor (VEGF), EGF, platelet?derived growth factor and angiotesin?2 following NPWT, while basic fibroblast growth factor decreased significantly. NPWT affects the local expression of angiogenesis?associated growth factors, which represents another mechanism to explain how NPWT accelerates wound healing. PMID:24584462

  9. Intracardiac Abscess with Cutaneous Fistula Secondary to Ventricular Septal Defect Repair Simulating Sternal Wound Infection

    PubMed Central

    Keshavamurthy, Suresh; Sepulveda, Edgardo; Miranda, Cyndee Cruz; Okamoto, Toshihiro; Pettersson, Gosta Bengt

    2014-01-01

    Cutaneous fistula as a clinical presentation of intracardiac abscess of the right side is such an unusual occurrence that it has not until now been reported in the English-language medical literature. We present a rare case of right-sided infective endocarditis caused by Achromobacter xylosoxidans in which recurrent infection presented as sternal wound discharge. The infection was found to have an intracardiac origin and was successfully managed by radical débridement on cardiopulmonary bypass. PMID:24955054

  10. Phenotypic and molecular characterization of Solobacterium moorei isolates from patients with wound infection.

    PubMed

    Zheng, Guili; Summanen, Paula H; Talan, David; Bennion, Robert; Rowlinson, Marie-Claire; Finegold, Sydney M

    2010-03-01

    Though seldom reported, Solobacterium moorei, which was first described in 2000, has been identified in specimens from patients with root canals, periradicular lesions, periodontal disease, dentoalveolar abscesses, bacteremia, septic thrombophlebitis, and halitosis. In the present study, we describe 9 cases of mixed wound infection, from a pool of 400 surgical wound infections that we have studied, in which S. moorei was isolated or found in a clone library. All isolates of S. moorei were identified by 16S rRNA gene sequence analysis, and then six were examined for their physiological and biochemical characteristics and for antimicrobial susceptibility. The results of the present study indicate that Solobacterium moorei may be a significant component in some mixed surgical wound infections and that surgical management and antimicrobial therapy may be indicated when these bacteria are identified in significant situations. PMID:20071554

  11. Evaluation of healing of infected cutaneous wounds treated with different energy densities

    NASA Astrophysics Data System (ADS)

    Santos, Nicole R. S.; Cangussú, Maria C. T.; N. dos Santos, Jean; Pinheiro, Antonio L. B.

    2011-03-01

    We aimed assess the effects of different energy densities of the association of red/IR laser light on the healing of cutaneous wounds infected Staphylococcus aureus. Background: Wound infection is the most common complication on healing wounds and cause both vascular and cellular responses on the tissue. Several therapeutics is used for improving wound healing including the use of different light sources, such as the Laser. Some energy densities present positive photobiological effects on the healing process. Material and Methods: 24 young adult male Wistar rats, under general anesthesia, had their dorsum shaven, cleaned and a 1 x 1cm cutaneous wound created with a scalpel and left without no suturing or dressings. The wounds were infected with Staphylococcus aureus and were randomly divided in 8 subgroups of 3 animals in each: Control, Group 10J/cm2, Group 20J/cm2, and Group 30J/cm2, 7 and 14 days each group. Laser phototherapy was carried out with a diode (?680nm/790nm, P= 30mW/40mW, CW, Laser, Ø = 3mm, PD=424mW/cm2 and 566mW/cm2, t=11.8/ 8.8 sec, E=0.35J) and started immediately after surgery and repeated at every other day during 7 days. Laser light was applied on 4 points around wounded area. The animals were killed at either 8th or 15th day after contamination. Specimens were taken, routinely cut and processed to wax, stained and underwent histological analysis. The results were statistically analyzed. Results: Both 20 and 30J/cm2 caused intense collagen deposition at the end of the experimental time. But, when 20 J/cm2 was used the fibers were also well organized. Conclusion: Our results indicate that irradiated subjects showed improved wound healing being the 20 J/cm2 the energy the caused better histological response.

  12. Measures for Preventing Wound Infections During Elective Open Surgery for Colorectal Cancer: Scrubbing With Gauze

    PubMed Central

    Goi, Takanori; Ueda, Yuki; Nakazawa, Toshiyuki; Sawai, Katsuji; Morikawa, Mitsuhiro; Yamaguchi, Akio

    2014-01-01

    In addition to the general surgical-site infection prevention measures in colorectal cancer surgery, we performed a simple subcutaneous scrubbing procedure with gauze at the time of abdominal closure, which reduced the incidence of wound infections. There are 289 patients whose primary colon cancer lesions were removed by elective surgeries. They were divided into Group A (74 patients with no wound infection prevention measures who were treated from 2002 to 2003), Group B (76 patients with wound infection prevention measures who were treated from 2007 to 2008), and Group C (139 patients with subcutaneous scrubbing with gauze plus the measures in Group B who were treated from 2009 to 2012). The incidence in Group A was 23%, while the corresponding values in Group B and Group C were 14.5% and 2.9%, respectively. The incidence of wound infections was substantially reduced by additional subcutaneous scrubbing with a saline solution and gauze during closure of a surgical incision. This very simple procedure was considered useful for surgical site infection prevention. PMID:24444266

  13. Collagen bilayer dressing with ciprofloxacin, an effective system for infected wound healing.

    PubMed

    Sripriya, Ramasamy; Kumar, Muthusamy Senthil; Ahmed, Mohamed Rafiuddin; Sehgal, Praveen Kumar

    2007-01-01

    Bacterial wound infection is a major problem, which hinders the normal healing process. In this study, a collagen bilayer dressing with ciprofloxacin was prepared from succinylated type-I collagen; FT-IR spectroscopy, SEM analysis, in vitro drug release pattern, antimicrobial activity and in vivo efficacy of the dressing were studied. The healing pattern was analyzed on days 3, 5, 7, 14 and 21 by wound healing rate, bacterial population, biochemical and histological examinations of tissue samples. FT-IR spectra showed the succinylation of collagen and ionic binding of ciprofloxacin to succinylated collagen. SEM analysis showed uniform drug distribution in collagen sponge and in vitro drug release pattern showed a release profile for 3 days with effective drug concentration confirmed by zone of inhibition. Ciprofloxacin counter-acted the effect of invading bacteria, as could be seen by considerable reduction in total bacterial population of the wound. In vivo analysis showed significant wound closure, biochemical analysis, such as protein, DNA, hydroxyproline, SOD, catalase, hexosamine and uronic acid from the granulation tissue, showed enhanced healing in the group treated with collagen bilayer dressing with ciprofloxacin. Histological analysis and wound closure further confirmed proper healing. Our results suggest that sustained release of ciprofloxacin from a collagen bilayer dressing eliminates bacteria at the site of infection, leaving a pathogen-free wound environment, and it can be used as a dressing for an on-site delivery system. PMID:17471769

  14. Long-term results of pectoralis major muscle transposition for infected sternotomy wounds.

    PubMed Central

    Pairolero, P C; Arnold, P G; Harris, J B

    1991-01-01

    During an 11.5-year period, 100 consecutive patients (79 male, 21 female) underwent repair of an infected sternotomy wound. Sixty-five patients had failed attempts at wound closure by other physicians. Median age was 61.5 years (range, 5 to 85 years). Reconstruction included muscle in 79 patients, omentum in 4, and both in 15. A total of 175 muscles were transposed, including 169 pectoralis major, 3 rectus abdominis, 2 external oblique, and 1 latissimus dorsi. Median number of operations was four (range, 1 to 11). Mechanical ventilation was required in 30 patients. Two perioperative deaths occurred, one related to sepsis. Median follow-up was 4.2 years (range, 1.3 to 13.5 years). Twenty-six patients had recurrent infection. Median time from our closure to recurrence was 5.5 months (range, 0.3 to 27.6 months). Cause of recurrence was inadequate removal of cartilage in 16 patients, bone in 6, and retained foreign body in 4. Eighteen patients had the wound reopened with further resection; 10 had another muscle or omentum transposition. There were 30 late deaths, only one related to recurrent infection. At the time of death or last follow-up, 92 patients had a healed chest wall. Transposition of the pectoralis major muscle remains an excellent method of management for infected sternotomy wounds. Failure is directly related to persistent infection of cartilage, bone, or retained foreign bodies. PMID:2039289

  15. Distinct innate immune responses to infection and wounding in the C. elegans epidermis

    PubMed Central

    Pujol, Nathalie; Cypowyj, Sophie; Ziegler, Katja; Millet, Anne; Astrain, Aline; Goncharov, Alexandr; Jin, Yishi; Chisholm, Andrew D.; Ewbank, Jonathan J.

    2008-01-01

    Summary Background In many animals, the epidermis is in permanent contact with the environment and represents a first line of defense against pathogens and injury. Infection of the nematode Caenorhabditis elegans by the natural fungal pathogen Drechmeria coniospora induces the expression in the epidermis of antimicrobial peptide (AMP) genes such as nlp-29. Here, we tested the hypothesis that injury might also alter AMP gene expression and sought to characterize the mechanisms that regulate the innate immune response. Results Injury induces a wound-healing response in C. elegans that includes induction of nlp-29 in the epidermis. We find that a conserved p38-MAP kinase cascade is required in the epidermis for the response to both infection and wounding. Through a forward genetic screen, we isolated mutants that failed to induce nlp-29 expression after D. coniospora infection. We identify a kinase, NIPI-3, related to human Tribbles homolog 1, that is likely to act upstream of the MAP2K SEK-1. We find NIPI-3 is required only for nlp-29 induction following infection and not following wounding. Conclusions Our results show that the C. elegans epidermis actively responds to wounding and infection via distinct pathways that converge on a conserved signaling cassette that controls the expression of the AMP gene nlp-29. A comparison between these results and MAP kinase signaling in yeast gives insights into the possible origin and evolution of innate immunity. PMID:18394898

  16. Prevena™, negative pressure wound therapy applied to closed Pfannenstiel incisions at time of caesarean section in patients deemed at high risk for wound infection.

    PubMed

    Anglim, B; O'Connor, H; Daly, S

    2014-11-10

    The aim of our retrospective study is to report on our experience using the Prevena™ wound system in obese patients undergoing caesarean section delivery. A total of 26 cases were identified from July 2012 to October 2013. The median BMI of these women was 45.3 kg/m(2). Elective caesarean sections were performed in 20 women (77%). There were four cases (15%) of superficial dehiscence. Factors associated with wound breakdown were wound infection (p = 0.03), increasing BMI (p < 0.001) and emergency LSCS (p = 0.04). In a logistic regression model the presence of infection was the only factor which remained associated with wound breakdown. Wound disruption is a major cause of morbidity following caesarean section in morbidly obese patients. The wound complication rate in our experience was low with the Prevena™ dressing with no cases of sheath dehiscence, and no patient required a second operation. The presence of infection is the most important factor in wound breakdown and should be the focus for management protocols. PMID:25383909

  17. Inflammatory and Antimicrobial Responses to Methicillin-Resistant Staphylococcus aureus in an In Vitro Wound Infection Model

    PubMed Central

    Haisma, Elisabeth M.; Rietveld, Marion H.; de Breij, Anna; van Dissel, Jaap T.

    2013-01-01

    Treatment of patients with burn wound infections may become complicated by the presence of antibiotic resistant bacteria and biofilms. Herein, we demonstrate an in vitro thermal wound infection model using human skin equivalents (HSE) and biofilm-forming methicillin-resistant Staphylococcus aureus (MRSA) for the testing of agents to combat such infections. Application of a liquid nitrogen-cooled metal device on HSE produced reproducible wounds characterized by keratinocyte death, detachment of the epidermal layer from the dermis, and re-epithelialization. Thermal wounding was accompanied by up-regulation of markers for keratinocyte activation, inflammation, and antimicrobial responses. Exposure of thermal wounded HSEs to MRSA resulted in significant numbers of adherent MRSA/HSE after 1 hour, and multiplication of these bacteria over 24-48 hours. Exposure to MRSA enhanced expression of inflammatory mediators such as TLR2 (but not TLR3), IL-6 and IL-8, and antimicrobial proteins human ?-defensin-2, -3 and RNAse7 by thermal wounded as compared to control HSEs. Moreover, locally applied mupirocin effectively reduced MRSA counts on (thermal wounded) HSEs by more than 99.9% within 24 hours. Together, these data indicate that this thermal wound infection model is a promising tool to study the initial phase of wound colonization and infection, and to assess local effects of candidate antimicrobial agents. PMID:24340061

  18. Usefulness of intrinsic surgical wound infection risk indices as predictors of postoperative pneumonia risk

    Microsoft Academic Search

    M. Delgado-Rodríguez; M. Medina-Cuadros; G. Martínez-Gallego; M. Sillero-Arenas

    1997-01-01

    The main objective of this report was to use two indices of intrinsic surgical wound infection risk, the SENIC index (Haley et al., 1985) and the NNIS index (Culver et al., 1991), to predict risk of postoperative pneumonia in general surgery patients. A prospective cohort study on 1483 patients admitted under the general surgery speciality of a tertiary hospital was

  19. Semiquantitative Culture of Open Surgical Wounds for Diagnosis of Surgical Site Infection

    Microsoft Academic Search

    E. Bouza; A. Burillo; P. Munoz; E. Cercenado; M. Rodríguez-Créixems

    2004-01-01

    The aim of this study was to assess the performance of a semiquantitative culture method and traditional qualitative culture for the diagnosis of surgical site infections resulting in an open wound. Results were correlated with the definitions for the diagnosis of SSI proposed by the Centers for Disease Control and Prevention, Atlanta, Ga., USA. The sensitivity, specificity, positive and negative

  20. A rare cause of wound infection after an open fracture: Shewanella putrefaciens

    PubMed Central

    Prinja, Aditya; Singh, Jagwant; Davis, Nwaka; Urwin, Gillian

    2013-01-01

    An elderly gentleman presented with an open fracture of the calcaneum and ankle, following a boating accident. Despite treatment with repeated surgical debridement, delayed closure, prolonged antibiotics and strict adherence to national guidelines on the management of open fractures, he developed a wound infection with a rare organism, Shewanella putrefaciens, that appears to be increasing in prevalence. PMID:23417948

  1. Prospective Identification of Risk Factors for Wound Infection After Lower Extremity Oncologic Surgery

    Microsoft Academic Search

    Carol D. Morris; Kent Sepkowitz; Claudette Fonshell; Neil Margetson; Janet Eagan; Jeremy Miransky; Patrick J. Boland; John Healey

    2003-01-01

    Background: Surgical site infections (SSI) are frequent causes of morbidity and mortality after orthopaedic oncologic procedures. This\\u000a study was conducted to identify the surgical site infection rate following a lower extremity or pelvic procedure and assess\\u000a the risk factors for acquiring SSI by direct observation of orthopaedic oncology patients’ wounds at a comprehensive cancer\\u000a center.\\u000a \\u000a \\u000a Methods: One hundred ten consecutive

  2. Aspergillus fumigatus sternal wound infections in patients undergoing open heart surgery.

    PubMed

    Richet, H M; McNeil, M M; Davis, B J; Duncan, E; Strickler, J; Nunley, D; Jarvis, W R; Tablan, O C

    1992-01-01

    During a 21-month period (July 1986-April 1988), six patients who underwent open heart surgery at Holston Valley Hospital and Medical Center in Kingsport, Tennessee, developed sternal would infections caused by Aspergillus fumigatus. All patients required sternectomy, reconstructive surgery, and long term amphotericin B therapy; no patient died. By univariate analysis, the following were significantly associated with A. fumigatus sternal would infection: chronic lung disease, a recent history of pneumonia, a greater mean number of admission diagnoses, and a particular surgeon. However, multivariate analysis identified chronic lung disease as the only independent risk factor and the best predictor of A. fumigatus sternal wound infections. No factors related to the surgical procedure or operating room personnel were associated with infection. A review of the characteristics of the patients undergoing open heart surgery showed that since 1985, there had been a trend for these patients at Holston Valley Hospital and Medical Center to be older and sicker, which may have contributed to the occurrence of infections never observed before. Despite an extensive investigation, no environmental source for A. fumigatus was identified. A. fumigatus, however, grew from the bronchial washing of one patient at the time the sternal wound infection was diagnosed, and a prospective study showed that the rate of A. fumigatus colonization among open heart surgery patients was the same as the rate of sternal wound infections caused by A. fumigatus. These data suggest that patients with chronic lung disease and respiratory colonization with A. fumigatus are at increased risk for A. fumigatus sternal wound infections after open heart surgery. PMID:1736660

  3. Nanohybrids of Silver Particles Immobilized on Silicate Platelet for Infected Wound Healing

    PubMed Central

    Chu, Chia-Yu; Peng, Fu-Chuo; Chiu, Ying-Fang; Lee, Hsing-Chuan; Chen, Chien-Wen; Wei, Jiun-Chiou; Lin, Jiang-Jen

    2012-01-01

    Silver nanoparticles supported on nanoscale silicate platelets (AgNP/NSP) possess interesting properties, including a large surface area and high biocide effectiveness. The nanohybrid of AgNP/NSP at a weight ratio 7/93 contains 5-nm Ag particles supported on the surface of platelets with dimensions of approximately 80×80×1 nm3. The nanohybrid expresses a trend of lower cytotoxicity at the concentration of 8.75 ppm Ag and low genotoxicity. Compared with conventional silver ions and the organically dispersed AgNPs, the nanohybrid promotes wound healing. We investigated overall wound healing by using acute burn and excision wound healing models. Tests on both infected wound models of mice were compared among the AgNP/NSP, polymer-dispersed AgNPs, the commercially available Aquacel, and silver sulfadiazine. The AgNP/NSP nanohybrid was superior for wound appearance, but had similar wound healing rates, vascular endothelial growth factor (VEGF)-A levels and transforming growth factor (TGF)-?1 expressions to Aquacel and silver sulfadiazine. PMID:22693632

  4. Combination of photodynamic and ultrasonic therapy for treatment of infected wounds in animal model

    NASA Astrophysics Data System (ADS)

    Menyaev, Yulian A.; Zharov, Vladimir P.

    2006-02-01

    One of the important problems of modern medicine is treatment of infected wounds. There are many diversified expedients of treatment, but none of them obey the modern physician completely. The aim of this study is to develop and test a new combined method of photodynamic ultrasonic therapy (PDUST) for treatment of infected wounds with focus on experimental trials. PDUST is based on a combination of two methods: photodynamic (PD) therapy (PDT) with photosensitizer and low frequency ultrasonic (US) therapy with antibiotic as tools for treatment of wounds and effectively killing bacteria. The main parameters are: US frequency - 26.5 kHz; US tip elongation - 40+/-20 ?m wavelength of light emitting diodes (LED) array - 660+/-10 nm; light intensity on biotissue surface - 1-2 mW/cm2; photosensitizer - an aluminum disulfonated phtalocyanine dissolved in a physiological solution in concentration 10 mg/l. The experiments were carried out with 70 male chinchilla rabbits divided into 7 groups, thus the dynamics of wounds healing were studied in different modes of PDUST. The PD and US methods supplement each other and in conjunction provide additive and especially synergetic effects. The experimental data demonstrated advantages of new technology in comparison with conventional methods in cases of treatment of extended suppurative inflammatory and profound wounds. The more detailed study of PDUST method's mechanism, which is based on low intensity of LED light, PD therapy and US influence is required.

  5. Nitrosoglutathione generating nitric oxide nanoparticles as an improved strategy for combating Pseudomonas aeruginosa-infected wounds.

    PubMed

    Chouake, Jason; Schairer, David; Kutner, Allison; Sanchez, David A; Makdisi, Joy; Blecher-Paz, Karin; Nacharaju, Parimala; Tuckman-Vernon, Chaim; Gialanella, Phil; Friedman, Joel M; Nosanchuk, Joshua D; Friedman, Adam J

    2012-12-01

    Pseudomonas aeruginosa is a community-acquired, nosocomial pathogen that is an important cause of human morbidity and mortality; it is intrinsically resistant to several antibiotics and is capable of developing resistance to newly developed drugs via a variety of mechanisms. P aeruginosa's ubiquity and multidrug resistance (MDR) warrants the development of innovative methods that overcome its ability to develop resistance. We have previously described a nitric oxide-releasing nanoparticle (NO-np) platform that effectively kills gram-positive and gram-negative organisms in vitro and accelerates clinical recovery in vivo in murine wound and abscess infection models. We have also demonstrated that when glutathione (GSH) is added to NO-np, the nitroso intermediate S-nitrosoglutathione (GSNO) is formed, which has greater activity against P aeruginosa and other gram-negative organisms compared with NO-np alone. In the current study, we evaluate the potential of NO-np to generate GSNO both in vitro and in vivo in a murine excisional wound model infected with an MDR clinical isolate of P aeruginosa. Whereas NO-np alone inhibited P aeruginosa growth in vitro for up to 8 hours, NO-np+GSH completely inhibited P aeruginosa growth for 24 hours. Percent survival in the NO-np+GSH-treated isolates was significantly lower than in the NO-np (36.1% vs 8.3%; P=.004). In addition, NO-np+GSH accelerated wound closure in P aeruginosa-infected wounds, and NO-np+GSH-treated wounds had significantly lower bacterial burden when compared to NO-np-treated wounds (P<.001). We conclude that GSNO is easily generated from our NO-np platform and has the potential to be used as an antimicrobial agent against MDR organisms such as P aeruginosa. PMID:23377518

  6. Risk Factors for Complications after Reconstructive Surgery for Sternal Wound Infection

    PubMed Central

    Takaku, Mitsuru; Matsuo, Shinji; Abe, Yoshiro; Harada, Hiroshi; Nagae, Hiroaki; Fujioka, Yusuke; Anraku, Kuniaki; Inagawa, Kiichi; Nakanishi, Hideki

    2014-01-01

    Background Although the utility of flaps for the treatment of sternal wound infections following median sternotomy has been reported for 30 years, there have been few reports on the risk factors for complications after reconstruction. The objective of this investigation was to identify factors related to complications after the reconstruction of sternal wound infections. Methods A retrospective analysis of 74 patients with reconstructive surgery after sternal wound infection over a 5-year period was performed. Clinical data including age, sex, body mass index (BMI), comorbidities, bacterial culture, previous cardiac surgery, wound depth, mortality rate, type of reconstructive procedure, and complication rate were collected. Results The patients' BMI ranged from 15.2 to 33.6 kg/m2 (mean, 23.1±3.74 kg/m2). Wound closure complications after reconstructive surgery were observed in 36.5% of the cases. The mortality rate was 2.7%. Diabetes mellitus significantly affected the rate of wound closure complications (P=0.041). A significant difference in the number of complications was seen between Staphylococcus aureus (S. aureus) and coagulase-negative Staphylococci (P=0.011). There was a correlation between harvesting of the internal thoracic artery and postoperative complications (P=0.048). The complication rates of the pectoralis major flap, rectus abdominis flap, omentum flap, a combination of pectoralis major flap and rectus abdominis flap, and direct closure were 23.3%, 33.3%, 100%, 37.5%, and 35.7%, respectively. Conclusions Diabetes mellitus, S. aureus, harvesting of the internal thoracic artery, and omentum flap were significant factors for complications after reconstruction. The omentum flap volume may be related to the complications associated with the omentum flap transfer in the present study. PMID:24883276

  7. Treatment with an oxazolidinone antibiotic inhibits toxic shock syndrome toxin-1 production in MRSA-infected burn wounds.

    PubMed

    Shupp, Jeffrey W; Ortiz, Rachel T; Moffatt, Lauren T; Jo, Daniel Y; Randad, Pranay R; Njimoluh, Khadijatou L; Mauskar, Neil A; Mino, Matthew J; Amundsen, Bethany; Jordan, Marion H

    2013-01-01

    Mortality rates in burn patients increase if they experience complications of infection. Frequently, the organisms associated with such infections are Staphylococci, including antibiotic-resistant species such as methicillin-resistant Staphylococcus aureus. Virulence factor production can further complicate treatment as a localized toxin presence may derail the healing process and allow a more invasive infection, while a toxin that becomes systemic can induce shock and cause host immune disruption. Male rats were anesthetized and subjected to full-thickness burn wounds. One day postinjury, wounds were inoculated with Toxic Shock Syndrome Toxin-1-producing methicillin-resistant S. aureus. Animals were then divided into three treatment groups: vancomycin, linezolid, or positive control. For nine additional days, animals received twice-daily antibiotics and wound assessments, blood draws, and wound biopsies were performed. All animals had wound quantitative cultures that exceeded 1 × 10 colony forming units (CFU) per gram 1 day after inoculation. Linezolid treatment significantly reduced the bacterial counts in the wounds. Positive controls and vancomycin-treated animals had toxins in their wounds by day 5 and this remained throughout the study (ranging from 20-80 ng/ml). Linezolid-treated animals had significant decrease in toxin production (< 5 ng/ml), and in most cases toxins were undetectable. No animals became systemically infected with bacteria at any point during the study. Superantigen production in burn wounds has morbid consequences in terms of long-term wound healing. A S. aureus burn wound infection model was created that allowed the study of the effect of two standard-use antibiotics on local burn wound pathophysiology. Most noteworthy is that low-dose linezolid arrested toxin production in the wound. PMID:23370994

  8. Risk factors for wound infection in health care facilities in Buea, Cameroon: aerobic bacterial pathogens and antibiogram of isolates

    PubMed Central

    Kihla, Akoachere Jane-Francis Tatah; Ngunde, Palle John; Evelyn, Mbianda Soupsop; Gerard, Nkwelang; Ndip, Roland Ndip

    2014-01-01

    Introduction Wound infection is a significant clinical challenge in hospitals in developing countries where proper healthcare delivery is hampered by limited resources. This study investigated the antibiotic susceptibility pattern of bacteria causing wound infection and risk factors for infection among hospitalized patients in Buea, Cameroon, to generate findings which could drive reformation of policies on infection control. Methods Aerobic bacteria were isolated from 212 swabs collected from patients with clinically diagnosed infected wounds. Risk factors for wound infection were investigated. Antibiotic susceptibility of isolates was determined by disk diffusion technique. The Chi-square test was employed to determine significant differences in isolation and distribution of organisms in various specimens. Differences were considered significant at P < 0.05. Results Twelve bacteria species were isolated from 169 (79.7%) specimens. Staphylococcus aureus, Pseudomonas aeruginosa and Klebsiella pneumoniae, the predominant isolates in all wound types exhibited a high preponderance of multidrug resistant strains. High rate of infection was attributed to lack of constant water supply and breakdown of sterilization equipment during the study period. Highest diversity of pathogens occurred in open wounds. There were no significant differences (P>0.05) in isolation of pathogens with respect to age, gender and wound type. Co-existing morbidity increased risk of wound infection. Isolates were susceptible to fluoroquinolones and resistant to oxacillin. Conclusion Wound infection with resistant bacteria constitutes a significant cause of morbidity in the study area. Findings reiterate the need to strengthen infection control and drug dispensing policies, and greater collaboration between microbiologists and medical practioners to stem the spread of resistant bacteria. PMID:25360190

  9. Sternal wound care to prevent infections in adult cardiac surgery patients.

    PubMed

    Stoodley, Lynda; Lillington, Linda; Ansryan, Lianna; Ota, Reiko; Caluya, Jun; Camello, Edwin; Huskins, Maria; Franco, Daniella; Silvino, Cherry Mae; Nwokafor, Ezioma; Van Zitter, Brandy; Olton, Maria; Howard, Linda; Bailey, Lorri; Mohler, Rhonda

    2012-01-01

    Sternal wound infection post-cardiac surgery is a serious complication that can lead to increased length of stay, substantial financial impact, and increased mortality. The occurrence of sternal wound infections has been reported from 0.4% to 4% of postoperative cardiac surgeries. It is imperative that every heart surgery program implements the best practice to prevent the detrimental effects of sternal wound infections. In an effort to improve the cardiothoracic (CT) surgery program in a community hospital, a decision was made to create a specialty floor including specialized nurses to care for open-heart surgery patients. In October 2010, a group of these nurses formed a working committee to explore ways to improve the overall care of our CT surgery patients. A vision and purpose for this committee were identified: (1) update and improve practice for CT surgery patients utilizing evidence-based standards, (2) successfully disseminate this information to all staff caring for the CT surgery patients, and (3) evaluate the impact of any practice changes on patient outcomes. An initial focus for the committee was to standardize sternal wound care among all staff members on the cardiovascular floors, cardiac care unit, and progressive care unit. PMID:22157494

  10. A novel multiplex PCR for detection of Pseudomonas aeruginosa: A major cause of wound infections

    PubMed Central

    Salman, Muhammad; Ali, Aamir; Haque, Abdul

    2013-01-01

    Background and Objective: Wound infections are often difficult to treat due to various bacterial pathogens. Pseudomonas aeruginosa is one of the common invaders of open wounds. Precise diagnosis of this etiological agent in wound infections is of critical importance particularly in treatment of problematic cases. The existing diagnostic methods have certain limitations particularly related to specificity. Our objective was to to establish a comprehensive and reliable multiplex PCR to confirm diagnosis of P. aeruginosa. Methods: A multiplex PCR test was developed for rapid and comprehensive identification of P. aeruginosa. Four highly specific genes were targeted simultaneously for detection of genus, species and exotoxin production (16S rDNA, gyrB, oprL and ETA) in P. aeruginosa; additionally one internal control gene (invA) of Salmonella was used. The specificity of the multiplex PCR was confirmed using internal and negative controls. Amplified fragments were confirmed by restriction analysis and DNA sequencing. Results: The developed method was applied on 40 morphologically suspected P. aeruginosa isolates (from 200 pus samples) and 18 isolates were confirmed as P. aeruginosa. In comparison, only 12 could be identified biochemically. Conclusions: Combination of the four reported genes in multiplex PCR provided more confident and comprehensive detection of P. aeruginosa which is applicable for screening of wound infections and assisting treatment strategy. PMID:24353667

  11. Wound Infection due to Vibrio vulnificus in Spain

    Microsoft Academic Search

    L. Torres; S. Escobar; A. I. López; M. L. Marco; V. Pobo

    2002-01-01

    .   \\u000a Vibrio vulnificus is a gram-negative rod that can cause septicaemia and skin lesions, usually in patients with underlying illnesses such as\\u000a chronic liver disease or diabetes mellitus. Infections caused by this bacterium are unusual in Spain. A case of skin infection\\u000a due to Vibrio vulnificus is reported in a patient whose abraded skin on his left leg came

  12. Use of antibiotics in the management of postirradiation wound infection and sepsis

    SciTech Connect

    Brook, I.

    1988-07-01

    Ionizing gamma irradiation depresses the host defenses and enhances the susceptibility of the immunocompromised host to local and systemic infection due to endogenous or exogenous microorganisms. Trauma and wounding act synergistically and decrease the survival after exposure to irradiation. The current antimicrobial agents suitable for controlling serious infections and their use in post irradiation local and systemic infection with and without trauma are discussed. The experience gained in managing immunocompromised patients following chemotherapy is reviewed. Empiric single agent or combination agent therapy should be directed at the eradication of potential gram-negative as well as gram-positive pathogens. The most important organisms known to cause these infections are Pseudomonas sp. and Enterobacteriaceae. Management of intra-abdominal infections following trauma should include early surgical correlation and antimicrobials directed against the Bacteroides fragilis group and Enterobacteriaceae. Staphylococcus aureus and Streptococcus pyogenes cause most skin and soft tissue infections following trauma. Chemoprophylaxis of enteric sources of systemic infection can be achieved by antimicrobials that selectively inhibit the Enterobacteriaceae sp. and preserve the anaerobic flora. The management of infection in the injured and irradiated host includes supportive and restorative therapy. Supportive therapy includes debridement and cleansing of wounds, fluids, immunoglobulin, and antimicrobials. Restorative therapy includes definite surgery repair and replenishment of the immune system by use of immunomodulators, growth factors, and bone marrow transplantation. Further studies are needed to examine the usefulness of presently available drugs and experimental agents in the irradiated and traumatized host. 111 references.

  13. Role of Muscle Free Flap in the Salvage of Complicated Scalp Wounds and Infected Prosthetic Dura

    PubMed Central

    Han, Dae Hee; Park, Myong Chul; Park, Dong Ha; Song, Hyunsuk

    2013-01-01

    Background The prosthetic dura is an essential element in the protection of the cranial parenchyma and prevention of cerebrospinal fluid leakage. Although prosthetic dura are widely used in neurosurgery, they occasionally provoke infection, which can be a major concern after neurosurgical treatment. However, removal of the prosthetic dura carries a risk of brain parenchyma injury and cerebrospinal fluid leakage. The salvage of infected prosthetic dural material has not been adequately addressed in the literature. In this study, we demonstrate the value of the combination of a meticulous surgical debridement of necrotic tissue and simultaneous muscle free flap for intractable postoperative epidural abscess without removal of the infected prosthetic dura. Methods Between 2010 and 2012, we reviewed the data of 11 patients with persistent infection on the prosthetic dura. The epidural infections each occurred after a neurosurgical procedure, and there was soft tissue necrosis with the disclosure of the underlying prosthetic dura and dead bone around the scalp wound. To salvage the infected prosthetic dura, meticulous debridement and a muscle free flap were performed. Results All 11 patients experienced complete recovery from the complicated wound problem without the need for further surgical intervention. No signs of prosthetic dural infection were observed during the mean follow-up period of 11 months. Conclusions The combination of a meticulous surgical debridement and coverage with a muscle free flap is an effective treatment for salvage of infected prosthetic dura. PMID:24286047

  14. Photodynamic therapy with a cationic functionalized fullerene rescues mice from fatal wound infections

    PubMed Central

    Lu, Zongshun; Dai, Tianhong; Huang, Liyi; Kurup, Divya B; Tegos, George P; Jahnke, Ashlee; Wharton, Tim; Hamblin, Michael R

    2011-01-01

    Aims Fullerenes are under intensive study for potential biomedical applications. We have previously reported that a C60 fullerene functionalized with three dimethylpyrrolidinium groups (BF6) is a highly active broad-spectrum antimicrobial photosensitizer in vitro when combined with white-light illumination. We asked whether this high degree of in vitro activity would translate into an in vivo therapeutic effect in two potentially lethal mouse models of infected wounds. Materials & methods We used stable bioluminescent bacteria and a low light imaging system to follow the progress of the infection noninvasively in real time. An excisional wound on the mouse back was contaminated with one of two bioluminescent Gram-negative species, Proteus mirabilis (2.5 × 107 cells) and Pseudomonas aeruginosa (5 × 106 cells). A solution of BF6 was placed into the wound followed by delivery of up to 180 J/cm2 of broadband white light (400–700 nm). Results In both cases there was a light-dose-dependent reduction of bioluminescence from the wound not observed in control groups (light alone or BF6 alone). Fullerene-mediated photodynamic therapy of mice infected with P. mirabilis led to 82% survival compared with 8% survival without treatment (p < 0.001). Photodynamic therapy of mice infected with highly virulent P. aeruginosa did not lead to survival, but when photodynamic therapy was combined with a suboptimal dose of the antibiotic tobramycin (6 mg/kg for 1 day) there was a synergistic therapeutic effect with a survival of 60% compared with a survival of 20% with tobramycin alone (p < 0.01). Conclusion These data suggest that cationic fullerenes have clinical potential as an antimicrobial photosensitizer for superficial infections where red light is not needed to penetrate tissue. PMID:21143031

  15. The Healing Effect of Licorice on Pseudomonas aeruginosa Infected Burn Wounds in Experimental Rat Model

    PubMed Central

    Tanideh, Nader; Rokhsari, Pedram; Mehrabani, Davood; Mohammadi Samani, Soleiman; Sabet Sarvestani, Fatemeh; Ashraf, Mohammad Javad; Koohi Hosseinabadi, Omid; Shamsian, Shahram; Ahmadi, Nasrollah

    2014-01-01

    BACKGROUND Burn is still one of the most devastating injuries in emergency medicine while improvements in wound healing knowledge and technology have resulted into development of new dressings. This study was undertaken to evaluate the healing effect of licorice in Pseudomonas aeruginosa infected burn wounds of experimental rat model. METHODS One hundred and twenty female Sprague-Dawley rats were randomly allocated to 4 equal groups. Group A received silver sulfadiazine ointment, Group B received 10% licorice extract and Group C was considered as control group and received gel base as the base of medication. Group D did not receive any medication and just underwent burn injury. A standard 3rd degree burn wound was produced by a hot plate with similar size about 20% of total body surface area (TBSA) and at identical temperature. After 24 h of burn production, 108 colony forming units (CFU) of toxigenic strains of P. aeruginosa (PA 103) were inoculated subcutaneously into the burnt area. After 3, 7, 14, 21 and 28 days of therapy, the animals were sacrificed and burn areas were macroscopically examined and histologically evaluated. RESULTS Decrease in size of the burn wounds, in inflammation and re-epithelialization were poor in groups B-D. Infection to P. aeruginosa was still visible in groups B-D but was absent in Group A. The mean histological score, tensile strength, maximum stress, yield strength and stiffness in groups B-D were lower compared with Group A. CONCLUSION Licorice extract in 10% concentration was shown not to be effective in healing of P. aeruginosa infected burn wounds. PMID:25489532

  16. Use of chitosan bandage to prevent fatal infections developing from highly contaminated wounds in mice

    PubMed Central

    Burkatovskaya, Marina; Tegos, George P; Swietlik, Emilia; Demidova, Tatiana N; Castano, Ana P; Hamblin, Michael R.

    2010-01-01

    HemCon® bandage is an engineered chitosan acetate preparation used as a hemostatic control dressing, and its chemical structure suggests that it should also be antimicrobial. We tested its ability to rapidly kill bacteria in vitro and in mouse models of infected wounds. We used the Gram-negative species Pseudomonas aeruginosa and Proteus mirabilis and the Gram-positive Staphylococcus aureus that had all been stably transduced with the entire bacterial lux operon to allow in vivo bioluminescence imaging. An excisional wound in Balb/c mice was inoculated with 50–250 million cells followed after 30 min by application of HemCon bandage, alginate sponge bandage, silver sulfadiazine cream or no treatment. HemCon was more adhesive to the wound and conformed well to the injury compared to alginate. Animal survival was followed over 15 days with observations of bioluminescence emission and animal activity daily. Chitosan acetate treated mice infected with P. aeruginosa and P. mirabilis all survived while those receiving no treatment, alginate and silver sulfadiazine demonstrated 25–100% mortality. Chitosan acetate was much more effective than other treatments in rapidly reducing bioluminescence in the wound consistent with its rapid bactericidal activity in vitro as well as its light-scattering properties. S. aureus formed only non-lethal localized infections after temporary immunosuppression of the mice but HemCon was again more effective in reducing bioluminescence. The data suggest that chitosan acetate rapidly kills bacteria in the wound before systemic invasion can take place, and is superior to alginate bandage and silver sulfadiazine that may both encourage bacterial growth in the short term. PMID:16616364

  17. Expression of the soxR Gene of Pseudomonas aeruginosa Is Inducible during Infection of Burn Wounds in Mice and Is Required To Cause Efficient Bacteremia

    Microsoft Academic Search

    UNHWAN HA; SHOUGUANG JIN

    1999-01-01

    Burn wounds are prone to infection by Pseudomonas aeruginosa, which is an opportunistic pathogen causing various human diseases. During infection, the bacterium senses environmental changes and regulates the expression of genes appropriate for survival. A purine-auxotrophic mutant of P. aeruginosa was unable to replicate efficiently on burn wounds, suggesting that burn wounds are purine-deficient environments. An in vivo expression technology

  18. The Physiology of Suberization: Roles in Resistance to Infection During Wound-Healing and in the Pink Eye Syndrome

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The suberized cells of potato native periderm and wound periderm provide broad and durable protection against infection, dehydration and other problems affecting tuber market quality. Suberization and maintenance of the resulting suberin barrier involve complex processes of great economic importanc...

  19. Persistent Wound Infection after Herniotomy Associated with Small-Colony Variants of Staphylococcus aureus

    Microsoft Academic Search

    M. Abele-Horn; B. Schupfner; P. Emmerling; H. Waldner; H. Göring

    2000-01-01

    Summary  \\u000a A small-colony variant (SCV) of Staphylococcus aureus was cultured from a patient with a persistent wound infection (abscess and fistula) 13 months after herniotomy. The strain\\u000a was nonhemolytic, nonpigmented and grew only anaerobically on Schaedler agar. As it was coagulase-negative, it was initially\\u000a misidentified as a coagulase-negative Staphylococcus. In further analysis, however, the microorganism was shown to be an

  20. Tc-99m(V)-DMSA in wound infection after closure of an ileostomy.

    PubMed

    Chang, Ming-Zhe; Tsai, Chien-Chung; Hung, Guang-Uei; Lin, Wan-Yu

    2005-12-01

    We present a 71-year-old man who underwent closure of an ileostomy and had a fever seven days post surgery. Both Tc-99m(V)-dimercaptosuccinic acid (DMSA) and gallium-67 citrate scans showed increased tracer accumulation in the right lower quadrant of the abdomen. Tc-99m(V)-DMSA scintigraphy can be a rapid alternative tool in the detection of wound infection in patients after ileostomy closure. PMID:16445002

  1. Isolation of Leclercia adecarboxylata from a wound infection after exposure to hurricane-related floodwater.

    PubMed

    Tam, Vernissia; Nayak, Seema

    2012-01-01

    A man in his early 80s presented to our emergency department with painless redness and swelling in his right leg. One week prior, he cleaned up floodwater in his basement after Hurricane Irene passed the Mid-Atlantic region of the USA in August 2011. Physical examination included large purple bullae and raised concern for necrotising fasciitis. Wound culture revealed a polymicrobial infection including Leclercia adecarboxylata. PMID:23109419

  2. Therapy of Acute and Delayed Spinal Infections after Spinal Surgery Treated with Negative Pressure Wound Therapy in Adult Patients

    PubMed Central

    Zwolak, Pawel; König, Matthias Alexander; Osterhoff, Georg; Wilzeck, Verena; Simmen, Hans-Peter; Jukema, Gerrolt Nico

    2013-01-01

    We present the results of the treatment of infected primary or delayed spine wounds after spinal surgery using negative pressure wound therapy. In our institution (University Hospital Zurich, Switzerland) nine patients (three women and six men; mean age 68.6, range 43-87 years) were treated in the period between January to December 2011 for non-healing spinal wounds. The treatment consisted of repeated debridements, irrigation and temporary closure with negative pressure wound therapy system. Three patients were admitted with a spinal epidural abscess; two with osteoporotic lumbar fracture; two with pathologic vertebra fracture and spinal cord compression, and two with vertebra fracture after trauma. All nine patients have been treated with antibiotic therapy. In one case the hardware has been removed, in three patients laminectomy was performed without instrumentation, in five patients there was no need to remove the hardware. The average hospital stay was 16.6 days (range 11-30). The average follow-up was 3.8, range 0.5-14 months. The average number of negative pressure wound therapy procedures was three, with the range 1-11. Our retrospective study focuses on the clinical problems faced by the spinal surgeon, clinical outcomes after spinal surgery followed by wound infection, and negative pressure wound therapy. Moreover, we would like to emphasize the importance for the patients and their relatives to be fully informed about the increased complications of surgery and about the limitations of treatment of these wounds with negative pressure wound therapy. PMID:24416474

  3. Honey as an Antimicrobial Agent Against Pseudomonas Aeruginosa Isolated from Infected Wounds

    PubMed Central

    Shenoy, Vishnu Prasad; Ballal, Mamatha; Shivananda, PG; Bairy, Indira

    2012-01-01

    Background: As natural products garner attention in the medical field due to emergence of antibiotic resistant strains of bacteria, honey is valued for its antibacterial activity. Objective: Fifty strains of Pseudomonas aeruginosa isolated from infected wounds were evaluated for their antibacterial action using honey in comparison with different antibiotics and Dettol. Methodology and Results: All the strains were found to be sensitive to honey at a minimum inhibitory concentration of 20% in comparison with Dettol at 10% using agar dilution method. In the second step, the time kill assay was performed on five isolates of P. aeruginosa to demonstrate the bactericidal activity of honey at different dilutions of honey ranging from 20% to 100% at regular time intervals. All the isolates of P. aeruginosa tested were killed in 12-24 h depending on the dilutions of the honey tested. Thus, honey could prevent the growth of P. aeruginosa even if it was diluted by deionized water by fivefolds in vitro. Honey had almost uniform bactericidal activity against P. aeruginosa irrespective of their susceptibility to different classes of antibiotics. Conclusion: Honey which is a natural, non-toxic, and an inexpensive product has activity against the P. aeruginosa isolated from infected wounds may make it an alternative topical choice in the treatment of wound infections. PMID:22754244

  4. Wound conditioning by vacuum assisted closure (V.A.C.) in postoperative infections after dorsal spine surgery

    PubMed Central

    Keel, Marius; Trentz, Otmar; Heinzelmann, Michael

    2006-01-01

    The use of vacuum assisted closure (V.A.C.) therapy in postoperative infections after dorsal spinal surgery was studied retrospectively. Successful treatment was defined as a stable healed wound that showed no signs of acute or chronic infection. The treatment of the infected back wounds consisted of repeated debridement, irrigation and open wound treatment with temporary closure by V.A.C. The instrumentation was exchanged or removed if necessary. Fifteen patients with deep subfascial infections after posterior spinal surgery were treated. The implants were exchanged in seven cases, removed completely in five cases and left without changing in one case. In two cases spinal surgery consisted of laminectomy without instrumentation. In two cases only the wound defects were closed by muscle flap, the remaining ones were closed by delayed suturing. Antibiotic treatment was necessary in all cases. Follow up was possible in 14 patients. One patient showed a new infection after treatment. The study illustrates the usefulness of V.A.C. therapy as a new alternative management for wound conditioning of complex back wounds after deep subfascial infection. PMID:16835734

  5. Staphylococcus aureus and repeat bacteremia in febrile patients as early signs of sternal wound infection after cardiac surgery

    PubMed Central

    2014-01-01

    Background Sternal wound infection is a devastating complication of cardiothoracic surgery that carries high postoperative morbidity and mortality rates. We explored whether our current program of extensive bacteriological examination including repeat blood cultures may contribute to the early diagnosis of sternal wound infection. Methods We retrospectively analyzed 112 patients who were subjected to our bacteriological examination protocol including within 90 days after cardiothoracic surgery. Univariate and multivariate analyses were made in order to identify risk factors for sternal infection. Results The median patient age was 75 years, and 65 patients were male. In 35 cases (31.2%) the blood cultures showed the presence of bacterial infection with the following frequencies: Staphylococcus aureus, 18 cases; Coagulase-negative Staphylococcus, 7 cases; other organisms, 10 cases. Eleven patients presented repeat bacteremia on at least 2 different occasions. Twenty patients (17.8%) presented sternal wound infections. There was no difference in operative mortality between the patients with and without sternal wound infection. Univariate and multivariate analyses demonstrated that bilateral mammary artery use (OR, 13.68, 95% CI, 1.09-167.36, p?=?0.043), positive blood culture for Staphylococcus aureus (OR, 19.51, 95% CI, 4.46-104.33, p?wound infection. Conclusion Repeat blood cultures in febrile patients appear to be useful for the early detection of Staphylococcus aureus and repeat bacteremia, and these were associated with sternal wound infection. Bilateral internal mammary artery use was another risk factor of sternal wound infection in febrile patients. These factors may identify patients suitable for expeditious radiological examination and aggressive treatments. PMID:24885820

  6. Does single application of topical chloramphenicol to high risk sutured wounds reduce incidence of wound infection after minor surgery? Prospective randomised placebo controlled double blind trial

    PubMed Central

    2009-01-01

    Objective To determine the effectiveness of a single application of topical chloramphenicol ointment in preventing wound infection after minor dermatological surgery. Design Prospective randomised placebo controlled double blind multicentre trial. Setting Primary care in a regional centre in Queensland, Australia. Participants 972 minor surgery patients. Interventions A single topical dose of chloramphenicol (n=488) or paraffin ointment (n=484; placebo). Main outcome measure Incidence of infection. Results The incidence of infection in the chloramphenicol group (6.6%; 95% confidence interval 4.9 to 8.8) was significantly lower than that in the control group (11.0%; 7.9 to 15.1) (P=0.010). The absolute reduction in infection rate was 4.4%, the relative reduction was 40%, and the relative risk of wound infection in the control group was 1.7 (95% confidence interval 1.1 to 2.5) times higher than in the intervention group. The number needed to treat was 22.8. Conclusion Application of a single dose of topical chloramphenicol to high risk sutured wounds after minor surgery produces a moderate absolute reduction in infection rate that is statistically but not clinically significant. Trial registration Current Controlled Trials ISRCTN73223053. PMID:19147639

  7. Secondary omental and pectoralis major double flap reconstruction following aggressive sternectomy for deep sternal wound infections after cardiac surgery

    PubMed Central

    2011-01-01

    Background Deep sternal wound infection after cardiac surgery carries high morbidity and mortality. Our strategy for deep sternal wound infection is aggressive strenal debridement followed by vacuum-assisted closure (VAC) therapy and omental-muscle flap reconstrucion. We describe this strategy and examine the outcome and long-term quality of life (QOL) it achieves. Methods We retrospectively examined 16 patients treated for deep sternal wound infection between 2001 and 2007. The most recent nine patients were treated with total sternal resection followed by VAC therapy and secondary closure with omental-muscle flap reconstruction (recent group); whereas the former seven patients were treated with sternal preservation if possible, without VAC therapy, and four of these patients underwent primary closure (former group). We assessed long-term quality of life after DSWI by using the Short Form 36-Item Health Survey, Version 2 (SF36v2). Results One patient died and four required further surgery for recurrence of deep sternal wound infection in the former group. The duration of treatment for deep sternal wound infection in the recent group was significantly shorter than that in previous group (63.4 ± 54.1 days vs. 120.0 ± 31.8 days, respectively; p = 0.039). Despite aggressive sternal resection, the QOL of patients treated for DSWI was only minimally compromised compared with age-, sex-, surgical procedures-matched patients without deep sternal wound infection. Conclusions Aggressive sternal debridement followed by VAC therapy and secondary closure with an omental-muscle flap is effective for deep sternal wound infection. In this series, it resulted in a lower incidence of recurrent infection, shorter hospitalization, and it did not compromise long-term QOL greatly. PMID:21501461

  8. Multidrug-resistant bacterial isolates in infected wounds at Jimma University Specialized Hospital, Ethiopia

    PubMed Central

    2013-01-01

    Background The term ’Multidrug-resistant’ (MDR) applies to a bacterium that is simultaneously resistant to a number of antimicrobials belonging to different chemical classes. The effectiveness of currently available antmicrobial drugs is decreasing due to the increasing number of resistant strains causing infections so that available therapeutic options for such organisms are severely limited. Objective The aim of this study was to determine multidrug-resistance rate of bacterial isolates that caused wound infections. Methods A Hospital based cross-sectional study was conducted on 322 wound samples taken from consecutive patients seen at inpatient and outpatient department of Jimma University Specialized Hospital from June to December 2011. Swabs from surgical incisions, burns, abscess and traumatic wounds were collected aseptically using Levine’s technique. Bacteriological culture and examination was done following standard microbiological techniques. Multidrug-resistance test was performed by disk diffusion method against 10 classes of antimicrobials. The data was analyzed for descriptive statistics using SPSS version 16 and Microsoft Excel. Results The overall MDR among gram positive and gram negative bacterial isolates were (77%) and (59.3%) respectively. About, 86.2%?S.aureus and 28.6% of Coagulase negative Staphylococci became MDR. Nearly 30.1% of S.aureus was resistant to six classes of antimicrobials. The average MDR rate of Proteus, Klebsiella, and Providencia species was 74.8%, 69.6% and 75% in that order. Nearly, 30.8% of Proteus sp, 32.6% of Klebsiella sp and 61% of Citrobacter sp were resistance to 4 classes each. Surprisingly, the average MDR rate for Citrobacter sp was 100%. About (76.7%) of S.aureus was Oxacillin/Methicillin resistant while (16.4%) were Vancomycin resistant. Proteus species was the predominant isolates (27.9%) followed by P.aeruginosa and S.aureus (19.3%) and (19%) respectively. Conclusion This study indicated that, the overall rate of MDR bacterial pathogens that caused wound infection was very high and many of the isolates were also identified as resistant to three or more classes of antimicrobials. Such widespread resistance to antimicrobial classes is something serious because a few treatment options remain for patients with wound infections. Periodic monitoring of etiology and antimicrobial susceptibility in areas where there is no culture facility is essential to assists physician in selection of chemotherapy. PMID:23879886

  9. Vacuum-assisted closure of necrotic and infected cranial wound with loss of dura mater: A technical note

    PubMed Central

    Ahmed, Osama; Storey, Christopher M.; Zhang, Shihao; Chelly, Marjorie R.; Yeoh, Melvin S.; Nanda, Anil

    2015-01-01

    Background: Complex cranial wounds can be a problematic occurrence for surgeons. Vacuum-assisted closure devices have a wide variety of applications and have recently been used in neurosurgical cases involving complex cranial wounds. There is only one report regarding the use of a vacuum-assisted closure device with loss of dura mater. We report a complicated case of a necrotic cranial wound with loss of dura mater. Case Description: A 68-year-old female underwent an evacuation of a subdural hematoma. Postoperatively, the patient developed a wound infection that required removal of the bone flap. The wound developed a wedge-shaped necrosis of the scalp with exposure of brain tissue due to loss of dura mater from previous surgeries. She underwent debridement and excision of the necrotic tissue with placement of a synthetic dural graft (Durepair®, Medtronic, Inc.) and placement of a wound vac. The patient underwent a latissismus dorsi muscle flap reconstruction that subsequently failed. After the wound vac was replaced, the synthetic dural graft was replaced with a fascia lata graft and an anterolateral thigh free flap reconstruction. We describe the technical nuances of this complicated case, how the obstacles were handled, and the literature that discusses the utility. Conclusion: We describe a case of a complex cranial wound and technical nuances on how to utilize a wound-vac with loss of dura mater. PMID:25657864

  10. Some Virulence Factors of Staphylococci Isolated From Wound and Skin Infections in Shahrekord, IR Iran

    PubMed Central

    Ebrahimi, Azizollah; Ghasemi, Maryam; Ghasemi, Bahram

    2014-01-01

    Background: Staphylococci release a large number of enzymes. Some of these, such as coagulase, beta- lactamase, hemolysins and biofilms are considered indices of pathogenicity. Objectives: The aim of the current study was based on the isolation and identification of Staphylococcus aureus and coagulase negative Staphylococci (CNS) strains from various skin lesions and examining their biofilms, beta- lactamase, hemolysins production and antibiotic resistance pattern. Materials and Methods: Sixty one infected wounds and 39 skin infections samples were collected and examined. After the culture and identification, examination for production of hemolysins, beta- lactamase, biofilm and susceptibility toward 9 antimicrobials was performed. Results: Out of 75 isolated Staphylococci, sixty (80%) were biofilm producers. Two overall prevalence of 28.5% and 100% of ß-lactamase production were recorded for isolated S. aureus and CNS, respectively. Twenty out of 49 (40.8%), the same number of ?- and ?- hemolytic S. aureus, were isolated while six (12.24%) were ? -hemolysin producers. Twenty two of Twenty six (84.6%) isolates of CNS, were hemolysin producers that all were ? type. The S. aureus isolates from wound infections, show a high sensitivity pattern to all examined antibiotics, this sensitivity pattern for isolates from skin dermatitis is relatively low, though. Conclusions: High percentage of hemolysins, biofilm and beta lactamase production by isolated Staphylococci, suggests an important role of these virulence factors in the pathogenesis of isolated Staphylococci from dermatitis lesions. The S. aureus isolates from wound infections, show a high sensitivity pattern to all examined antibiotics. Only ciprofloxacin was found to be active against all isolates from dedermatitis lesions. PMID:25147697

  11. Eradication of a chronic wound and driveline infection after redo-LVAD implantation.

    PubMed

    Walter, Veronika; Stock, Ulrich A; Soriano-Romero, Mauricio; Schnitzbauer, Andreas; Moritz, Anton; Beiras-Fernandez, Andres

    2014-01-01

    A 48 year old patient with dilated cardiomyopathy and chronic acne inversa underwent implantation of a LVAD system (Heartmate II, Thoratec, USA) March 2011. During 2011 and 2012 the patient was repeatedly readmitted for treatment of driveline infection with MRSA. Colonization was controlled with Linezolid and Rifampicin however reoccurred after discontinuation. In August 2012 the LVAD-system was exchanged due to pump dysfunction (HVAD, HeartWare Inc., USA). Postoperatively, the patient presented with ascites which secreted through the driveline exit. Consequently, the abdominal wall was surgically corrected to prevent exit of peritoneal fluid through the driveline, and the patient was discharged with sterile wound swabs. However 6 weeks after discharge the driveline exit wound started secreting pus showing abundant growth of multi resistant staphylococcus aureus (MRSA). With clinical signs of increasing liver failure with regular need for paracentesis, and clinical signs of local infection, a CT scan of the abdomen was performed revealing an enrichment of contrast medium along the driveline and an abscess-like formation on the abdominal wall. Patient was admitted receiving regular dose Daptomycin and Rifampicin. The latter was discontinued after ten days. The abscess, surrounding driveline exit and abdominal wall cavity was excised and vacuum treatment initiated. Total duration of Daptomycin therapy was 3 weeks. While first week skin and wound swabs were still positive for MRSA, all samples were sterile after the second week. Inflammation was monitored by leucocyte count and IL6. The secretion of pus along the driveline ceased, the wound cavity was closed subsequently. After discharge and stop of antibiotics skin and driveline swabs remained negative for MRSA (10 weeks). PMID:24685284

  12. Treatment of hardware infection after osteosynthesis of lower leg using negative pressure wound therapy and transforming powder dressing.

    PubMed

    Marinovi?, Marin; Ivandci?, Aldo; Spanjol, Josip; Pina, Maja; Bakota, Bore; Bandalovi?, Ante; Cukeljs, Fabijan

    2014-12-01

    Fractures of the distal part of the lower leg are more common in everyday practice and traumatology. In young and active patients these injuries are mainly caused by high energy trauma. They are treated with external fixator in first step, and in second step, after sanation of the soft tissue, with open reduction and internal fixation (ORIF). It is very safe and effective method of treatment. Treatment of the infections that occur in the early postoperative period after open reduction and internal fixation represents a great problem and challenge for surgeons. It is widely accepted that the presence of deep infection can't be cured in the presence of hardware. However, removal of hardware in the presence of unhealed fractures significantly complicates sanation of infection and fracture itself We have decided to present a 35-years-old patient with a hardware infection with present chronic wound with hardware exposed eight months after the first operation and six months after second operation. The wound measured one centimeter in diameter with cell detritus and bad granulations tissue inside the wound. Hardwre was exposed in the depth of the wound.The secretion was minimal. Negative Pressure Wound Therapy (NPWT) was applicated after debridemet and lavage performed in ambulatory conditions. The starting therapy was continuously -125 mm Hg of vacuum. After five days of NPWT the defect was partially filled with granula- tion tissue. For another five days we continue with NPWT with the same values of-125 mm Hg pressure but in the inter- mitent mode. After that period we used transforming powder dressing for covering and protection of the wound with was filled with granulation tissue. Five days later, wound was completely healed with epithelisation. After four months of patient follow-up, we found the wound is completely repaired. The patient denies pain and has continued orderly flow of fracture healing, with no signs of infection. PMID:25842766

  13. Daptomycin and Its Immunomodulatory Effect: Consequences for Antibiotic Treatment of Methicillin-Resistant Staphylococcus aureus Wound Infections after Heart Surgery

    PubMed Central

    Tirilomis, Theodor

    2014-01-01

    Infections by methicillin-resistant Staphylococcus aureus (MRSA) play an increasing role in the postoperative course. Although wound infections after cardiac surgery are rare, the outcome is limited by the prolonged treatment with high mortality. Not only surgical debridement is crucial, but also antibiotic support. Next to vancomycin and linezolid, daptomycin gains increasing importance. Although clinical evidence is limited, daptomycin has immunomodulatory properties, resulting in the suppression of cytokine expression after host immune response stimulation by MRSA. Experimental studies showed an improved efficacy of daptomycin in combination with administration of vitamin E before infecting wounds by MRSA. PMID:24653723

  14. Sternal wound infections in patients after coronary artery bypass grafting using bilateral skeletonized internal mammary arteries.

    PubMed Central

    Sofer, D; Gurevitch, J; Shapira, I; Paz, Y; Matsa, M; Kramer, A; Mohr, R

    1999-01-01

    OBJECTIVES: This study evaluated the risks of sternal wound infections in patients undergoing myocardial revascularization using bilateral skeletonized internal mammary arteries (IMAs). BACKGROUND: The skeletonized IMA is longer than the pedicled one, thus providing the cardiac surgeon with increased versatility for arterial myocardial revascularization without the use of vein grafts. It is isolated from the chest wall gently with scissors and silver clips, and no cauterization is employed. Preservation of collateral blood supply to the sternum and avoidance of thermal injury enable more rapid healing and decrease the risk of sternal wound infection. METHODS: From April 1996 to August 1997, 545 patients underwent arterial myocardial revascularization using bilateral skeletonized IMAs. The right gastroepiploic artery was used in 100 patients (18%). The average age of the patients was 65 years; 431 (79%) were men and 114 (21%) were women; 179 (33%) were older than 70 years of age; 166 (30%) were diabetics. The average number of grafts was 3.2 per patient. RESULTS: The 30-day operative mortality rate was 2% (n = 11). There were six perioperative infarcts (1.1%) and six strokes (1.1%); 9 patients had sternal infection (1.7%) and 15 (2.8%) had superficial infection. Risk factors for sternal infection were chronic obstructive pulmonary disease and emergency operation. Superficial sternal wound infections were more common in women and in patients with chronic obstructive pulmonary disease, renal failure, or peripheral vascular disease. The 1-year actuarial survival rate was 97%. Two of the six late deaths were not cardiac-related. Late dehiscence occurred in three patients (0.6%). The death rate (early and late) of patients with any sternal complication was higher than that of patients without those complications (33% vs. 2.7%). CONCLUSIONS: Routine arterial myocardial revascularization using bilateral skeletonized IMAs is safe, and postoperative morbidity and mortality rates are low, even in elderly patients and those with diabetes. Chronic obstructive pulmonary disease and emergency operations were found to be associated with an increased risk of sternal infections, and the authors recommend avoiding the use of bilateral skeletonized IMAs in patients with these preoperative risk factors. PMID:10203094

  15. RNAIII-Inhibiting Peptide Enhances Healing of Wounds Infected with Methicillin-Resistant Staphylococcus aureus?

    PubMed Central

    Simonetti, Oriana; Cirioni, Oscar; Ghiselli, Roberto; Goteri, Gaia; Scalise, Alessandro; Orlando, Fiorenza; Silvestri, Carmela; Riva, Alessandra; Saba, Vittorio; Madanahally, Kiran D.; Offidani, Annamaria; Balaban, Naomi; Scalise, Giorgio; Giacometti, Andrea

    2008-01-01

    Quorum sensing is a mechanism through which a bacterial population receives input from neighboring cells and elicits an appropriate response to enable survival within the host. Inhibiting quorum sensing by RNAIII-inhibiting peptide (RIP) has been demonstrated as a very effective mode of prevention and therapy for device-associated staphylococcal infections and was tested here for healing of wounds that are otherwise resistant to conventional antibiotics. Wounds, established through the panniculus carnosus of BALB/c mice, were inoculated with 5 × 107 CFU of methicillin-resistant Staphylococcus aureus. Mice were treated with Allevyn, RIP-soaked Allevyn (containing 20 ?g RIP), daily intraperitoneal teicoplanin (7 mg/kg of body weight), Allevyn and teicoplanin, and RIP-soaked Allevyn and daily intraperitoneal teicoplanin. The main outcome measures were quantitative bacterial culture and histological examination with assessment of microvessel density and of vascular endothelial growth factor (VEGF) expression in tissue sections. Treatment with RIP-soaked Allevyn together with teicoplanin injection greatly reduced the bacterial load to 13 CFU/g (control untreated animals had 108 CFU/g bacteria). All other treatments were also significantly effective but only reduced the bacterial load to about 103 CFU/ml. Histological examination indicated that only treatment with RIP-soaked Allevyn with teicoplanin injection restored epithelial, granulation, and collagen scores, as well as microvessel density and VEGF expression, to the levels found with uninfected mice. In conclusion, we observed that RIP may be useful for the management of infected wounds and that it could represent an exciting and future alternative to the conventional antibiotics, at present considered the gold-standard treatments for methicillin-resistant S. aureus infections. PMID:18391046

  16. Prevention of abdominal wound infection (PROUD trial, DRKS00000390): study protocol for a randomized controlled trial

    PubMed Central

    2011-01-01

    Background Wound infection affects a considerable portion of patients after abdominal operations, increasing health care costs and postoperative morbidity and affecting quality of life. Antibacterial coating has been suggested as an effective measure to decrease postoperative wound infections after laparotomies. The INLINE metaanalysis has recently shown the superiority of a slowly absorbable continuous suture for abdominal closure; with PDS plus® such a suture has now been made available with triclosan antibacterial coating. Methods/Design The PROUD trial is designed as a randomised, controlled, observer, surgeon and patient blinded multicenter superiority trial with two parallel groups and a primary endpoint of wound infection during 30 days after surgery. The intervention group will receive triclosan coated polydioxanone sutures, whereas the control group will receive the standard polydioxanone sutures; abdominal closure will otherwise be standardized in both groups. Statistical analysis is based on intention-to-treat population via binary logistic regression analysis, the total sample size of n = 750 is sufficient to ensure alpha = 5% and power = 80%, an interim analysis will be carried out after data of 375 patients are available. Discussion The PROUD trial will yield robust data to determine the effectiveness of antibacterial coating in one of the standard sutures for abdominal closure and potentially lead to amendment of current guidelines. The exploration of clinically objective parameters as well as quality of life holds immediate relevance for clinical management and the pragmatic trial design ensures high external validity. Trial Registration The trial protocol has been registered with the German Clinical Trials Register (DRKS00000390). PMID:22103965

  17. [Effector molecules of the innate immune system for treatment of wound infections].

    PubMed

    Steinsträsser, L; Langer, S; Lehnhardt, M; Steinau, H U

    2007-04-01

    Skin is a substantial immune organ and represents the most important barrier against the potentially hostile environment. Its first line of defense are effector molecules of the innate immune system, which in contrast to the adaptive immune system reacts immediately against penetrating pathogenic microbes. Antimicrobial peptides represent the basis of the phylogenetically oldest part of the immune system. New studies show that reduced local cutaneous expression of antimicrobial peptide in burned skin is involved in the higher incidence of wound infections. The epithelium has an essential function in recognizing colonies of micro-organisms and in initial antimicrobial defenses. PMID:17377758

  18. Toluidine blue-mediated photodynamic therapy of oral wound infections in rats

    Microsoft Academic Search

    J. Lin; L. J. Bi; Z. G. Zhang; Y. M. Fu; T. T. Dong

    2010-01-01

    The purpose of this study was to examine the effect of toluidine blue (TB)-mediated photodynamic therapy (PDT) on oral wound\\u000a infections in rats. The study called for a combination treatment of a 1mg\\/ml solution of TB with a red light at three intensity\\u000a settings of 12 J\\/cm2, 24 J\\/cm2 and 48 J\\/cm2. In the group that was given the highest light dose of

  19. Antimicrobial activity of the recombinant designer host defence peptide P-novispirin G10 in infected full-thickness wounds of porcine skin

    Microsoft Academic Search

    F. Jacobsen; A. Mohammadi-Tabrisi; T. Hirsch; D. Mittler; P. H. Mygind; C. P. Sonksen; D. Raventos; H. H. Kristensen; S. Gatermann; M. Lehnhardt; A. Daigeler; H. U. Steinau; L. Steinstraesser

    2007-01-01

    Objectives: The growing number of patients with impaired wound healing and the development of multidrug-resistant bacteria demand the investigation of alternatives in wound care. The antimicrobial activity of naturally occurring host defence peptides and their derivatives could be one alternative to the existing therapy options for topical treatment of wound infection. Therefore, the aim of this study was to investigate

  20. Vacuum-assisted therapy accelerates wound healing in necrotizing soft tissue infections: our experience in two intravenous drug abuse patients.

    PubMed

    Marinis, Athanasios; Voultsos, Mavroudis; Grivas, Paraskevas; Dikeakos, Panagiotis; Liarmakopoulos, Emmanouil; Paschalidis, Nikolaos; Rizos, Spyros

    2013-12-01

    Negative pressure wound therapy using vacuum-assisted closure (VAC) devices is currently a well established technique for managing complicated wounds. Such wounds occur after aggressive surgical debridement for necrotizing soft tissue infections (NSTI). In this report we present our experience in two intravenous drug abusers managed with VAC for NSTIs. The patients were 25 and 34 years old, HCV positive and presented with oedema of the upper femoral compartments and concomitant severe sepsis. Ultrasonography and computed tomography revealed severe cellulitis, fluid collection and necrosis of the affected fasciae and muscles. After emergent and subsequent aggressive surgical debridement during the first 48h, the VAC device was applied. Both patients had an uncomplicated postoperative course and a fast recovery from their multiorgan dysfunction. Suture closure of the wounds was achieved at the 25th and 38th postoperative days respectively and patients were discharged without any motor deficit. Negative pressure wound therapy is a modern therapeutic modality for treating complicated infected wounds. Moreover, it accelerates wound healing and primary closure, facilitating patient ambulation and recovery. A dedicated medical and nursing team is an important prerequisite for a successful outcome. PMID:24335462

  1. Pyoderma gangrenosum after cardiac surgery masquerading as a fulminant sternal wound infection

    PubMed Central

    Suzuki, Kei; Sieczka, Elizabeth; Tranbaugh, Robert; Hoffman, Darryl

    2014-01-01

    INTRODUCTION Pyoderma gangrenosum (PG) is a rare, ulcerative inflammatory skin pathology frequently associated with systemic inflammatory disease. While rare after surgery, recognition of this disease in the post-surgical setting is important as it can mimic wound infection. There have been ten case reports to date of PG occurring immediately after cardiac surgery, with all of them presenting within the first week post-operatively. PRESENTATION OF CASE We herein present a delayed and dramatic presentation of PG nine days after mitral valve replacement and repair of patent foramen ovale, two days after being discharged with a seemingly normal healing wound. Diagnosis of this disease in the postoperative period requires high suspicion when the characteristic ulcerative lesions are seen diffusely in all surgical wounds and show minimal improvement with antibiotic treatment or debridement. DISCUSSION/CONCLUSION Our case highlights the importance of recognizing this disease in the postoperative period, even in a delayed presentation and initially limited to one of the surgical sites. This case calls for an awareness of this disease entity amongst cardiac surgeons as well as intensivists. PMID:25544482

  2. The effect of a honey based gel and silver sulphadiazine on bacterial infections of in vitro burn wounds.

    PubMed

    Boekema, B K H L; Pool, L; Ulrich, M M W

    2013-06-01

    Bacterial contamination remains a constant threat in burn wound care. Topical treatments to combat contaminations have good bactericidal effects but can have detrimental effects for the healing process. Treatments with for example silver can increase healing times. Honey based products can be a good alternative as it is antibacterial and patient-friendly. We evaluated the bactericidal and cytotoxic effects of a honey based gel and silver sulphadiazine in a human burn wound model with Pseudomonas aeruginosa. After adding 10(5)colony forming units of P. aeruginosa, topical treatments were applied on the burn wound models. After 2, 12, 24, 28 and 70 h, bacteria were dislodged and counted by plating dilutions. Cytotoxic effects were evaluated histologically in samples of burn wound models treated topically for 3 weeks, without bacteria. L-Mesitran Soft significantly reduced the bacterial load (5-log reduction) up to 24h but did not completely eliminate bacteria from the burn wounds. After Flammazine(®) treatment, only a few colony forming units were observed at all time points. In contrast, re-epithelialization was significantly reduced after application of Flammazine(®) compared to L-Mesitran Soft or control. This in vitro model of burn wound infection can be used to evaluate topical treatments. L-Mesitran Soft is a good alternative for treating burn wounds but the slightly lower bactericidal activity in the burn wound model warrants a higher frequency of application. PMID:23036845

  3. A Study of Post-Caesarean Section Wound Infections in a Regional Referral Hospital, Oman

    PubMed Central

    Dhar, Hansa; Al-Busaidi, Ibrahim; Rathi, Bhawna; Nimre, Eman A.; Sachdeva, Vibha; Hamdi, Ilham

    2014-01-01

    Objectives: The aim of this study was to determine the incidence of surgical site infections (SSI) in patients undergoing a Caesarean section (CS) and to identify risk factors, common bacterial pathogens and antibiotic sensitivity. SSI significantly affect the patient’s quality of life by increasing morbidity and extending hospital stays. Methods: A retrospective cross-sectional study was conducted in Nizwa Hospital, Oman, to determine the incidence of post-Caesarean (PCS) SSI from 2001 to 2012. This was followed by a case-control study of 211 PCS cases with SSI. Controls (220) were randomly selected cases, at the same hospital in the same time period, who had undergone CS without any SSI. Data was collected on CS type, risk factors, demographic profile, type of organism, drug sensitivity and date of infection. Results: The total number of PCS wound infections was 211 (2.66%). There was a four-fold higher incidence of premature rupture of the membranes (37, 17.53%) and a three-fold higher incidence of diabetes (32, 15.16%) in the PCS cases compared with controls. The most common organisms responsible for SSI were Staphylococcus aureus (66, 31.27%) and the Gram-negative Escherichia coli group (40, 18.95%). The most sensitive antibiotics were aminoglycoside and cephalosporin. Polymicrobial infections were noted in 42 (19.90%), while 47 (22.27%) yielded no growth. A high incidence of associated risk factors like obesity, hypertension, anaemia and wound haematoma was noted. Conclusion: Measures are recommended to reduce the incidence of SSI, including the implementation of infection prevention practices and the administration of antibiotic prophylaxis with rigorous surgical techniques. PMID:24790744

  4. Effect of near-infrared diode laser and indocyanine green to treat infections on different wound models

    NASA Astrophysics Data System (ADS)

    Topaloglu, Nermin; Yuksel, Sahru; Gulsoy, Murat

    2014-05-01

    The emergence of antibiotic resistant bacteria causes significant increase in deaths due to wound infections around the world. Nowadays, it could be impossible to find appropriate antibiotics to treat some bacterial strains, especially multidrug resistant types. The aim of this study is to use photodynamic therapy that destroys these kinds of bacteria with the interaction of Indocyanine green (ICG) and 808-nm diode laser. In this study, antibacterial Photodynamic Therapy technique that we call ICG-IR Laser PDT was applied on antibiotic-resistant strains of Staphylococcus aureus that infected two different types of wound model (excisional and abrasion wound model) in vivo. Wistar albino rats were used to create animal wound models. Excisional or abrasion wounds were formed on the dorsal skin of the rats. They were infected with Staphylococcus aureus. 300 mW and 500 mW of 808-nm diode laser were applied on the wounds for 30 minutes and 15 minutes of exposure duration, respectively. ICG concentrations applied topically were 500, 1000, 1500 and 2000 ?g/ml. Then the tissue was dissected properly and homogenized in buffer solution. From this solution, bacterial cell count was determined by serial dilution method. 1-2 log reduction in viable cell count was observed after these applications. The temperature increase in the tissue was between 6-8°C during these applications. From these findings, it was understood that this method with 808-nm and ICG is promising but it must be improved by further dosimetry studies.

  5. Bacteria isolated from conspecific bite wounds in Norway and black rats: implications for rat bite-associated infections in people.

    PubMed

    Himsworth, Chelsea G; Zabek, Erin; Tang, Patrick; Parsons, Kirbee L; Koehn, Martha; Jardine, Claire M; Patrick, David M

    2014-02-01

    Bites associated with wild and domestic Norway and black rats (Rattus norvegicus and Rattus rattus) may have a variety of health consequences in people. Bite-related infections are among the most significant of these consequences; however, there is little data on the infectious agents that can be transmitted from rats to people through biting. This is problematic because without an accurate understanding of bite-related infection risks, it is difficult for health professionals to evaluate the adequacy of existing guidelines for empirical therapy. The objectives of this study were to increase our knowledge of the bacterial species associated with rat bites by studying bite wounds that wild rats inflict upon one another and to review the literature regarding rat bites and bite wound management. Wild Norway and black rats (n=725) were trapped in Vancouver, Canada, and examined for bite wounds in the skin. All apparently infected wounds underwent aerobic and anaerobic culture, and isolated bacteria were identified. Thirty-six rats had bite wound-related infections, and approximately 22 different species of bacteria belonging to 18 genera were identified. Staphylococcus aureus was the most common isolate; however, the majority of infections (72.5%) were polymicrobial. Rat bites can result in infection with a number of aerobic and anaerobic Gram-positive and Gram-negative bacteria. In humans, these wounds are best managed through early recognition and cleansing. The benefit of prophylactic antimicrobial treatment is debatable, but given the deep puncturing nature of rodent bites, we suggest that they should be considered a high risk for infection. Antibiotics selected should include coverage for a broad range of bacterial species. PMID:24528094

  6. Bacteria Isolated from Conspecific Bite Wounds in Norway and Black Rats: Implications for Rat Bite–Associated Infections In People

    PubMed Central

    Zabek, Erin; Tang, Patrick; Parsons, Kirbee L.; Koehn, Martha; Jardine, Claire M.; Patrick, David M.

    2014-01-01

    Abstract Bites associated with wild and domestic Norway and black rats (Rattus norvegicus and Rattus rattus) may have a variety of health consequences in people. Bite-related infections are among the most significant of these consequences; however, there is little data on the infectious agents that can be transmitted from rats to people through biting. This is problematic because without an accurate understanding of bite-related infection risks, it is difficult for health professionals to evaluate the adequacy of existing guidelines for empirical therapy. The objectives of this study were to increase our knowledge of the bacterial species associated with rat bites by studying bite wounds that wild rats inflict upon one another and to review the literature regarding rat bites and bite wound management. Wild Norway and black rats (n=725) were trapped in Vancouver, Canada, and examined for bite wounds in the skin. All apparently infected wounds underwent aerobic and anaerobic culture, and isolated bacteria were identified. Thirty-six rats had bite wound–related infections, and approximately 22 different species of bacteria belonging to 18 genera were identified. Staphylococcus aureus was the most common isolate; however, the majority of infections (72.5%) were polymicrobial. Rat bites can result in infection with a number of aerobic and anaerobic Gram-positive and Gram-negative bacteria. In humans, these wounds are best managed through early recognition and cleansing. The benefit of prophylactic antimicrobial treatment is debatable, but given the deep puncturing nature of rodent bites, we suggest that they should be considered a high risk for infection. Antibiotics selected should include coverage for a broad range of bacterial species. PMID:24528094

  7. A comparative study of the effect of different topical agents on burn wound infections

    PubMed Central

    Gunjan, Katara; Shobha, Chamania; Sheetal, Chitnis; Nanda, Hemvani; Vikrant, Chitnis; Chitnis, Dhananjay Sadashiv

    2012-01-01

    Background: Topical agents are used to treat burn wound infections. Aims and Objective: The present work was aimed to find out the in vitro efficacy of different topical agents against burn wound pathogens. Settings and Design: Randomly selected gram-positive (29) and gram-negative bacterial (119) isolates from burn wound cases admitted in burn unit of Choithram Hospital and Research Centre, Indore, were included in the in vitro activity testing for silver nitrate, silver sulphadiazine (SSD), chlorhexidine, cetrimide, nitrofuran, soframycin, betadine, benzalkonium chloride and honey by growth inhibition on agar medium. Materials and Methods: Multidrug-resistant isolates of gram-positive and gram-negative bacteria were checked for different topical agents. 1% topical agent was mixed with Mueller-Hinton agar. Two microlitres of bacterial suspension adjusted to 0.5 McFarland turbidity standard was spread over the topical agent containing plates. The plates without the topical agent were used as control plates. The plates were incubated for 48 h at 37°C. Results: SSD (148/148), silver nitrate (148/148) and chlorhexidine (148/148) showed excellent activity against all the pathogens. Neosporin had poor activity against Pseudomonas aeruginosa, (4/44) Proteus spp. (2/4) and group D streptococci (1/4). Betadine did not show activity against the bacterial isolates in the presence of organic matter. Honey did not exert any antimicrobial activity under the study conditions. Conclusion: SSD, silver nitrate and chlorhexidine have excellent activity against all the bacterial pathogens and could be used empirically, while identification of the infective agent is required for selecting the alternative topical agents such as nitrofuran, soframycin, and benzalkonium chloride. PMID:23162237

  8. Estimated costs of postoperative wound infections. A case-control study of marginal hospital and social security costs.

    PubMed Central

    Poulsen, K. B.; Bremmelgaard, A.; Sørensen, A. I.; Raahave, D.; Petersen, J. V.

    1994-01-01

    A cohort of 4515 surgical patients in ten selected intervention groups was followed. Three hundred and seventeen developed postoperative wound infections, and 291 of these cases were matched 1:1 to controls by operation, sex and age. In comparison to the controls the cases stayed longer in hospital after the intervention and had more contact after discharge with the social security system. Using data from a national sentinel reference database of the incidence of postoperative wound infections, and using national activity data, we established an empirical cost model based on the estimated marginal costs of hospital resources and social sick pay. It showed that the hospital resources spent on the ten groups, which represent half of the postoperative wound infections in Denmark, amounted to approximately 0.5% of the annual national hospital budget. This stratified model creates a better basis for selecting groups of operations which need priority in terms of preventive measures. PMID:7925666

  9. Role of Arginine and Omega-3 Fatty Acids in Wound Healing and Infection.

    PubMed

    Alexander, J Wesley; Supp, Dorothy M

    2014-11-01

    Significance: Only a few decades ago, the primary focus of nutritional supplementation was to prevent deficiencies of essential nutrients. It is now recognized that, at higher than essential levels, selected nutrients can have a pharmacologic effect to prevent or treat disease. Recent Advances: Two of the most important pharmaconutrients, arginine, and the omega-3 polyunsaturated fatty acids in fish oil, have been shown to have profound effects on wound healing and infections. Critical Issues: Both arginine and fish oils have independent benefits, but the combination appears to be much more effective. This combination has been shown to affect outcomes involving wound healing and infections, as reviewed here, and can also affect incidence and outcomes in cardiovascular disease, diabetes, organ transplant rejection, and other inflammatory conditions. These possibilities have not yet progressed to widespread clinical application. Future Directions: The optimal combinations of immunonutrients, timing of administration, and the doses needed for best results need to be determined in preclinical and clinical studies. Also, the mechanisms involved in the administration of pharmaconutrients need to be established. PMID:25371851

  10. The effect of clary sage oil on staphylococci responsible for wound infections

    PubMed Central

    G?owacka, Anna; Pozna?ska-Kurowska, Katarzyna; Kaszuba, Andrzej; Urbaniak, Anna; Kowalczyk, Edward

    2015-01-01

    Introduction The spreading of bacterial antibiotic resistance among clinical strains of pathogenic bacteria has made investigators to search for other active antibacterial agents which could provide a valuable complement to the existing therapies. Aim To determine the antibacterial activity of clary sage oil (Salvia sclarea L.) against Staphylococcus clinical strains which were isolated from patients with wound infections. Material and methods A comprehensive evaluation of Staphylococcus clinical strain resistance to antibiotics was performed. The constituents of clary sage oil were assayed by GC-FID-MS analysis. The minimal inhibitory concentration (MIC) of the tested essential oil against staphylococci by the micro-dilution broth method was determined. Results The clary sage oil was active against Staphylococcus aureus, S. epidermidis and S. xylosus with MIC values ranging from 3.75 to 7.00 µl/ml. Conclusions The results of the in vitro tests encourage to use formulations containing sage oil as the active natural antimicrobial agent. Because of its antimicrobial properties clary sage oil may be applied to treat wounds and skin infections.

  11. Impaired Wound Healing Predisposes Obese Mice to Severe Influenza Virus Infection

    PubMed Central

    O’Brien, Kevin B.; Vogel, Peter; Duan, Susu; Govorkova, Elena A.; Webby, Richard J.; McCullers, Jonathan A.

    2012-01-01

    (See the editorial commentary by Beck, on pages 172–3, and the article by Kim et al, on pages 244–51.) For the first time, obesity appeared as a risk factor for developing severe 2009 pandemic influenza infection. Given the increase in obesity, there is a need to understand the mechanisms underlying poor outcomes in this population. In these studies, we examined the severity of pandemic influenza virus in obese mice and evaluated antiviral effectiveness. We found that genetically and diet-induced obese mice challenged with either 2009 influenza A virus subtype H1N1 or 1968 subtype H3N2 strains were more likely to have increased mortality and lung pathology associated with impaired wound repair and subsequent pulmonary edema. Antiviral treatment with oseltamivir enhanced survival of obese mice. Overall, these studies demonstrate that impaired wound lung repair in the lungs of obese animals may result in severe influenza virus infection. Alternative approaches to prevention and control of influenza may be needed in the setting of obesity. PMID:22147799

  12. Chitosan-hyaluronic acid/nano silver composite sponges for drug resistant bacteria infected diabetic wounds.

    PubMed

    Anisha, B S; Biswas, Raja; Chennazhi, K P; Jayakumar, R

    2013-11-01

    The aim of this work was to develop an antimicrobial sponge composed of chitosan, hyaluronic acid (HA) and nano silver (nAg) as a wound dressing for diabetic foot ulcers (DFU) infected with drug resistant bacteria. nAg (5-20 nm) was prepared and characterized. The nanocomposite sponges were prepared by homogenous mixing of chitosan, HA and nAg followed by freeze drying to obtain a flexible and porous structure. The prepared sponges were characterized using SEM and FT-IR. The porosity, swelling, biodegradation and haemostatic potential of the sponges were also studied. Antibacterial activity of the prepared sponges was analysed using Escherichia coli, Staphylococcus aureus, methicillin-resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa and Klebsiella pneumonia. Chitosan-HA/nAg composite sponges showed potent antimicrobial property against the tested organisms. Sponges containing higher nAg (0.005%, 0.01% and 0.02%) concentrations showed antibacterial activity against MRSA. Cytotoxicity and cell attachment studies were done using human dermal fibroblast cells. The nanocomposite sponges showed a nAg concentration dependent toxicity towards fibroblast cells. Our results suggest that this nanocomposite sponges could be used as a potential material for wound dressing for DFU infected with antibiotic resistant bacteria if the optimal concentration of nAg exhibiting antibacterial action with least toxicity towards mammalian cells is identified. PMID:24060281

  13. Surgical wound infections diagnosed after discharge from hospital: epidemiologic differences with in-hospital infections

    Microsoft Academic Search

    Marcelino Medina-Cuadros; María Sillero-Arenas; Gabriel Martínez-Gallego; Miguel Delgado-Rodríguez

    1996-01-01

    Bacground: The purpose of this study was to study postoperative infections detected in hospital and after discharge and to identify risk factors for such infections.Methods: A prospective cohort study was used, with a follow-up of 30 days after hospital discharge, on 1483 patients admitted to the general surgery service of a tertiary care hospital. The main outcome measure was surgical

  14. [Obstacles in wound healing].

    PubMed

    Huljev, Dubravko

    2013-10-01

    Wound healing is a complex process that involves a significant number of chemical and physiological events acting on the cellular and molecular level. Wound healing passes through four stages, which are not distinctly separated one from another. There are many factors that can affect the wound healing process and their activities slow down, or completely interrupt the healing process. Wound around tissue ischemia, which is due to spasm of the arteries or atherosclerotic changes in them, can easily lead to slowing down or even stops the wound healing process. Wound infections and use of corticosteroids are significant barriers to healing. Other factors that can influence the course of wound healing are inadequate nutrition with consequent lack of energy or protein and some vitamins, wound abidance, wound bed status, localization of wound, etc. Only with the knowledge of the wound healing pathophysiology and understanding all the factors that may affect delayed wound healing, we can adequately prevent and treat chronic wounds. PMID:24371970

  15. Antimicrobial effects of plasma-mediated bipolar radiofrequency ablation on bacteria and fungi relevant for wound infection.

    PubMed

    Sönnergren, Henrik H; Strömbeck, Louise; Faergemann, Jan

    2012-01-01

    Infection constitutes an important part of wound pathology and impedes wound healing. Plasma-mediated bipolar radiofrequency ablation (Coblation(®)) is a tissue-removal technique suggested for use in wound treatment. The aims of this study were to determine the antimicrobial effect of ablation exposure on bacteria and fungi relevant to wound infection, and how exposure time, temperature and aerobic/anaerobic growth influence the effect. Suspensions of 10(6) colony-forming units/ml of Staphylococcus aureus, Streptococcus pyogenes, Pseudomonas aeruginosa, Escherichia coli and Candida albicans were exposed to ablation or thermal control for 500, 1000 or 2000 ms, or left untreated, and incubated aerobically. E. coli was also incubated anaerobically. Ablation was significantly (p?wound infection independent of aerobic/anaerobic growth and thermal effect. PMID:21727993

  16. Characterization of Slackia exigua Isolated from Human Wound Infections, Including Abscesses of Intestinal Origin ?

    PubMed Central

    Kim, Keun-Sung; Rowlinson, Marie-Claire; Bennion, Robert; Liu, Chengxu; Talan, David; Summanen, Paula; Finegold, Sydney M.

    2010-01-01

    Eleven clinical strains isolated from infected wound specimens were subjected to polyphasic taxonomic analysis. Sequence analysis of the 16S rRNA gene showed that all 11 strains were phylogenetically related to Slackia exigua. Additionally, conventional and biochemical tests of 6 of the 11 strains were performed as supplementary methods to obtain phenotypic identification by comparison with the phenotypes of the relevant type strains. S. exigua has been considered an oral bacterial species in the family Coriobacteriaceae. This organism is fastidious and grows poorly, so it may easily be overlooked. The 16S rRNA gene sequences and the biochemical characteristics of four of the S. exigua strains isolated for this study from various infections indicative of an intestinal source were almost identical to those of the validated S. exigua type strain from an oral source and two of the S. exigua strains from oral sources evaluated in this study. Thus, we show for the first time that S. exigua species can be isolated from extraoral infections as well as from oral infections. The profiles of susceptibility to selected antimicrobials of this species were also investigated for the first time. PMID:20107092

  17. [Modern wound dressings].

    PubMed

    Triller, Ciril; Huljev, Dubravko; Planinsek Rucigaj, Tanja

    2013-10-01

    Chronic wounds are, due to the slow healing, a major clinical problem. In addition to classic materials, a great number of supportive wound dressings for chronic wound treatment, developed on the basis of new knowledge about the pathophysiological events in non-healing wounds, are available on the market. Today we know that modern wound dressings provide the best local environment for optimal healing (moisture, warmth, appropriate pH). Wound dressings control the amount of exudate from the wound and bacterial load, thus protecting local skin from the wound exudate and the wound from secondary infections from the environment. Using supportive wound dressings makes sense only when the wound has been properly assessed, the etiologic factors have been clarified and the obstacles making the wound chronic identified. The choice of dressing is correlated with the characteristics of the wound, the knowledge and experience of the medical staff, and the patient's needs. We believe that the main advantage of modern wound dressing versus conventional dressing is more effective wound cleaning, simple dressing application, painless bandaging owing to reduced adhesion to the wound, and increased absorption of the wound exudate. Faster wound granulation shortens the length of patient hospitalization, and eventually facilitates the work of medical staff. The overall cost of treatment is a minor issue due to faster wound healing despite the fact that modern supportive wound dressings are more expensive than conventional bandaging. The article describes different types of modern supportive wound dressings, as well as their characteristics and indications for use. PMID:24371980

  18. [A role of negative pressure therapy in the treatment of surgical wound infection after intramedullary osteosynthesis in pertrochanteric femoral fracture].

    PubMed

    Marinovi?, Marin; Spanjol, Josip; Laginja, Stanislava; Grzalja, Nikola; Bakota, Bore; Fumi?, Nera; Sepac, Brigita; Seremet, Jasmina

    2013-10-01

    Fractures of the proximal femur are specific to older adults. Today, life expectancy for men and women is increasing, so one can expect an increased number of hip fractures. Elderly people suffer from associated diseases that may compromise the biological potential in healing of surgical wounds. On the other hand, there is an increased number of microorganisms resistant to antimicrobial drugs, so an increased number of postoperative infections can be expected. With conventional treatment methods of postoperative infections where the osteo-synthetic material is present in tissue, negative pressure therapy is gradually taking an increasingly important role in the treatment of these conditions. Because of its simple application in hospital or outpatient setting and good comfort with no pain for the patient, negative pressure therapy contributes significantly to healing of the wounds without removing osteosynthetic material from the wound. PMID:24371986

  19. Negative pressure wound therapy in the management of late deep infections after open reconstruction of achilles tendon rupture.

    PubMed

    Mosser, Philipp; Kelm, Jens; Anagnostakos, Konstantinos

    2015-01-01

    Infection is a major complication after open reconstruction of Achilles tendon ruptures. We report on the use of vacuum-assisted closure (VAC) therapy in the treatment of late deep infections after open Achilles tendon reconstruction. Six patients (5 males [83.33%], 1 female [16.67%]; mean age, 52.8 [range 37 to 66] years) were been treated using an identical protocol. Surgical management consisted of debridement, lavage, and necrectomy of infected tendon parts. The VAC therapy was used for local wound preconditioning and infection management. A continuous negative pressure of 125 mm Hg was applied on each wound. For final wound closure, a split-thickness skin graft was performed. The skin graft healing process was also supported by VAC therapy during the first 5 days. The VAC dressings were changed a mean average of 3 (range 1 to 4) times until split-thickness skin grafting could be performed. The mean total duration of the VAC therapy was 13.6 ± 5.9 days. The mean hospital stay was 31.2 ± 15.9 days. No complications with regard to bleeding, seroma, or hematoma formation beneath the skin graft were observed. At a mean follow-up duration of 29.9 (range 4 to 65) months, no re-infection or infection persistence was observed. The VAC device seems to be a valuable tool in the treatment of infected tendons. The generalization of these conclusions should await the results of future studies with larger patient series. PMID:25451209

  20. In Vivo Imaging of Bioluminescent Escherichia coli in a Cutaneous Wound Infection Model for Evaluation of an Antibiotic Therapy

    Microsoft Academic Search

    Samir Jawhara; Serge Mordon

    2004-01-01

    A rapid, continuous method for noninvasively monitoring the effectiveness of several antibacterial agents in real time by using a model of wound infection was developed. This study was divided into three steps: (i) construction of a plasmid to transform Escherichia coli into a bioluminescent variant, (ii) study of the bioluminescent E. coli in vitro as a function of temperature and

  1. Postoperative wound infection: a controlled study of the increased duration of hospital stay and direct cost of hospitalization.

    PubMed Central

    Green, J W; Wenzel, R P

    1977-01-01

    The increased hospital stay and direct cost of hospitalization that resulted from a postoperative wound infection (presence of pus at the incision site) after each of 6 common operations were evaluated. With the aid of the hospital computer, matched controls were obtained with respect to patient age, sex, exact operation performed, clinical service performing operation, pathologic finding, and underlying disease process which might alter the patient's predisposition toward infection. Several of the operations (appendectomy. cholecystectomy, total abdominal hysterectomy, and coronary artery bypass graft) were subtyped in order to obtain equivalence between controls and infected patients. In general, an infection doubles the postoperative stay and significantly increases the hospital expense. PMID:300233

  2. Evidence-based management of deep wound infection after spinal instrumentation.

    PubMed

    Lall, Rishi R; Wong, Albert P; Lall, Rohan R; Lawton, Cort D; Smith, Zachary A; Dahdaleh, Nader S

    2015-02-01

    In this study, evidence-based medicine is used to assess optimal surgical and medical management of patients with post-operative deep wound infection following spinal instrumentation. A computerized literature search of the PubMed database was performed. Twenty pertinent studies were identified. Studies were separated into publications addressing instrumentation retention versus removal and publications addressing antibiotic therapy regimen. The findings were classified based on level of evidence (I-III) and findings were summarized into evidentiary tables. No level I or II evidence was identified. With regards to surgical management, five studies support instrumentation retention in the setting of early deep infection. In contrast, for delayed infection, the evidence favors removal of instrumentation at the time of initial debridement. Surgeons should be aware that for deformity patients, even if solid fusion is observed, removal of instrumentation may be associated with significant loss of correction. A course of intravenous antibiotics followed by long-term oral suppressive therapy should be pursued if instrumentation is retained. A shorter treatment course may be appropriate if hardware is removed. PMID:25308619

  3. Epidermal keratinocytes initiate wound healing and pro-inflammatory immune responses following percutaneous schistosome infection.

    PubMed

    Bourke, Claire D; Prendergast, Catriona T; Sanin, David E; Oulton, Tate E; Hall, Rebecca J; Mountford, Adrian P

    2015-03-01

    Keratinocytes constitute the majority of cells in the skin's epidermis, the first line of defence against percutaneous pathogens. Schistosome larvae (cercariae) actively penetrate the epidermis to establish infection, however the response of keratinocytes to invading cercariae has not been investigated. Here we address the hypothesis that cercariae activate epidermal keratinocytes to promote the development of a pro-inflammatory immune response in the skin. C57BL/6 mice were exposed to Schistosoma mansoni cercariae via each pinna and non-haematopoietic cells isolated from epidermal tissue were characterised for the presence of different keratinocyte sub-sets at 6, 24 and 96h p.i. We identified an expansion of epidermal keratinocyte precursors (CD45(-), CD326(-), CD34(+)) within 24h of infection relative to naïve animals. Following infection, cells within the precursor population displayed a more differentiated phenotype (?6integrin(-)) than in uninfected skin. Parallel immunohistochemical analysis of pinnae cryosections showed that this expansion corresponded to an increase in the intensity of CD34 staining, specifically in the basal bulge region of hair follicles of infected mice, and a higher frequency of keratinocyte Ki67(+) nuclei in both the hair follicle and interfollicular epidermis. Expression of pro-inflammatory cytokine and stress-associated keratin 6b genes was also transiently upregulated in the epidermal tissue of infected mice. In vitro exposure of keratinocyte precursors isolated from neonatal mouse skin to excretory/secretory antigens released by penetrating cercariae elicited IL-1? and IL-1? production, supporting a role for keratinocyte precursors in initiating cutaneous inflammatory immune responses. Together, these observations indicate that S.mansoni cercariae and their excretory/secretory products act directly upon epidermal keratinocytes, which respond by initiating barrier repair and pro-inflammatory mechanisms similar to those observed in epidermal wound healing. PMID:25575749

  4. Comparative prophylactic efficacies of ciprofloxacin, ofloxacin, cefazolin, and vancomycin in experimental model of staphylococcal wound infection.

    PubMed Central

    Kernodle, D S; Kaiser, A B

    1994-01-01

    Recent shifts in the species and antibiotic resistance patterns of bacteria causing nosocomial infections present new challenges for providing effective prophylaxis in surgery. Traditional regimens lack activity against methicillin-resistant staphylococci and many gram-negative species causing nosocomial infections. The new fluoroquinolones exhibit in vitro activity against many emerging surgical wound pathogens. To determine the potential of this class of antimicrobial agents for use in surgery, we compared the prophylactic efficacies of ciprofloxacin and ofloxacin with those of cefazolin and vancomycin in a guinea pig model of abscess formation. Four Staphylococcus aureus strains, one Staphylococcus epidermidis strain, and one Staphylococcus haemolyticus strain were evaluated. Vancomycin was the most effective prophylactic agent, exhibiting in vivo activity against all strains which was superior or equivalent to those of all other agents tested. Cefazolin was the least effective agent and surpassed the two quinolones in prophylactic efficacy against only one organism, a quinolone- and methicillin-resistant strain of S. aureus. The two quinolones provided excellent protection against infection with all but the quinolone-resistant isolate. The in vivo emergence of quinolone resistance among quinolone-susceptible isolates was not detected. The methicillin-resistant, quinolone-susceptible S. epidermidis and S. haemolyticus isolates were extremely susceptible to prophylaxis, exhibiting 50% infective doses above 4 x 10(6) CFU for seven of the eight antibiotic-strain combinations. We conclude that ciprofloxacin and ofloxacin may be effective antistaphylococcal agents in surgery. The role of these agents remains to be defined, and the definition should include consideration of an adverse effect upon antibiotic resistance patterns of organisms causing nosocomial infections. PMID:8092833

  5. Epidermal keratinocytes initiate wound healing and pro-inflammatory immune responses following percutaneous schistosome infection

    PubMed Central

    Bourke, Claire D.; Prendergast, Catriona T.; Sanin, David E.; Oulton, Tate E.; Hall, Rebecca J.; Mountford, Adrian P.

    2015-01-01

    Keratinocytes constitute the majority of cells in the skin’s epidermis, the first line of defence against percutaneous pathogens. Schistosome larvae (cercariae) actively penetrate the epidermis to establish infection, however the response of keratinocytes to invading cercariae has not been investigated. Here we address the hypothesis that cercariae activate epidermal keratinocytes to promote the development of a pro-inflammatory immune response in the skin. C57BL/6 mice were exposed to Schistosoma mansoni cercariae via each pinna and non-haematopoietic cells isolated from epidermal tissue were characterised for the presence of different keratinocyte sub-sets at 6, 24 and 96 h p.i. We identified an expansion of epidermal keratinocyte precursors (CD45?, CD326?, CD34+) within 24 h of infection relative to naïve animals. Following infection, cells within the precursor population displayed a more differentiated phenotype (?6integrin?) than in uninfected skin. Parallel immunohistochemical analysis of pinnae cryosections showed that this expansion corresponded to an increase in the intensity of CD34 staining, specifically in the basal bulge region of hair follicles of infected mice, and a higher frequency of keratinocyte Ki67+ nuclei in both the hair follicle and interfollicular epidermis. Expression of pro-inflammatory cytokine and stress-associated keratin 6b genes was also transiently upregulated in the epidermal tissue of infected mice. In vitro exposure of keratinocyte precursors isolated from neonatal mouse skin to excretory/secretory antigens released by penetrating cercariae elicited IL-1? and IL-1? production, supporting a role for keratinocyte precursors in initiating cutaneous inflammatory immune responses. Together, these observations indicate that S.mansoni cercariae and their excretory/secretory products act directly upon epidermal keratinocytes, which respond by initiating barrier repair and pro-inflammatory mechanisms similar to those observed in epidermal wound healing. PMID:25575749

  6. Negative-pressure wound therapy induces endothelial progenitor cell mobilization in diabetic patients with foot infection or skin defects.

    PubMed

    Seo, Sang Gyo; Yeo, Ji Hyun; Kim, Ji Hye; Kim, Ji-Beom; Cho, Tae-Joon; Lee, Dong Yeon

    2013-01-01

    Non healing chronic wounds are difficult to treat in patients with diabetes and can result in severe medical problems for these patients and for society. Negative-pressure wound therapy (NPWT) has been adopted to treat intractable chronic wounds and has been reported to be effective. However, the mechanisms underlying the effects of this treatment have not been elucidated. To assess the vasculogenic effect of NPWT, we evaluated the systemic mobilization of endothelial progenitor cells (EPCs) during NPWT. Twenty-two of 29 consecutive patients who presented at the clinic of Seoul National Universty Hospital between December 2009 and November 2010 who underwent NPWT for diabetic foot infections or skin ulcers were included in this study. Peripheral blood samples were taken before NPWT (pre-NPWT) and 7-14 days after the initiation of NPWT (during-NPWT). Fluorescence-activated cell sorting (FACS) analysis showed that the number of cells in EPC-enriched fractions increased after NPWT, and the numbers of EPC colony forming units (CFUs) significantly increased during NPWT. We believe that NPWT is useful for treating patients with diabetic foot infections and skin ulcers, especially when these conditions are accompanied by peripheral arterial insufficiency. The systemic mobilization of EPCs during NPWT may be a mechanism for healing intractable wounds in diabetic patients with foot infections or skin defects via the formation of increased granulation tissue with numerous small blood vessels. PMID:24232261

  7. 30 The ScienTiST April 2006 By perturbing the microenvironment, wounds and infection

    E-print Network

    Nelson, Celeste M.

    30 The ScienTiST April 2006 Ecologyof Tumors ThE By perturbing the microenvironment, wounds microenvironment is in response to signals from the tumor. fRoM WoUNDS, TUMoRS Harold Dvorak and colleagues at Beth between the tumor stroma and the wounding environment in 1986,4 and it is now well recognized

  8. Identification of a hydroxy substituted calamenene—a sesquiterpene associated with wound reactions in non-infected xylem of Tilia spp

    Microsoft Academic Search

    Eckhard Melcher; Peter Jüngel; Bianca Möllendorf; Uwe Schmitt

    2003-01-01

    Xylem of lime trees (Tilia spp.) with wound reactions was structurally investigated by scanning (SEM) and transmission electron microscopy (TEM) as well as chemically analyzed by direct thermal desorption-gas chromatography–mass spectrometry (DTD-GC–MS). Wound reactions in the outer xylem lead to distinct discolourations around the wound. Within a 4-week response no fungal infection occurred in discoloured xylem. At the fine structural

  9. Real-time monitoring of bacterial infection in vivo: development of bioluminescent staphylococcal foreign-body and deep-thigh-wound mouse infection models.

    PubMed

    Kuklin, Nelly A; Pancari, Gregory D; Tobery, Timothy W; Cope, Leslie; Jackson, Jesse; Gill, Charles; Overbye, Karen; Francis, Kevin P; Yu, Jun; Montgomery, Donna; Anderson, Annaliesa S; McClements, William; Jansen, Kathrin U

    2003-09-01

    Staphylococcal infections associated with catheter and prosthetic implants are difficult to eradicate and often lead to chronic infections. Development of novel antibacterial therapies requires simple, reliable, and relevant models for infection. Using bioluminescent Staphylococcus aureus, we have adapted the existing foreign-body and deep-wound mouse models of staphylococcal infection to allow real-time monitoring of the bacterial colonization of catheters or tissues. This approach also enables kinetic measurements of bacterial growth and clearance in each infected animal. Persistence of infection was observed throughout the course of the study until termination of the experiment at day 16 in a deep-wound model and day 21 in the foreign-body model, providing sufficient time to test the effects of antibacterial compounds. The usefulness of both animal models was assessed by using linezolid as a test compound and comparing bioluminescent measurements to bacterial counts. In the foreign-body model, a three-dose antibiotic regimen (2, 5, and 24 h after infection) resulted in a decrease in both luminescence and bacterial counts recovered from the implant compared to those of the mock-treated infected mice. In addition, linezolid treatment prevented the formation of subcutaneous abscesses, although it did not completely resolve the infection. In the thigh model, the same treatment regimen resulted in complete resolution of the luminescent signal, which correlated with clearance of the bacteria from the thighs. PMID:12936968

  10. Surgical wound care - closed

    MedlinePLUS

    ... your doctor used one of the following: Stitches (sutures) Clips Staples Skin glue Proper wound care can help prevent ... infection Cover your wound so that stitches or staples don't catch on clothing Protect the area ...

  11. Ability of Bacteriophage in Resolving Wound Infection Caused by Multidrug-Resistant Acinetobacter baumannii in Uncontrolled Diabetic Rats.

    PubMed

    Shivaswamy, VinodKumar Chickmangalure; Kalasuramath, Suneeta Basavaraj; Sadanand, Chethan Kumar; Basavaraju, Abhishek Kilagere; Ginnavaram, Varsha; Bille, Sumanth; Ukken, Sanjay Saju; Pushparaj, Usha Nandini

    2015-04-01

    Acinetobacter baumannii, a substantial nosocomial pathogen, has developed resistance to almost all available antimicrobial drugs. Bacteriophage therapy is a possible alternative treatment for multidrug-resistant (MDR) bacterial infections. In this study, we have successfully isolated bacteriophage active against clinical strains of A. baumannii by enrichment from hospital sewage sludge using representatives of those strains. The bacteriophage isolated against A. baumannii formed plaques against beta-lactamases producing strains of A. baumannii. The utility of bacteriophage specific for A. baumannii to resolve wound infection in uncontrolled diabetic rats was evaluated. Five groups of uncontrolled diabetic rats were used. Group I was noninfected (Control), Group II was infected with MDR A. baumannii and challenged with bacteriophage, Group III was infected with MDR A. baumannii, Group IV was infected with MDR A. baumannii and challenged with antibiotic colistin, and Group V consisted of noninfected rats and sprayed with phage (Phage control). A significant decrease in infection, period of epithelization, and wound contraction was observed in the phage-challenged group when compared with antibiotic-treated uncontrolled diabetic rats and the control group. To conclude the study, new insights are provided into the biology of the broad host range of A. baumannii phage, demonstrating that A. baumannii phage has prospects for the treatment of infections caused by the MDR A. baumannii. PMID:25411824

  12. A clinical study on the efficacy of Panchavalkala cream in Vrana Shodhana w.s.r to its action on microbial load and wound infection

    PubMed Central

    Bhat, K. Shobha; Vishwesh, B. N.; Sahu, Manoranjan; Shukla, Vijay Kumar

    2014-01-01

    Background: The science of wound healing is advancing rapidly, particularly as a result of new therapeutic approaches. The wound healing effect of different herbal ointments have been enormous and are in wide practice these days. Aim: To evaluate the efficacy of Panchavalkala cream over wound debridement (wound infection and microbial load). Materials and Methods: Ghanasatwa (water extract) of the individual drugs of Panchavalkala was prepared and the extract formulated as herbal ointment. This was used to treat patients of infected chronic non healing wounds. The signs and symptoms of infection were graded before and during the course of treatment. Tissue biopsy to estimate the microbial load prior to and during the course of treatment was done. Results: The clinical symptoms like Slough, swelling, redness, pain, discharge, tenderness, and malodor in wounds showed statistically significant reduction following treatment. The microbial load of the wounds was also reduced significantly. Conclusion: In most of the cases, there was a progressive reduction in the microbial load with time, during the course of treatment indicating the efficacy of the formulation in reducing the microbial load and thus controlling infection, facilitating wound healing. PMID:25558157

  13. Clinical Trial on the Incidence of Wound Infection and Patient Satisfaction After Stoma Closure: Comparison of Two Skin Closure Techniques

    PubMed Central

    Yoon, Sang Il; Bae, Sun Mi; Park, Dong Guk

    2015-01-01

    Purpose Surgical site infection (SSI) is one of the most common complications that can occur after stoma closure. Reports have described differences in the incidence of wound infection depending on the skin closure technique, but there is no consensus on the ideal closure technique for a stoma wound. The aim of this study was to compare the incidence of SSI and the patient satisfaction between a circumferential purse-string approximation (CPA) and a primary linear closure (PC) of a stoma wound. Methods This prospective nonrandomized trial enrolled 48 patients who underwent a stoma closure from February 2010 to October 2013. Patients were divided into two groups according to the stoma closing technique: the CPA group (n = 34) and the PC group (n = 14). The incidences of SSI for the two groups were compared, and the patients' satisfaction with the stoma closure was determined by using a questionnaire. Results SSI occurred in 3 of 48 patients (6.3%) and was more frequent in the PC group than in the CPA group (3/14 [21.4%] vs. 0/34 [0%], P = 0.021). Time to complete healing after stoma closure in the CPA group was 32 days (range, 14-61 days). Patients in the CPA group were more satisfied with the resulting wound scar (P = 0.043). Conclusion After stoma closure, CPA was associated with a significantly lower incidence of wound infection and greater patient satisfaction compared to PC. However, with the CPA technique, the time to heal is longer than it is with PC. PMID:25745624

  14. Microbial Profiling of Combat Wound Infection through Detection Microarray and Next-Generation Sequencing

    PubMed Central

    Allen, Jonathan E.; Brown, Trevor S.; Gardner, Shea N.; McLoughlin, Kevin S.; Forsberg, Jonathan A.; Kirkup, Benjamin C.; Chromy, Brett A.; Luciw, Paul A.; Elster, Eric A.

    2014-01-01

    Combat wound healing and resolution are highly affected by the resident microbial flora. We therefore sought to achieve comprehensive detection of microbial populations in wounds using novel genomic technologies and bioinformatics analyses. We employed a microarray capable of detecting all sequenced pathogens for interrogation of 124 wound samples from extremity injuries in combat-injured U.S. service members. A subset of samples was also processed via next-generation sequencing and metagenomic analysis. Array analysis detected microbial targets in 51% of all wound samples, with Acinetobacter baumannii being the most frequently detected species. Multiple Pseudomonas species were also detected in tissue biopsy specimens. Detection of the Acinetobacter plasmid pRAY correlated significantly with wound failure, while detection of enteric-associated bacteria was associated significantly with successful healing. Whole-genome sequencing revealed broad microbial biodiversity between samples. The total wound bioburden did not associate significantly with wound outcome, although temporal shifts were observed over the course of treatment. Given that standard microbiological methods do not detect the full range of microbes in each wound, these data emphasize the importance of supplementation with molecular techniques for thorough characterization of wound-associated microbes. Future application of genomic protocols for assessing microbial content could allow application of specialized care through early and rapid identification and management of critical patterns in wound bioburden. PMID:24829242

  15. Topical “Soft Candle” Applications for Infected Diabetic Foot Wounds: A Cause for Concern?

    PubMed Central

    Cawich, Shamir O.; Harnarayan, Patrick; Islam, Shariful; Nahmorah J., Bobb; Budhooram, Steve; Ramsewak, Shivaa; Ramdass, Michael J.; Naraynsingh, Vijay

    2014-01-01

    Aims: There is a cultural barrier to early medical intervention for diabetic foot infections in Trinidad & Tobago, stemming from the strong cultural belief in “soft candle” as effective treatment. We carried out a case-control study to evaluate the outcomes of “soft candle” to treat diabetic foot infections. Methods: All consecutive patients admitted with diabetic foot infections were interviewed to collect data on: demographics, medical history, unhealthy lifestyle markers (exposure to risk factors for chronic diseases), chosen treatment and details of “soft candle” use. The hospital records were accessed on discharge to records the main outcome measures: HbA1c readings, duration of hospitalization, amputation and in-hospital mortality. Two groups were defined: The control group included patients who sought medical attention after detecting a foot infection. The study group included patients who recognized their infection but voluntarily chose to utilize “soft candle” regimens. We excluded patients who voluntarily chose to use other forms of non-traditional treatment or sought no treatment at all. Outcomes were compared using SPSS ver 19. A two-tailed P value was calculated for variables of interest in each group using Fisher’s exact test. The duration of hospitalization between the groups was compared using paired T-Test. A P value <0.05 was considered statistically significant. Results: There were 442 patients who met inclusion criteria: There were 60 patients in the study group at an average age of 55.2 years (SD ± 11.4; range 43-88): 63% had HBA1c readings >7.0% at presentation and 95% had unhealthy lifestyle habits. There were 382 patients in the control group at an average age of 59.1 years (SD ± 12.6, Range 37-89): 74% with HBA1c readings >7.0% at presentation and 48% with unhealthy lifestyle habits. Patients who used “soft candle” had significantly longer duration of hospitalization (15.5 ± 10.2 vs 9.2 ± 3.9 days; P<0.001) and major amputations (13.3% vs 5.6%; P=0.048) that was considered clinically significant. There was no difference in minor amputations (31.7% vs 34.3%; P=0.770) or in-hospital mortality (1.7% vs 0.52%; P=0.355) between the groups. Conclusion: In its current form, the traditional practice of topical “soft candle” application to diabetic foot wounds may be potentially harmful. Persons with diabetes should be warned about these effects. We have identified the target population for educational campaigns. PMID:25018679

  16. Wound Edge Protectors in Open Abdominal Surgery to Reduce Surgical Site Infections: A Systematic Review and Meta-Analysis

    PubMed Central

    Mihaljevic, André L.; Müller, Tara C.; Kehl, Victoria; Friess, Helmut; Kleeff, Jörg

    2015-01-01

    Importance Surgical site infections remain one of the most frequent complications following abdominal surgery and cause substantial costs, morbidity and mortality. Objective To assess the effectiveness of wound edge protectors in open abdominal surgery in reducing surgical site infections. Evidence Review A systematic literature search was conducted according to a prespecified review protocol in a variety of data-bases combined with hand-searches for randomized controlled trials on wound edge protectors in patients undergoing laparotomy. A qualitative and quantitative analysis of included trials was conducted. Findings We identified 16 randomized controlled trials including 3695 patients investigating wound edge protectors published between 1972 and 2014. Critical appraisal uncovered a number of methodological flaws, predominantly in the older trials. Wound edge protectors significantly reduced the rate of surgical site infections (risk ratio 0.65; 95%CI, 0.51–0.83; p = 0.0007; I2 = 52%). The results were robust in a number of sensitivity analyses. A similar effect size was found in the subgroup of patients undergoing colorectal surgery (risk ratio 0.65; 95%CI, 0.44–0.97; p = 0.04; I2 = 56%). Of the two common types of wound protectors double ring devices were found to exhibit a greater protective effect (risk ratio 0.29; 95%CI, 0.15–0.55) than single-ring devices (risk ratio 0.71; 95%CI, 0.54–0.92), but this might largely be due to the lower quality of available data for double-ring devices. Exploratory subgroup analyses for the degree of contamination showed a larger protective effect in contaminated cases (0.44; 95%CI, 0.28–0.67; p = 0.0002, I2 = 23%) than in clean-contaminated surgeries (0.72, 95%CI, 0.57–0.91; p = 0.005; I2 = 46%) and a strong effect on the reduction of superficial surgical site infections (risk ratio 0.45; 95%CI, 0.24–0.82; p = 0.001; I2 = 72%). Conclusions and Relevance Wound edge protectors significantly reduce the rate of surgical site infections in open abdominal surgery. Further trials are needed to explore their effectiveness in different risk constellations. PMID:25816365

  17. A semi-stochastic cell-based model for in vitro infected 'wound' healing through motility reduction: a simulation study.

    PubMed

    Vermolen, F J; Gefen, A

    2013-02-01

    We consider the migration and viability of individual cells in bacterial-infected cell colonies. Cell movement is assumed to take place as a result of sensing the strain energy density as a mechanical stimulus. The model is based on tracking the motion and viability of each individual cell in a cell colony, and the formalism was published in an earlier paper. The present innovations are an application to a simulation of a 'wound healing assay' in which bacteria infect the wound through impairing the motility of cells and an extension with effects from inertia. Though based on simple principles, the model is based on experiments on living fibroblasts on a flat substrate. PMID:23147230

  18. Differential induction of acquired resistance and PR gene expression in tobacco by virus infection, ethephon treatment, UV light and wounding

    Microsoft Academic Search

    Frans Th. Brederode; Huub J. M. Linthorst; John F. Bol

    1991-01-01

    Genes for acidic, extracellular and basic, intracellular pathogenesis-related (PR) proteins of tobacco were studied for their response to tobacco mosaic virus (TMV) infection, ethephon treatment, wounding and UV light. The genes encoding the acidic PR proteins (PR-1, PR-2, PR-3, PR-4 and PR-5) responded similarly to the different forms of stress. They appeared to be highly inducible by TMV, moderately inducible

  19. Use of the Surgical Wound Infection Model To Determine the Efficacious Dosing Regimen of Retapamulin, a Novel Topical Antibiotic

    Microsoft Academic Search

    Stephen Rittenhouse; Christine Singley; Jennifer Hoover; Roni Page; David Payne

    2006-01-01

    The effect of topically applied retapamulin ointment was evaluated using various dosing regimens in the Staphylococcus aureus and Streptococcus pyogenes wound infection model. Retapamulin (1%, wt\\/wt) was effica- cious using twice-daily (b.i.d.) applications for 4 or 5 days. These data underpinned the decision to evaluate 1% retapamulin b.i.d. in clinical trials. The pleuromutilin retapamulin is a new class of topical

  20. Impact of wound edge protection devices on surgical site infection after laparotomy: multicentre randomised controlled trial (ROSSINI Trial)

    PubMed Central

    2013-01-01

    Objective To determine the clinical effectiveness of wound edge protection devices in reducing surgical site infection after abdominal surgery. Design Multicentre observer blinded randomised controlled trial. Participants Patients undergoing laparotomy at 21 UK hospitals. Interventions Standard care or the use of a wound edge protection device during surgery. Main outcome measures Surgical site infection within 30 days of surgery, assessed by blinded clinicians at seven and 30 days and by patient’s self report for the intervening period. Secondary outcomes included quality of life, duration of stay in hospital, and the effect of characteristics of the patient and operation on the efficacy of the device. Results 760 patients were enrolled with 382 patients assigned to the device group and 378 to the control group. Six patients in the device group and five in the control group did not undergo laparotomy. Fourteen patients, seven in each group, were lost to follow-up. A total of 184 patients experienced surgical site infection within 30 days of surgery, 91/369 (24.7%) in the device group and 93/366 (25.4%) in the control group (odds ratio 0.97, 95% confidence interval 0.69 to 1.36; P=0.85). This lack of benefit was consistent across wound assessments performed by clinicians and those reported by patients and across all secondary outcomes. In the secondary analyses no subgroup could be identified in which there was evidence of clinical benefit associated with use of the device. Conclusions Wound edge protection devices do not reduce the rate of surgical site infection in patients undergoing laparotomy, and therefore their routine use for this role cannot be recommended. Trial registration Current Controlled Trials ISRCTN 40402832 PMID:23903454

  1. Canibacter oris gen. nov., sp. nov., isolated from an infected human wound.

    PubMed

    Aravena-Román, M; Inglis, T J J; Siering, C; Schumann, P; Yassin, A F

    2014-05-01

    A facultatively anaerobic, Gram-reaction-positive, catalase- and oxidase-negative, rod-shaped bacterium isolated from an infected human wound caused by a dog bite was characterized by phenotypic and molecular genetic methods. Phylogenetic analysis based on 16S rRNA gene sequences showed that strain IMMIB Q2029717T was a member of the order Micrococcales of the class Actinobacteria, displaying 91.6% to 96% sequence similarity with members of the family Microbacteriaceae. Phylogentic trees generated by different algorithms indicated that the strain forms an independent phylogenetic line of descent that consistently clustered proximal to the base of the genus Leucobacter. Chemical studies revealed the presence of a cell-wall murein based on L-lysine (type B1?), major menaquinone (MK-10) and a DNA G+C content of 56.9 mol%. The distinct phylogenetic position, ribotyping and matrix-assisted laser desorption/ionization time-of-flight MS profiles and the significant phenotypic differences clearly separate strain IMMIB Q2029717T from its nearest phylogenetic neighbour and support its classification as a representative of a novel genus and species, with the suggested name Canibacter oris gen. nov., sp. nov. The type strain is IMMIB Q2029717T (=DSM 27064T=CCUG 64069T). PMID:24510975

  2. Bactericidal effects of non-thermal argon plasma in vitro, in biofilms and in the animal model of infected wounds.

    PubMed

    Ermolaeva, Svetlana A; Varfolomeev, Alexander F; Chernukha, Marina Yu; Yurov, Dmitry S; Vasiliev, Mikhail M; Kaminskaya, Anastasya A; Moisenovich, Mikhail M; Romanova, Julia M; Murashev, Arcady N; Selezneva, Irina I; Shimizu, Tetsuji; Sysolyatina, Elena V; Shaginyan, Igor A; Petrov, Oleg F; Mayevsky, Evgeny I; Fortov, Vladimir E; Morfill, Gregor E; Naroditsky, Boris S; Gintsburg, Alexander L

    2011-01-01

    Non-thermal (low-temperature) physical plasma is under intensive study as an alternative approach to control superficial wound and skin infections when the effectiveness of chemical agents is weak due to natural pathogen or biofilm resistance. The purpose of this study was to test the individual susceptibility of pathogenic bacteria to non-thermal argon plasma and to measure the effectiveness of plasma treatments against bacteria in biofilms and on wound surfaces. Overall, Gram-negative bacteria were more susceptible to plasma treatment than Gram-positive bacteria. For the Gram-negative bacteria Pseudomonas aeruginosa, Burkholderia cenocepacia and Escherichia coli, there were no survivors among the initial 10(5) c.f.u. after a 5 min plasma treatment. The susceptibility of Gram-positive bacteria was species- and strain-specific. Streptococcus pyogenes was the most resistant with 17?% survival of the initial 10(5) c.f.u. after a 5 min plasma treatment. Staphylococcus aureus had a strain-dependent resistance with 0 and 10?% survival from 10(5) c.f.u. of the Sa 78 and ATCC 6538 strains, respectively. Staphylococcus epidermidis and Enterococcus faecium had medium resistance. Non-ionized argon gas was not bactericidal. Biofilms partly protected bacteria, with the efficiency of protection dependent on biofilm thickness. Bacteria in deeper biofilm layers survived better after the plasma treatment. A rat model of a superficial slash wound infected with P. aeruginosa and the plasma-sensitive Staphylococcus aureus strain Sa 78 was used to assess the efficiency of argon plasma treatment. A 10 min treatment significantly reduced bacterial loads on the wound surface. A 5-day course of daily plasma treatments eliminated P. aeruginosa from the plasma-treated animals 2 days earlier than from the control ones. A statistically significant increase in the rate of wound closure was observed in plasma-treated animals after the third day of the course. Wound healing in plasma-treated animals slowed down after the course had been completed. Overall, the results show considerable potential for non-thermal argon plasma in eliminating pathogenic bacteria from biofilms and wound surfaces. PMID:20829396

  3. Reduction of a Multidrug-Resistant Pathogen and Associated Virulence Factors in a Burn Wound Infection Model: Further Understanding of the Effectiveness of a Hydroconductive Dressing

    PubMed Central

    Carney, Bonnie C.; Ortiz, Rachel T.; Bullock, Rachael M.; Prindeze, Nicholas J.; Moffatt, Lauren T.; Robson, Martin C.

    2014-01-01

    Objective: Drawtex's ability to remove pathogens and associated virulence factors has been demonstrated in vitro. A model of burn wound infection was used to characterize the in vivo impact of this dressing on infection and wound healing. Methods: Paired burn wounds were created on the dorsum of Sprague Dawley rats and were inoculated with methicillin-resistant Staphylococcus aureus (MRSA). Animals were divided into 2 groups, half with wounds that received experimental dressing and the remaining half with control dressing-treated wounds. Dressings remained in place through 3, 6, 9, or 14 days after injury, and methicillin-resistant S aureus and virulence factors were quantified. Laser Doppler imaging was used to examine wound perfusion, and local host immune response was assessed through the quantification of mRNA expression. Results: By day 3, less methicillin-resistant S aureus was measured in wounds treated with experimental-dressing compared to control-dressing wounds. Quantities remained lower in the experimental group through day 14 (P < .001). More methicillin-resistant S aureus was quantified in the experimental dressing itself than in control dressing at all time points (P < .05). Experimental dressing-treated wounds contained less toxic shock syndrome toxin 1 and Panton-Valentine leukocidin than controls (P < .01) on days 6, 9, and 14. Induction of toll-like receptor 2, NOD-like receptor family, pyrin domain containing 3, and interleukin 6 was significantly lower in experimental-dressing treated wounds than in controls on days 6 and 9 (P < .05). Conclusions: The hydroconductive dressing provided a significant reduction in pathogen and virulence factors compared to a control dressing. As a result of clearance of virulence factors from the wound bed, a requisite alteration in host innate immune response was observed. PMID:25525484

  4. Identification of a hydroxy substituted calamenene--a sesquiterpene associated with wound reactions in non-infected xylem of Tilia spp.

    PubMed

    Melcher, Eckhard; Jüngel, Peter; Möllendorf, Bianca; Schmitt, Uwe

    2003-03-01

    Xylem of lime trees (Tilia spp.) with wound reactions was structurally investigated by scanning (SEM) and transmission electron microscopy (TEM) as well as chemically analyzed by direct thermal desorption-gas chromatography-mass spectrometry (DTD-GC-MS). Wound reactions in the outer xylem lead to distinct discolorations around the wound. Within a 4-week response no fungal infection occurred in discoloured xylem. At the fine structural level, wound reactions become primarily visible as the secretion of dark-staining substances from parenchyma cells into lumens of vessels and fibres. With increasing reaction time vessels aggregate large amounts of secretion products, whereas in fibres wall-associated linings are formed and the inner secondary wall appears incrusted. After 2-3 months a narrow, greenish-brown boundary developed at the transition between the discoloured outer and the unchanged inner xylem. This green-brown boundary layer remained non-infected also in older wounds. DTD-GC-MS analyses revealed that the sesquiterpene Hydroxycalamenene represents a key substance of wound reactions in non-infected lime trees. Other substances such as fatty acids or their esters and coniferyl aldehydes or their derivatives were also found. TEM investigations of the samples after DTD-GC-MS showed less pronounced cell wall-attached linings in fibres as well as reduced incrustation of inner secondary walls. The massive deposits in the vessel lumens remained unchanged. The role of these wound reaction products and their ways of synthesis are discussed. PMID:12620322

  5. The Role of Antibiotic Prophylaxis in Prevention of Wound Infection After Lichtenstein Open Mesh Repair of Primary Inguinal Hernia

    PubMed Central

    Aufenacker, Theo J.; van Geldere, Dirk; van Mesdag, Taco; Bossers, Astrid N.; Dekker, Benno; Scheijde, Edo; van Nieuwenhuizen, Roos; Hiemstra, Esther; Maduro, John H.; Juttmann, Jan-Willem; Hofstede, Diederik; van Der Linden, Cunera T. M.; Gouma, Dirk J.; Simons, Maarten P.

    2004-01-01

    Objective: To determine whether the use of prophylactic antibiotics is effective in the prevention of postoperative wound infection after Lichtenstein open mesh inguinal hernia repair. Summary Background Data: A recent Cochrane meta-analysis (2003) concluded that “antibiotic prophylaxis for elective inguinal hernia repair cannot be firmly recommended or discarded.” Methods: Patients with a primary inguinal hernia scheduled for Lichtenstein repair were randomized to a preoperative single dose of 1.5 g intravenous cephalosporin or a placebo. Patients with recurrent hernias, immunosuppressive diseases, or allergies for the given antibiotic were excluded. Infection was defined using the Centers for Disease Control and Prevention criteria. Results: We included 1040 patients in the study between November 1998 and May 2003. According to the intention-to-treat principle, 1008 patients were analyzed. There were 8 infections (1.6%) in the antibiotic prophylaxis group and 9 (1.8%) in the placebo group (P = 0.82). There was 1 deep infection in the antibiotic prophylaxis group and 2 in the placebo group (P = 0.57). Statistical analysis showed an absolute risk reduction of 0.19% (95% confidence interval, ?1.78%–1.40%) and a number needed to treat of 520 for the total number of infections. For deep infection, the absolute risk reduction is 0.20% (95% confidence interval, ?0.87%–0.48%) with a number needed to treat of 508. Conclusions: A low percentage (1.7%) of wound infection after Lichtenstein open mesh inguinal (primary) hernia repair was found, and there was no difference between the antibiotic prophylaxis or placebo group. The results show that, in Lichtenstein inguinal primary hernia repair, antibiotic prophylaxis is not indicated in low-risk patients. PMID:15570201

  6. Severe Wound Infection with Photobacterium damselae ssp. damselae and Vibrio harveyi, following a Laceration Injury in Marine Environment: A Case Report and Review of the Literature

    PubMed Central

    Hundenborn, Jörg; Thurig, Steffi

    2013-01-01

    Marine microorganisms are uncommon etiologies of skin and skin structure infections, that is, wound infections. We report a case of severe wound infection, caused by the marine Photobacterium damselae (Vibrionaceae), in a 64-year-old male patient, returning from Australia. The isolate tested positive for pPHDD1, a plasmid conferring high-level virulence. Furthermore, the wound was coinfected with Vibrio harveyi, a halophile bacterium, which has never been reported from human infections before. Identification was achieved by use of Matrix-Assisted Laser Desorption-Ionization Time of Flight Mass Spectrometry (MALDI-TOF) and confirmed by 16S rDNA sequencing. Data retrieval from bibliography was complicated since P. damselae has been renamed often with a number of synonyms present in the literature: Photobacterium damsela, Vibrio damselae, Vibrio damsela, Pasteurella damselae, and Listonella damsela. With all synonyms used as query terms, a literature search provided less than 20 cases published worldwide. A majority of those cases presenting as severe wound infection are even fatal following progression into necrotizing fasciitis. Management with daily wound dressing and antibiotic therapy (ofloxacin empirically, followed by doxycycline after availability of microbiology) led in the reported case to a favorable outcome, which seems to be, however, the exception based on a review of the available literature. PMID:24171004

  7. Nip it in the bud. Controlling wound infection with preoperative shaving.

    PubMed

    Kovach, T

    1990-09-01

    1. Postoperative wound sepsis can double the normal patient hospital stay and significantly add to the cost of hospitalization. Close skin shaving prior to surgery (especially if done the night prior to surgery) is a contributing factor to postoperative wound sepsis rates. 2. This problem can be managed by selecting a preoperative shaving technique that rids the skin surface of hair, soils, and microorganisms, but still leaves the epidermal layer intact as a natural barrier against opportunistic microorganisms. 3. Hair removal at the surgical site is not the cause of postoperative wound sepsis. Preoperative techniques that remove hair shafts and not epidermal layers are important in managing this problem in the operating room. PMID:2219242

  8. Study of photodynamic therapy in the control of isolated microorganisms from infected wounds--an in vitro study.

    PubMed

    Pereira de Lima Carvalho, Denise; Guerra Pinto, Juliana; Di Paula Costa Sorge, Camila; Rodrigues Benedito, Fabiana Regis; Khouri, Sonia; Ferreira Strixino, Juliana

    2014-01-01

    The effective treatment of infected wounds continues to be a serious challenge, mainly due to the rise of antibiotic-resistant bacteria. Photodynamic therapy (PDT) refers to the topical or systemic administration of a non-toxic, photosensitizing agent (PS), followed by irradiation with visible light of a suitable wavelength. The possibility of applying the PDT locally is what makes it so favorable to the treatment of infected wounds. The goal of this study was to evaluate the action of the PDT in the inactivation in vitro of microorganisms coming from infected wounds, using methylene blue (MB) and photodithazine (PDZ) as the PS and comparing the efficacy of these two compounds for PDT on bacteria. For the application of PDT, isolated microorganisms identified from material collected from wounds were suspended in a saline solution containing 10(6) viable cells/ml. Each isolated microorganism was submitted to PDT with MB and with PDZ in accordance with the following treatment groups: N/T--no treatment; T1--PDT with PDZ; T2--PDT with MB; T3--irradiation without PS; T4--treatment with PDZ without light; and T5--treatment with MB without light. As a light source, an LED-based device was used (Biopdi/Irrad-Lead 660), composed of 54 LEDs, each with 70 mW of power in the 660 nm region of the electromagnetic spectrum. Each tray of 96 wells was irradiated with an intensity of 25 mW/cm(2) and a dose of light of 50 J/cm(3) for 33 min. All the tests were made in duplicate. It was then concluded that the PDT with PDZ was capable of inhibiting the growth of gram-positive bacteria samples, however it did not have the same effect on gram-negative bacteria, which showed growth greater than 100,000 CFU; the PDT with MB showed an effectiveness on gram-positive as well as gram-negative bacteria, for it was able to inhibit bacterial growth in both cases. PMID:23455656

  9. Preliminary in vitro evaluation of an adjunctive therapy for extremity wound infection reduction: rapidly resorbing local antibiotic delivery.

    PubMed

    Jackson, Stephanie R; Richelsoph, Kelly C; Courtney, Harry S; Wenke, Joseph C; Branstetter, Joanna G; Bumgardner, Joel D; Haggard, Warren O

    2009-07-01

    Despite the continuing advances in treatment of open fractures and musculoskeletal wounds, infection remains a serious complication. Current treatments to prevent infection utilize surgical debridement and irrigation, and high doses of systemic antimicrobial therapy. The aim of this work was to evaluate, in vitro, the potential of a fast-resorbing calcium sulfate pellet loaded with an antibiotic. The pellet could be used as an adjunctive therapy at the time of debridement and irrigation to reduce bacterial wound contamination. Small pellets containing a binder and calcium sulfate were engineered to resorb rapidly (within 24 h) and deliver high local doses of antibiotic (amikacin, gentamicin, or vancomycin) to the wound site while minimizing systemic effects. Results from dissolution, elution, and biological activity tests against P. aeruginosa and S. aureus were used to compare the performance of antibiotic-loaded, rapidly resorbing calcium sulfate pellets to antibiotic-loaded crushed conventional calcium sulfate pellets. Antibiotic-loaded rapidly resorbing pellets dissolved in vitro in deionized water in 12-16 h and released therapeutic antibiotic levels in phosphate buffered saline that were above the minimal inhibitory concentration for P. aeruginosa and S. aureus, completely inhibiting the growth of these bacteria for the life of the pellet. Crushed conventional calcium sulfate pellets dissolved over 4-6 days, but the eluates only contained sufficient antibiotic to inhibit growth for the first 4 h. These data indicate that fast-resorbing pellets can release antibiotics rapidly and at therapeutic levels. Adjunctive therapy with fast-acting pellets is promising and warrants further in vivo studies. PMID:19105225

  10. In Vivo Bioluminescence Imaging To Evaluate Systemic and Topical Antibiotics against Community-Acquired Methicillin-Resistant Staphylococcus aureus-Infected Skin Wounds in Mice

    PubMed Central

    Guo, Yi; Ramos, Romela Irene; Cho, John S.; Donegan, Niles P.; Cheung, Ambrose L.

    2013-01-01

    Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) frequently causes skin and soft tissue infections, including impetigo, cellulitis, folliculitis, and infected wounds and ulcers. Uncomplicated CA-MRSA skin infections are typically managed in an outpatient setting with oral and topical antibiotics and/or incision and drainage, whereas complicated skin infections often require hospitalization, intravenous antibiotics, and sometimes surgery. The aim of this study was to develop a mouse model of CA-MRSA wound infection to compare the efficacy of commonly used systemic and topical antibiotics. A bioluminescent USA300 CA-MRSA strain was inoculated into full-thickness scalpel wounds on the backs of mice and digital photography/image analysis and in vivo bioluminescence imaging were used to measure wound healing and the bacterial burden. Subcutaneous vancomycin, daptomycin, and linezolid similarly reduced the lesion sizes and bacterial burden. Oral linezolid, clindamycin, and doxycycline all decreased the lesion sizes and bacterial burden. Oral trimethoprim-sulfamethoxazole decreased the bacterial burden but did not decrease the lesion size. Topical mupirocin and retapamulin ointments both reduced the bacterial burden. However, the petrolatum vehicle ointment for retapamulin, but not the polyethylene glycol vehicle ointment for mupirocin, promoted wound healing and initially increased the bacterial burden. Finally, in type 2 diabetic mice, subcutaneous linezolid and daptomycin had the most rapid therapeutic effect compared with vancomycin. Taken together, this mouse model of CA-MRSA wound infection, which utilizes in vivo bioluminescence imaging to monitor the bacterial burden, represents an alternative method to evaluate the preclinical in vivo efficacy of systemic and topical antimicrobial agents. PMID:23208713

  11. In vivo bioluminescence imaging to evaluate systemic and topical antibiotics against community-acquired methicillin-resistant Staphylococcus aureus-infected skin wounds in mice.

    PubMed

    Guo, Yi; Ramos, Romela Irene; Cho, John S; Donegan, Niles P; Cheung, Ambrose L; Miller, Lloyd S

    2013-02-01

    Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) frequently causes skin and soft tissue infections, including impetigo, cellulitis, folliculitis, and infected wounds and ulcers. Uncomplicated CA-MRSA skin infections are typically managed in an outpatient setting with oral and topical antibiotics and/or incision and drainage, whereas complicated skin infections often require hospitalization, intravenous antibiotics, and sometimes surgery. The aim of this study was to develop a mouse model of CA-MRSA wound infection to compare the efficacy of commonly used systemic and topical antibiotics. A bioluminescent USA300 CA-MRSA strain was inoculated into full-thickness scalpel wounds on the backs of mice and digital photography/image analysis and in vivo bioluminescence imaging were used to measure wound healing and the bacterial burden. Subcutaneous vancomycin, daptomycin, and linezolid similarly reduced the lesion sizes and bacterial burden. Oral linezolid, clindamycin, and doxycycline all decreased the lesion sizes and bacterial burden. Oral trimethoprim-sulfamethoxazole decreased the bacterial burden but did not decrease the lesion size. Topical mupirocin and retapamulin ointments both reduced the bacterial burden. However, the petrolatum vehicle ointment for retapamulin, but not the polyethylene glycol vehicle ointment for mupirocin, promoted wound healing and initially increased the bacterial burden. Finally, in type 2 diabetic mice, subcutaneous linezolid and daptomycin had the most rapid therapeutic effect compared with vancomycin. Taken together, this mouse model of CA-MRSA wound infection, which utilizes in vivo bioluminescence imaging to monitor the bacterial burden, represents an alternative method to evaluate the preclinical in vivo efficacy of systemic and topical antimicrobial agents. PMID:23208713

  12. Wound infections in day-case hand surgery: a prospective study.

    PubMed Central

    Hashemi, Kambiz; Blakeley, Christopher J.

    2004-01-01

    BACKGROUND: There is little published information about postoperative infection rates in day-case hand surgery and the possible factors promoting infection. RESULTS: We report on infection rates observed in day-case hand surgery of 1035 cases over a 2-year period performed by two consultant surgeons. Infection rates of just over 1% were observed. CONCLUSION: We believe that this low infection rate reflects seniority of surgeon, operative technique and short duration of operation. PMID:15527586

  13. Minor amputation and palliative wound care as a strategy to avoid major amputation in patients with foot infections and severe peripheral arterial disease.

    PubMed

    Barshes, Neal R; Gold, Benjamin; Garcia, Aimee; Bechara, Carlos F; Pisimisis, George; Kougias, Panos

    2014-09-01

    Foot infections occurring in patients with severe peripheral arterial disease (PAD) who are not considered candidates for revascularization and limb salvage efforts are generally treated with major amputations. Herein we describe our early experiences in managing foot infections with minor amputations and palliative wound care as a strategy to avoid the functional disability often associated with major amputations. Patients with severe PAD that underwent minor amputations and subsequent palliative wound care for moderate/severe infections were paired with age-matched controls with PAD that underwent primary major amputations for foot infections. Eleven patients who underwent minor amputations and palliative wound care of 13 limbs were compared to an age-matched cohort of 12 patients undergoing 13 major amputations.The median age was 80 years in both groups. Survival at 1 and 2 years did not differ significantly between groups. All patients who were ambulatory and/or independently living remained so following palliative management; in contrast, major amputation changed ambulatory status in 75% of patients and independent living status in 50%. Palliative management did not result in ascending/systemic sepsis or progressive necrosis. The need for reoperations was uncommon in both groups. In summary, minor amputations and operative drainage with subsequent palliative wound care appears to be a safe management option in patients with severe PAD and moderate or severe foot infections that are not candidates for revascularization. Palliative management may result in less functional impairment than major amputation. PMID:25049375

  14. Unusual development of granulomas on the healing surface of burn wounds associated with MRSA infections

    Microsoft Academic Search

    R. K. Gang; J. Bajec; J. Krishna; S. C. Sanyal

    1996-01-01

    Ten patients with a mean age of 14.5 years and partial skin thickness burns involving 3–5 per cent body surface areas developed rapidly proliferating tumour-like growths on the surface of their healing wounds within 10–21 days of sustaining the injuries. The number of tumours on every patient was either single or multiple and each increased in size daily. The growths

  15. Novel biodegradable sandwich-structured nanofibrous drug-eluting membranes for repair of infected wounds: an in vitro and in vivo study

    PubMed Central

    Chen, Dave Wei-Chih; Liao, Jun-Yi; Liu, Shih-Jung; Chan, Err-Cheng

    2012-01-01

    Background The purpose of this study was to develop novel sandwich-structured nanofibrous membranes to provide sustained-release delivery of vancomycin, gentamicin, and lidocaine for repair of infected wounds. Methods To prepare the biodegradable membranes, poly(D, L)-lactide-co-glycolide (PLGA), collagen, and various pharmaceuticals, including vancomycin, gentamicin, and lidocaine, were first dissolved in 1,1,1,3,3,3-hexafluoro-2-propanol. They were electrospun into sandwich-structured membranes with PLGA/collagen as the surface layers and PLGA/drugs as the core. An elution method and a high-pressure liquid chromatography assay were used to characterize in vivo and in vitro drug release from the membranes. In addition, repair of infected wounds in rats was studied. Histological examination of epithelialization and granulation at the wound site was also performed. Results The biodegradable nanofibrous membranes released large amounts of vancomycin and gentamicin (well above the minimum inhibition concentration) and lidocaine in vivo for more than 3 weeks. A bacterial inhibition test was carried out to determine the relative activity of the antibiotics released. The bioactivity ranged from 40% to 100%. The nanofibrous membranes were functionally active in treating infected wounds, and were very effective as accelerators in early-stage wound healing. Conclusion Using the electrospinning technique, we will be able to manufacture biodegradable, biomimetic, nanofibrous, extracellular membranes for long-term delivery of various drugs. PMID:22359454

  16. Antimicrobial susceptibility pattern of bacterial isolates from wound infection and their sensitivity to alternative topical agents at Jimma University Specialized Hospital, South-West Ethiopia

    PubMed Central

    2014-01-01

    Background Wound infection is one of the health problems that are caused and aggravated by the invasion of pathogenic organisms. Information on local pathogens and sensitivity to antimicrobial agents, and topical agents like acetic acid is crucial for successful treatment of wounds. Objectives To determine antimicrobial susceptibility pattern of bacterial isolates from wound infection and their sensitivity to alternative topical agents at Jimma University Specialized Hospital. Methods A cross sectional study was conducted among patients with wound infection visiting Jimma University Specialized Hospital, from May to September 2013. Wound swab was collected using sterile cotton swabs and processed for bacterial isolation and susceptibility testing to antimicrobial agents, acetic acid, hydrogen peroxide and dabkin solution following standard bacteriological techniques. Biochemical tests were done to identify the species of the organisms. Sensitivity testing was done using Kirby- Baur disk diffusion method. Minimum inhibitory and bactericidal concentration was done using tube dilution method. Results In this study 145 bacterial isolates were recovered from 150 specimens showing an isolation rate of 87.3%. The predominant bacteria isolated from the infected wounds were Staphylococcus aureus 47 (32.4%) followed by Escherichia coli 29 (20%), Proteus species 23 (16%), Coagulase negative Staphylococci 21 (14.5%), Klebsiella pneumoniae 14 (10%) and Pseudomonas aeruginosa 11 (8%). All isolates showed high frequency of resistance to ampicillin, penicillin, cephalothin and tetracycline. The overall multiple drug resistance patterns were found to be 85%. Acetic acid (0.5%), Dabkin solution (1%) and 3% hydrogen peroxide were bactericidal to all isolated bacteria and lethal effect observed when applied for 10 minutes. Conclusions On in vitro sensitivity testing, ampicillin, penicillin, cephalothin and tetracycline were the least effective. Gentamicin, norfloxacin, ciprofloxacin, vancomycin and amikacin were the most effective antibiotics. Acetic acid (0.5%), dabkin solution (1%) and H2O2 (3%) were bactericidal to all isolates. PMID:24731394

  17. Biofilm in wound care.

    PubMed

    Rajpaul, Kumal

    2015-03-01

    A biofilm can be described as a microbial colony encased in a polysaccharide matrix which can become attached to a wound surface. This can affect the healing potential of chronic wounds due to the production of destructive enzymes and toxins which can promote a chronic inflammatory state within the wound. Biofilms can be polymicrobial and can result in delayed wound healing and chronic wound infection resistant to antibiotics, leading to prolonged hospitalisation for some patients. There appears to be a correlation between biofilms and non-healing in chronic wounds. It is suggested that biofilms are a major player in the chronicity of wounds. They are a complex concept to diagnose and management needs to be multifactorial. PMID:25757387

  18. Intervention for Postpartum Infections Following Caesarean Section

    ClinicalTrials.gov

    2014-10-15

    Surgical Wound Infection; Infection; Cesarean Section; Cesarean Section; Dehiscence; Complications; Cesarean Section; Complications; Cesarean Section, Wound, Dehiscence; Wound; Rupture, Surgery, Cesarean Section

  19. One year ago not business as usual: Wound management, infection and psychoemotional control during tertiary medical care following the 2004 Tsunami disaster in southeast Asia

    Microsoft Academic Search

    Marc Maegele; Sven Gregor; Nedim Yuecel; Christian Simanski; Thomas Paffrath; Dieter Rixen; Markus M Heiss; Claudia Rudroff; Stefan Saad; Walter Perbix; Frank Wappler; Andreas Harzheim; Rosemarie Schwarz; Bertil Bouillon

    2006-01-01

    INTRODUCTION: Following the 2004 tsunami disaster in southeast Asia severely injured tourists were repatriated via airlift to Germany. One cohort was triaged to the Cologne-Merheim Medical Center (Germany) for further medical care. We report on the tertiary medical care provided to this cohort of patients. METHODS: This study is an observational report on complex wound management, infection and psychoemotional control

  20. Septic diseases associated with the hoof complex: abscesses, punctures wounds, and infection of the lateral cartilage.

    PubMed

    Redding, W Rich; O'Grady, Stephen E

    2012-08-01

    Hoof abscesses are probably the most common cause of acute severe lameness in horses encountered by veterinarians and farriers. Most affected horses show sudden, severe (acute) lameness; the degree of lameness varies from being subtle in the early stages to non-weight bearing. There is still debate between the veterinary and farrier professions as to who should treat a hoof abscess and the best method to resolve the abscess. Puncture wounds to the sole of the foot can introduce bacteria and debris to the solar surface of the distal phalanx and produce a fracture or a septic pedal osteitis. PMID:22981199

  1. Staphylococcus intermedius in canine gingiva and canine-inflicted human wound infections: laboratory characterization of a newly recognized zoonotic pathogen.

    PubMed Central

    Talan, D A; Staatz, D; Staatz, A; Goldstein, E J; Singer, K; Overturf, G D

    1989-01-01

    Staphylococcal gingival flora was characterized in cultures from 135 dogs. Staphylococcus intermedius was isolated in 39% of the cultures, S. aureus was isolated in 10%, and both were isolated in 2.0%. S. aureus was isolated more often from dogs of working breeds with weights of greater than 40 lb (ca. 18 kg) and with outdoor habitats than was S. intermedius, which was associated with dogs of nonworking breeds with weights of less than 40 lb and indoor habitats. S. intermedius was distinguished from S. aureus by the following characteristics: coagulation of rabbit plasma at 4 h (26 versus 100%, respectively), hemolysis of sheep blood at 24 h (30 versus 79%, respectively), and mannitol fermentation at 24 h (4 versus 93%, respectively). A clear separation of the two species was apparent only with the acetoin (modified Voges-Proskauer) reaction (100% of the S. aureus isolates versus 0% of the S. intermedius isolates) and beta-galactosidase activity on the API Staph-Ident strip (0% of the S. aureus isolates and 100% of the S. intermedius isolates). Susceptibilities of S. intermedius and S. aureus were 72 and 7%, respectively, to penicillin G, and 100% of both species to oxacillin. Fourteen previously collected strains of coagulase-positive staphylococci from infected canine-inflicted human wounds were reanalyzed; 3 of 14 (21%) isolates were S. intermedius. We conclude that S. intermedius is a common canine gingival flora and is responsible for some canine-inflicted human wound infections, thus representing a newly recognized zoonotic pathogen. PMID:2913039

  2. Protective efficacy of Pseudomonas aeruginosa type-A flagellin in the murine burn wound model of infection.

    PubMed

    Faezi, Sobhan; Safarloo, Maryam; Amirmozafari, Nour; Nikokar, Iraj; Siadat, Seyed Davar; Holder, Ian Alan; Mahdavi, Mehdi

    2014-02-01

    The main goal of this study was to develop a vaccination strategy that would enhance the protective response against the recombinant type A flagellin (r-fla-A) of Pseudomonas aeruginosa in the burn wound sepsis model. Inbred mice were immunized with r-fla-A with or without alum adjuvant. The vaccinated mice were burned and challenged with P. aeruginosa. To evaluate the type of induced immune response, sera were analyzed by ELISA for total IgG, IgG1, and IgG2a isotypes. To determine the functional activity of anti r-fla IgG, opsonophagocytic killing and motility inhibition assay was performed. In vivo administration of r-fla-A afforded a remarkable improvement in survival of mice (83.3%) challenged with homologous strain (PAK) in the burn wound infection. The antibodies generated against the r-fla-A achieved 25% survival in immunized mice that had been infected with heterologous strain PAO1. Flagellin also induced high level humoral immune response via high titers of serum IgG1 in the burn and challenged mice. Anti r-fla-A antibody promoted phagocytosis of the PAK strain, and the number of viable bacterial cells decreased over 53.1%; In contrast, low opsonophagocytic killing activity (17.4%) was observed when the antiserum to r-fla-A was treated with the PAO1 strain. The anti r-fla-A antisera was able to inhibit the motility of the homologous strains; however, they did not inhibit the heterologous strains. We concluded that active immunization with recombinant type A-flagellin could protect burn mice against lethal P. aeruginosa challenge via immobilization of the pathogen which promoted the phagocytic activity. PMID:23758581

  3. Gene encoding polygalacturonase inhibitor in apple fruit is developmentally regulated and activated by wounding and fungal infection.

    PubMed

    Yao, C; Conway, W S; Ren, R; Smith, D; Ross, G S; Sams, C E

    1999-04-01

    A cDNA encoding polygalacturonase-inhibiting protein (PGIP) from mature apple fruit has been cloned and characterized. The open reading frame encodes a polypeptide of 330 amino acids, in which 24 amino acids at the N-terminus comprise the signal peptide. Apple PGIP contains 10 imperfect leucine-rich repeat sequence motifs averaging 24 amino acids in length. In addition to the 1.3 kb PGIP transcript, the cloned cDNA also hybridized to RNA molecules with sizes of 3.2 and 5.0 kb. Genomic DNA analysis revealed that the apple PGIP probably belongs to a small family of genes. PGIP transcript levels varied in fruit collected at different maturities, suggesting the gene is developmentally regulated. Very high PGIP transcript levels were detected in decayed areas and the tissue adjacent to the inoculation sites of Penicillium expansum and Botrytis cinerea. However, no increase in the amount of PGIP transcript in tissue distant from the decayed region was observed. Wounding on fruit also induced PGIP gene expression but to a much lessser extent when compared with decayed areas. After storage at 0 degrees C for 1 month, the abundance of PGIP transcript in ripe fruit was substantially increased. The PGIP gene in immature and ripe fruit was rapidly up-regulated by fungal infections, while in stored fruit the induction was very limited and concurred with an increase of fruit susceptibility to fungal colonization. Since PGIP gene expression is regulated by fruit development and responds to wounding, fungal infection and cold storage, these observations suggest that apple PGIP may have multiple roles during fruit development and stress response. PMID:10380809

  4. Are Quantitative Bacterial Wound Cultures Useful?

    PubMed Central

    2014-01-01

    Determining if a nonhealing wound is infected can be difficult. The surface of a wound is not sterile and can be colonized with numerous commensal, environmental, and potentially pathogenic microorganisms. Different types of wounds have various clinical presentations, with some signs and symptoms more likely to be present than others depending on the type and location of the wound. Clinicians often order microbiology wound cultures to assist in determining if a nonhealing wound is infected. This minireview briefly summarizes the clinical microbiology of wound cultures, with an emphasis on the history and utility (or lack thereof) of the quantitative wound culture. PMID:24648547

  5. Notes from the field: rapidly growing nontuberculous Mycobacterium wound infections among medical tourists undergoing cosmetic surgeries in the Dominican Republic--multiple states, March 2013-February 2014.

    PubMed

    Schnabel, David; Gaines, Joanna; Nguyen, Duc B; Esposito, Douglas H; Ridpath, Alison; Yacisin, Kari; Poy, Joe A; Mullins, Jocelyn; Burns, Rachel; Lijewski, Virginia; McElroy, Nora P; Ahmad, Nina; Harrison, Cassandra; Parinelli, Ellen J; Beaudoin, Amanda L; Posivak-Khouly, Leah; Pritchard, Scott; Jensen, Bette J; Toney, Nadege C; Moulton-Meissner, Heather A; Nyangoma, Edith N; Barry, Anita M; Feldman, Katherine A; Blythe, David; Perz, Joseph F; Morgan, Oliver W; Kozarsky, Phyllis; Brunette, Gary W; Sotir, Mark

    2014-03-01

    In August 2013, the Maryland Department of Health and Mental Hygiene (MDHMH) was notified of two persons with rapidly growing nontuberculous mycobacterial (RG-NTM) surgical-site infections. Both patients had undergone surgical procedures as medical tourists at the same private surgical clinic (clinic A) in the Dominican Republic the previous month. Within 7 days of returning to the United States, both sought care for symptoms that included surgical wound abscesses, clear fluid drainage, pain, and fever. Initial antibiotic therapy was ineffective. Material collected from both patients' wounds grew Mycobacterium abscessus exhibiting a high degree of antibiotic resistance characteristic of this organism. PMID:24598597

  6. The vacuum-assisted closure system for the treatment of deep sternal wound infections after cardiac surgery

    Microsoft Academic Search

    Tatjana M Fleck; Michael Fleck; Reinhard Moidl; Martin Czerny; Rupert Koller; Pietro Giovanoli; Michael J Hiesmayer; Daniel Zimpfer; Ernst Wolner; Martin Grabenwoger

    2002-01-01

    BackgroundThe VAC system (vacuum-assisted wound closure) is a noninvasive active therapy to promote healing in difficult wounds that fail to respond to established treatment modalities. The system is based on the application of negative pressure by controlled suction to the wound surface. The method was introduced into clinical practice in 1996. Since then, numerous studies proved the effectiveness of the

  7. Prevention of bloodstream infections by photodynamic inactivation of multiresistant Pseudomonas aeruginosa in burn wounds

    NASA Astrophysics Data System (ADS)

    Hashimoto, M. C. E.; Prates, R. A.; Toffoli, D. J.; Courrol, L. C.; Ribeiro, M. S.

    2010-02-01

    Bloodstream infections are potentially life-threatening diseases. They can cause serious secondary infections, and may result in endocarditis, severe sepsis or toxic-shock syndrome. Pseudomonas aeruginosa is an opportunistic pathogen and one of the most important etiological factors responsible for nosocomial infections, mainly in immuno-compromissed hosts, characteristic of patients with severe burns. Its multiresistance to antibiotics produces many therapeutic problems, and for this reason, the development of an alternative method to antibiotic therapy is needed. Photodynamic inactivation (PDI) may be an effective and alternative therapeutic option to prevent bloodstream infections in patients with severe burns. In this study we report the use of PDI to prevent bloodstream infections in mice with third-degree burns. Burns were produced on the back of the animals and they were infected with 109 cfu/mL of multi-resistant (MR) P. aeruginosa. Fifteen animals were divided into 3 groups: control, PDT blue and PDT red. PDT was performed thirty minutes after bacterial inoculation using 10?M HB:La+3 and a light-emitting diode (LED) emitting at ?=460nm+/-20nm and a LED emitting at ?=645 nm+/-10nm for 120s. Blood of mice were colected at 7h, 10h, 15h, 18h and 22h pos-infection (p.i.) for bacterial counting. Control group presented 1×104 cfu/mL in bloodstream at 7h p.i. increasing to 1×106 at 22h, while mice PDT-treated did not present any bacteria at 7h; only at 22h p.i. they presented 1×104cfu/mL. These results suggest that HB:La+3 associated to blue LED or red LED is effective to delay and diminish MR P.aeruginosa bloodstream invasion in third-degree-burned mice.

  8. Therapeutic Efficacy of Halocidin-Derived Peptide HG1 in a Mouse Model of Surgical Wound Infection with Methicillin-Resistant Staphylococcus aureus?

    PubMed Central

    Lee, Young Shin; Shin, Yong Pyo; Shin, Seo Hwa; Park, Seungmi; Kim, Myung Hwa; Lee, In Hee

    2011-01-01

    We evaluated the therapeutic potential of HG1, an antimicrobial peptide, as a novel topical antibiotic by the use of a mouse surgical wound model of infection with methicillin-resistant Staphylococcus aureus. First, we attempted to determine whether or not HG1 infiltrated into the dermis when topically administered. Second, we evaluated the antibiotic effects of HG1 on skin infection via bacterial-enumeration and microscopic analyses. The results showed that topically administered HG1 was capable of penetrating into the dermis at the infection site, where it exerted its antimicrobial effects. PMID:21220538

  9. Resolution of concomitant Achromobacter xylosoxidans burn wound infection without adjustment of antimicrobial therapy.

    PubMed

    Ng, Zhi Yang; Fang, George; Leo, Kah Woon

    2014-01-01

    Achromobacter xylosoxidans is part of an emerging group of Gram negative bacterial infections with potentially severe sequelae, especially in the immunocompromised population such as burn patients. While antimicrobial therapy for patients with A. xylosoxidans bacteremia has been reported, the literature is scarce with regard to treatment in patients with positive tissue cultures only. Herein, we report our institution's experience with such a case and a brief review of the current literature on this micro-organism in the setting of non-bacteremic infection. PMID:24987220

  10. Wound infection caused by Lichtheimia ramosa due to a car accident

    PubMed Central

    Bibashi, Evangelia; de Hoog, G. Sybren; Pavlidis, Theodoros E.; Symeonidis, Nikolaos; Sakantamis, Athanasios; Walther, Grit

    2012-01-01

    A 32-year-old immunocompetent man sustained severe traumas contaminated with organic material due to a car accident. An infection caused by Lichtheimia ramosa at the site of contamination was early diagnosed and cured by multiple surgical debridement and daily cleansing with antiseptic solution only. PMID:24432204

  11. Role of Motility and Flagellin Glycosylation in the Pathogenesis of Pseudomonas aeruginosa Burn Wound Infections

    Microsoft Academic Search

    Shiwani K. Arora; Alice N. Neely; Barbara Blair; Stephen Lory; Reuben Ramphal

    2005-01-01

    In this study, we tested the contribution of flagellar motility, flagellin structure, and its glycosylation in Pseudomonas aeruginosa using genetically defined flagellar mutants. All mutants and their parent strains were tested in a burned-mouse model of infection. Motility and glycosylation of the flagellum appear to be important determinants of flagellar-mediated virulence in this model. This is the first report where

  12. IB-367 pre-treatment improves the in vivo efficacy of teicoplanin and daptomycin in an animal model of wounds infected with meticillin-resistant Staphylococcus aureus.

    PubMed

    Cirioni, Oscar; Silvestri, Carmela; Pierpaoli, Elisa; Barucca, Alessandra; Kamysz, Wojciech; Ghiselli, Roberto; Scalise, Alessandro; Brescini, Lucia; Castelli, Pamela; Orlando, Fiorenza; Kamysz, Elzbieta; Guerrieri, Mario; Giacometti, Andrea; Provinciali, Mauro

    2013-10-01

    Antimicrobial peptides are known as immunomodulators and antibiotic enhancers. We report that administration of an antimicrobial peptide, IB-367, was efficacious in increasing the antimicrobial activity of daptomycin and teicoplanin in a mouse model of wound infection caused by meticillin-resistant Staphylococcus aureus (MRSA). Mice were assigned to seven groups: an IB-367 pre-treated group with no antibiotics given after challenge, two IB-367 pre-treated groups plus daptomycin or teicoplanin given after challenge, two groups treated with daptomycin or teicoplanin only after challenge, and two control groups without infection or that did not receive any treatment. The main outcome measures were quantitative bacterial culture and analysis of natural killer (NK) cytotoxicity and leukocyte phenotype. The wound, established through the panniculus carnosus muscle of mice, was infected by MRSA. Bacterial cultures of mice receiving antibiotics alone showed a -2 log decrease, whilst those for IB-367 plus daptomycin or teicoplanin showed a -4 log decrease. IB-367 plus daptomycin showed the highest efficacy. The higher antimicrobial effect exerted by IB-367 was associated with increased levels of NK cytotoxicity but not of NK cell number. IB-367 increased the number of both CD11b and Gr-1 cells 3 days after MRSA challenge, whereas both of these leukocyte populations were reduced at 10 days after challenge. Our data suggest that a combination of IB-367 with antibiotic exerts a therapeutic effect and may be useful for the management of staphylococcal wounds. PMID:23813277

  13. Vitamin E improves the in vivo efficacy of tigecycline and daptomycin in an animal model of wounds infected with meticillin-resistant Staphylococcus aureus.

    PubMed

    Provinciali, Mauro; Cirioni, Oscar; Orlando, Fiorenza; Pierpaoli, Elisa; Barucca, Alessandra; Silvestri, Carmela; Ghiselli, Roberto; Scalise, Alessandro; Brescini, Lucia; Guerrieri, Mario; Giacometti, Andrea

    2011-12-01

    A relevant bacterial load in cutaneous wounds significantly interferes with the normal process of healing. Vitamin E (VE) is a known immunomodulator and immune enhancer. Here, it was shown that administration of VE before infection was effective at increasing the antimicrobial activity of daptomycin (DAP) or tigecycline (TIG) in a mouse model of wound infection caused by meticillin-resistant Staphylococcus aureus (MRSA). A wound was established through the panniculus carnosus of mice and inoculated with MRSA. Mice were assigned to six groups: a VE pre-treated group with no antibiotics given after MRSA challenge; two VE pre-treated groups with DAP or TIG given after MRSA challenge; two groups treated with DAP or TIG only after MRSA challenge; and a control group that did not receive any treatment. Mice receiving each antibiotic alone showed a 3 log decrease in the number of c.f.u. recovered compared with the control group, mice treated with VE plus TIG had a 4 log decrease, whilst mice treated with VE plus DAP had the largest decrease in c.f.u. recovered (5 logs). The increased antimicrobial effect seen from treatment with VE plus antibiotics was associated with increased levels of natural killer cell cytotoxicity, with a more pronounced increase in leukocyte populations in mice treated with VE plus DAP. These data suggest that treatment with VE prior to infection and subsequent antibiotic treatment act in synergy. PMID:21835971

  14. Wound Microbiology and Associated Approaches to Wound Management

    PubMed Central

    Bowler, P. G.; Duerden, B. I.; Armstrong, D. G.

    2001-01-01

    The majority of dermal wounds are colonized with aerobic and anaerobic microorganisms that originate predominantly from mucosal surfaces such as those of the oral cavity and gut. The role and significance of microorganisms in wound healing has been debated for many years. While some experts consider the microbial density to be critical in predicting wound healing and infection, others consider the types of microorganisms to be of greater importance. However, these and other factors such as microbial synergy, the host immune response, and the quality of tissue must be considered collectively in assessing the probability of infection. Debate also exists regarding the value of wound sampling, the types of wounds that should be sampled, and the sampling technique required to generate the most meaningful data. In the laboratory, consideration must be given to the relevance of culturing polymicrobial specimens, the value in identifying one or more microorganisms, and the microorganisms that should be assayed for antibiotic susceptibility. Although appropriate systemic antibiotics are essential for the treatment of deteriorating, clinically infected wounds, debate exists regarding the relevance and use of antibiotics (systemic or topical) and antiseptics (topical) in the treatment of nonhealing wounds that have no clinical signs of infection. In providing a detailed analysis of wound microbiology, together with current opinion and controversies regarding wound assessment and treatment, this review has attempted to capture and address microbiological aspects that are critical to the successful management of microorganisms in wounds. PMID:11292638

  15. Antimicrobial photodynamic therapy with RLP068 kills methicillin-resistant Staphylococcus aureus and improves wound healing in a mouse model of infected skin abrasion PDT with RLP068/Cl in infected mouse skin abrasion.

    PubMed

    Vecchio, Daniela; Dai, Tianhong; Huang, Liyi; Fantetti, Lia; Roncucci, Gabrio; Hamblin, Michael R

    2013-09-01

    Photodynamic therapy (PDT) is an alternative treatment for infections that can kill drug resistant bacteria without damaging host-tissue. In this study we used bioluminescent methicillin-resistant Staphylococcus aureus, in a mouse skin abrasion model, to investigate the effect of PDT on bacterial inactivation and wound healing. RLP068/Cl, a tetracationic Zn(II)phthalocyanine derivative and toluidine blue (TBO) were used. The light-dose response of PDT to kill bacteria in vivo and the possible recurrence in the days post-treatment were monitored by real-time bioluminescence imaging, and wound healing by digital photography. The results showed PDT with RLP068/Cl (but not TBO) was able to kill bacteria, to inhibit bacterial re-growth after the treatment and to significantly accelerate the wound healing process (© 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim). PMID:22987338

  16. Emergency Wound Care After a Natural Disaster

    MedlinePLUS

    ... as possible if: There is a foreign object (soil, wood, metal, or other objects) embedded in the ... life, and ocean water. Wounds in contact with soil and sand can become infected. Puncture wounds can ...

  17. Wound morbidity after kidney transplant.

    PubMed

    Fockens, M Matthijs; Alberts, Victor P; Bemelman, Frederike J; van der Pant, Karlijn A M I; Idu, Mirza M

    2015-03-01

    Context-Wound morbidity is an important surgical complication after kidney transplant.Objective-To assess risk factors for postoperative wound complications and the impact of such complications on outcomes of kidney transplant.Design and Patients-Retrospectively, 108 consecutive kidney transplant patients between January 2010 and December 2010 were included in the analysis. Wound morbidity was defined as a surgical site infection or symptomatic lymphocele requiring intervention. Patient, donor, and surgical characteristics were reviewed.Results-Eight lymphoceles and 5 surgical site infections occurred in 12 patients. Risk factors for wound complications were recipient's age (P<.01), body mass index (P=.01), urinary tract infection (P=.01), and prolonged postoperative wound drainage (P=.047). Wound morbidity did not increase the incidence of delayed graft function, acute rejection, graft failure, or mortality. Obesity, recipient's age, urinary tract infection, and prolonged wound drainage are risk factors for wound-related complications. Graft and patient survival rates are comparable between patients with and without wound-related complications. PMID:25758800

  18. Impact of Vacuum-Assisted Closure (VAC) Therapy on Clinical Outcomes of Patients with Sternal Wound Infections: A Meta-Analysis of Non-Randomized Studies

    PubMed Central

    Falagas, Matthew E.; Tansarli, Giannoula S.; Kapaskelis, Anastasios; Vardakas, Konstantinos Z.

    2013-01-01

    Objective To examine the impact of VAC therapy on mortality of patients with sternal wound infections after cardiothoracic surgery. Summary Background Data Controversial results regarding mortality of patients with sternal wound infections were published. Methods We performed a systematic search in PubMed and Scopus. Mortality was the primary outcome of the meta-analysis. Recurrences, complications and length of stay were secondary outcomes. Results Twenty-two retrospective studies including 2467 patients were eligible for inclusion. Patients treated with VAC had significantly lower mortality compared to those treated without VAC [2233 patients, RR?=?0.40, (95% CI 0.28, 0.57)]. This finding was consistent regardless of the study design, the exclusion of studies with positive findings, the criteria for establishment of the compared groups, the time of mortality assessment or the type of infections under study, provided that adequate data was available. VAC therapy was associated with fewer recurrences (RR?=?0.34, 95% CI: 0.19–0.59). The meta-analysis did not show any difference in the length of stay (RR?=??2.25, 95% CI: ?7.52–3.02). Conclusions VAC therapy was associated with lower mortality than other surgical techniques in retrospective cohorts of patients with DSWIs following cardiothoracic surgery. PMID:23741379

  19. [Application of modern wound dressings in the treatment of chronic wounds].

    PubMed

    Triller, Ciril; Huljev, Dubravko; Smrke, Dragica Maja

    2012-10-01

    Chronic and acute infected wounds can pose a major clinical problem because of associated complications and slow healing. In addition to classic preparations for wound treatment, an array of modern dressings for chronic wound care are currently available on the market. These dressings are intended for the wounds due to intralesional physiological, pathophysiological and pathological causes and which failed to heal as expected upon the use of standard procedures. Classic materials such as gauze and bandage are now considered obsolete and of just historical relevance because modern materials employed in wound treatment, such as moisture, warmth and appropriate pH are known to ensure optimal conditions for wound healing. Modern wound dressings absorb wound discharge, reduce bacterial contamination, while protecting wound surrounding from secondary infection and preventing transfer of infection from the surrounding area onto the wound surface. The use of modern wound dressings is only justified when the cause of wound development has been established or chronic wound due to the underlying disease has been diagnosed. Wound dressing is chosen according to wound characteristics and by experience. We believe that the main advantages of modern wound dressings versus classic materials include more efficient wound cleaning, simpler placement of the dressing, reduced pain to touch, decreased sticking to the wound surface, and increased capacity of absorbing wound exudate. Modern wound dressings accelerate the formation of granulation tissue, reduce the length of possible hospital stay and facilitate personnel work. Thus, the overall cost of treatment is reduced, although the price of modern wound dressings is higher than that of classic materials. All types of modern wound dressings, their characteristics and indications for use are described. PMID:23193824

  20. Wound Care: Preventing Infection

    MedlinePLUS

    ... enough to prevent dry skin. Maintain a good prosthetic fit at all times and take care to ... go away when prosthesis is off. Treatment — Check prosthetic fit before the red area becomes an abrasion. ...

  1. A novel technique for the treatment of infected metalwork in orthopaedic patients using skin closure over irrigated negative pressure wound therapy dressings

    PubMed Central

    Chapman, AWP; Krikler, S; Krkovic, M

    2013-01-01

    Introduction There has been recent interest in the use of negative pressure wound therapy (NWPT) as an adjunct to parenteral antibiotics in the treatment of infection in orthopaedic patients with metalwork in situ. To address some of the limitations of standard NPWT in this situation, the senior author has developed a modified method of treatment for infected metalwork (excluding arthroplasty) in orthopaedic patients that includes irrigation and skin closure over the standard NPWT dressing. Methods This retrospective study examined the outcome of a case series of 16 trauma and orthopaedic patients with deep infection involving metalwork in whom this modified form of NPWT was used. In conjunction with standard parenteral antibiotic therapy and a multidisciplinary approach, this modified technique included serial debridements in theatre, irrigation and negative pressure dressings over a white polyvinyl alcohol foam (KCI, Kidlington, UK) as well as closure of the skin over the foam. Results Among the 16 patients, there was a variety of upper and lower limb as well as spinal trauma and elective cases. In all 16 patients, there was successful resolution of the infection with no early or unplanned removal of any metalwork required. Conclusions Patients with infected metalwork are a heterogeneous group, and often suffer high morbidity and mortality. The modified NPWT technique shows potential as an adjunct in the treatment of complex orthopaedic patients with infected metalwork. PMID:23484994

  2. Wound closure and the reconstructive ladder in plastic surgery.

    PubMed

    Simman, Richard

    2009-01-01

    Wound closure requires deep understanding of wound physiology, anatomy, and the healing phase of the wound. The basic principles of wound closure, diabetes control, normal nutrition status, infection control, mechanical stress avoidance, and nursing care are all important elements in achieving healing of acute and chronic wounds. This goal is achievable only through the interdisciplinary approach to wound healing. A number of wound closure techniques are available to the plastic surgeon. This armamentarium includes a variety of techniques, from simple primary wound closure to more-sophisticated and -costly flap reconstructive techniques. This article summarizes the components of the reconstructive ladder for wound closure that are available to the reconstructive surgeon. PMID:24527102

  3. Efficacy of a dual-ring wound protector for prevention of incisional surgical site infection after Whipple's procedure (pancreaticoduodenectomy) with preoperatively-placed intrabiliary stents: protocol for a randomised controlled trial

    PubMed Central

    Bressan, Alexsander K; Roberts, Derek J; Edwards, Janet P; Bhatti, Sana U; Dixon, Elijah; Sutherland, Francis R; Bathe, Oliver; Ball, Chad G

    2014-01-01

    Introduction Among surgical oncology patients, incisional surgical site infection is associated with substantially increased morbidity, mortality and healthcare costs. Moreover, while adults undergoing pancreaticoduodenectomy with preoperative placement of an intrabiliary stent have a high risk of this type of infection, and wound protectors may significantly reduce its risk, no relevant studies of wound protectors yet exist involving this patient population. This study will evaluate the efficacy of a dual-ring wound protector for prevention of incisional surgical site infection among adults undergoing pancreaticoduodenectomy with preoperatively-placed intrabiliary stents. Methods and analysis This study will be a parallel, dual-arm, randomised controlled trial that will utilise a more explanatory than pragmatic attitude. All adults (?18?years) undergoing a pancreaticoduodenectomy at the Foothills Medical Centre in Calgary, Alberta, Canada with preoperative placement of an intrabiliary stent will be considered eligible. Exclusion criteria will include patient age <18?years and those receiving long-term glucocorticoids. The trial will employ block randomisation to allocate patients to a commercial dual-ring wound protector (the Alexis Wound Protector) or no wound protector and the current standard of care. The main outcome measure will be the rate of surgical site infection as defined by the Centers for Disease Control and Prevention criteria within 30?days of the index operation date as determined by a research assistant blinded to treatment allocation. Outcomes will be analysed by a statistician blinded to allocation status by calculating risk ratios and 95% CIs and compared using Fisher's exact test. Ethics and dissemination This will be the first randomised trial to evaluate the efficacy of a dual-ring wound protector for prevention of incisional surgical site infection among patients undergoing pancreaticoduodenectomy. Results of this study are expected to be available in 2016/2017 and will be disseminated using an integrated and end-of-grant knowledge translation strategy. Trial registration number ClinicalTrials.gov identifier NCT01836237. PMID:25146716

  4. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: risk stratification based on wound, ischemia, and foot infection (WIfI).

    PubMed

    Mills, Joseph L; Conte, Michael S; Armstrong, David G; Pomposelli, Frank B; Schanzer, Andres; Sidawy, Anton N; Andros, George

    2014-01-01

    Critical limb ischemia, first defined in 1982, was intended to delineate a subgroup of patients with a threatened lower extremity primarily because of chronic ischemia. It was the intent of the original authors that patients with diabetes be excluded or analyzed separately. The Fontaine and Rutherford Systems have been used to classify risk of amputation and likelihood of benefit from revascularization by subcategorizing patients into two groups: ischemic rest pain and tissue loss. Due to demographic shifts over the last 40 years, especially a dramatic rise in the incidence of diabetes mellitus and rapidly expanding techniques of revascularization, it has become increasingly difficult to perform meaningful outcomes analysis for patients with threatened limbs using these existing classification systems. Particularly in patients with diabetes, limb threat is part of a broad disease spectrum. Perfusion is only one determinant of outcome; wound extent and the presence and severity of infection also greatly impact the threat to a limb. Therefore, the Society for Vascular Surgery Lower Extremity Guidelines Committee undertook the task of creating a new classification of the threatened lower extremity that reflects these important considerations. We term this new framework, the Society for Vascular Surgery Lower Extremity Threatened Limb Classification System. Risk stratification is based on three major factors that impact amputation risk and clinical management: Wound, Ischemia, and foot Infection (WIfI). The implementation of this classification system is intended to permit more meaningful analysis of outcomes for various forms of therapy in this challenging, but heterogeneous population. PMID:24126108

  5. Wound healing.

    PubMed

    Waldorf, H; Fewkes, J

    1995-01-01

    Wound healing is a dynamic biologic process of repairing insults to the integumentary system. It is commonly divided into three phases: inflammatory, proliferative, and maturation. Each phase has unique cellular and substance constituents without which it cannot progress normally. A large variety of factors may influence any part of wound healing, including local factors such as bacteria, oxygen tension, and bleeding, and systemic factors such as the mental and physical health of the patient. There are also extrinsic factors that can be influenced by the caretakers of the wound to enhance wound healing. Areas of intervention include using antiseptic technique when one is dealing with the wound, using good surgical technique, choosing the appropriate wounding method and repair for the individual patient, and using antibiotics and special wound dressings. Modern science and technology are giving us new insights into wound healing and leading us to exciting new ways of influencing it, including the topical use of growth factors, artificial skins, cultured epithelium with and without dermal components, and electrical stimulation. The future of wound healing holds a better understanding of the complexities of the physiologic events that occur and a translation of that into a biologically active and interactive wound care. PMID:7794680

  6. Investigation of an Outbreak of Wound Infections due to Alcaligenes xylosoxidans Transmitted by Chlorhexidine in a Burns Unit

    Microsoft Academic Search

    H. Vu-Thien; J. C. Darbord; D. Moissenet; C. Dulot; J. B. Dufourcq; P. Marsol; A. Garbarg-Chenon

    1998-01-01

    Alcaligenes xylosoxidans, an environmental gram-negative bacillus, was isolated within a 1-month period from six patients in a pediatric burns unit.\\u000a Twelve isolates were studied, one from each of the six patients (five from wound cultures and one from a blood culture) and\\u000a one from each of six contaminated atomizers containing chlorhexidine diluted to 600?mg\\/l. The biochemical and susceptibility\\u000a patterns of

  7. Recent advances in topical wound care

    PubMed Central

    Sarabahi, Sujata

    2012-01-01

    There are a wide variety of dressing techniques and materials available for management of both acute wounds and chronic non-healing wounds. The primary objective in both the cases is to achieve a healed closed wound. However, in a chronic wound the dressing may be required for preparing the wound bed for further operative procedures such as skin grafting. An ideal dressing material should not only accelerate wound healing but also reduce loss of protein, electrolytes and fluid from the wound, and help to minimize pain and infection. The present dictum is to promote the concept of moist wound healing. This is in sharp contrast to the earlier practice of exposure method of wound management wherein the wound was allowed to dry. It can be quite a challenge for any physician to choose an appropriate dressing material when faced with a wound. Since wound care is undergoing a constant change and new products are being introduced into the market frequently, one needs to keep abreast of their effect on wound healing. This article emphasizes on the importance of assessment of the wound bed, the amount of drainage, depth of damage, presence of infection and location of wound. These characteristics will help any clinician decide on which product to use and where,in order to get optimal wound healing. However, there are no ‘magical dressings’. Dressings are one important aspect that promotes wound healing apart from treating the underlying cause and other supportive measures like nutrition and systemic antibiotics need to be given equal attention. PMID:23162238

  8. Gene Induction of Stilbene Biosynthesis in Scots Pine in Response to Ozone Treatment, Wounding, and Fungal Infection1

    PubMed Central

    Chiron, Hélène; Drouet, Alain; Lieutier, François; Payer, Hans-Dieter; Ernst, Dieter; Sandermann, Heinrich

    2000-01-01

    The S-adenosyl-l-methionine:pinosylvin-O-methyltransferase (PMT)2 gene was sequenced from Scots pine (Pinus sylvestris). The open reading frame is arranged in two exons spaced by one 102-bp intron. Promoter regulatory elements such as two “CAAT” boxes and one “TATA” box were identified. Several cis-regulatory elements were recognized: stress-responsive elements (Myb-responsive elements) as well as G, H, and GC boxes. Moreover, elicitor-responsive elements (W boxes) and a sequence resembling the simian virus 40 enhancer core were found. In phloem and needles of control trees, the transcripts of stilbene synthase (STS) and PMT were hardly detectable. Increased ozone fumigation up to 0.3 ?L L?1 enhanced the transcript level of STS and PMT in needles but not in healthy phloem. Wounding, e.g. mock inoculation, of stem-phloem was characterized by a transient increase in STS and PMT transcripts, which was more pronounced in the case of fungal inoculation. Combination of fungal-challenge or mock treatment with ozone resulted in a positive interaction at 0.3 ?L L?1. Scots pine stilbene formation appeared to be induced via STS and PMT gene expression upon ozone and fungal stress as well as wounding. The broad stress-responsiveness is in agreement with the range of various cis-acting elements detected in the STS and PMT promoters. PMID:11027734

  9. Survival, germination, and growth of Epichloe typhina and significance of leaf wounds and insects in infection of orchardgrass

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Epichloë typhina, [choke] is an important stroma-producing endophytic ascomycete that is responsible for significant yield loss in orchardgrass seed production fields. Although infections are presumed to occur through leaves and stems, details of the infection process and conditions that favor leaf ...

  10. Wounded Constituents

    E-print Network

    A. Bialas

    2012-02-21

    The concept of the "wounded" hadronic constituents is formulated. Preliminary estimates indicate that it may help to understand the transverse mass dependence of particle production in hadron-nucleus and nucleus-nucleus collisions.

  11. Delivery of Methylene Blue and meso-tetra (N-methyl-4-pyridyl) porphine tetra tosylate from cross-linked poly(vinyl alcohol) hydrogels: a potential means of photodynamic therapy of infected wounds.

    PubMed

    Donnelly, Ryan F; Cassidy, Corona M; Loughlin, Ryan G; Brown, Anthony; Tunney, Michael M; Jenkins, Mark G; McCarron, Paul A

    2009-09-01

    Poly(vinyl alcohol)-borate complexes were evaluated as a potentially novel drug delivery platform suitable for in vivo use in photodynamic antimicrobial chemotherapy (PACT) of wound infections. An optimised formulation (8.0%w/w PVA, 2.0%w/w borax) was loaded with 1.0 mg ml(-1) of the photosensitisers Methylene Blue (MB) and meso-tetra (N-methyl-4-pyridyl) porphine tetra tosylate (TMP). Both drugs were released to yield receiver compartment concentrations (>5.0 microg ml(-1)) found to be phototoxic to both planktonic and biofilm-grown methicillin-resistant Staphylococcus aureus (MRSA), a common cause of wound infections in hospitals. Newborn calf serum, used to simulate the conditions prevalent in an exuding wound, did not adversely affect the properties of the hydrogels and had no significant effect on the rate of TMP-mediated photodynamic kill of MRSA, despite appreciably reducing the fluence rate of incident light. However, MB-mediated photodynamic kill of MRSA was significantly reduced in the presence of calf serum and when the clinical isolate was grown in a biofilm. Results support the contention that delivery of MB or TMP using gel-type vehicles as part of PACT could make a contribution to the photodynamic eradication of MRSA from infected wounds. PMID:19651522

  12. Low level laser therapy (AlGaInP) applied at 5J/cm2 reduces the proliferation of Staphylococcus aureus MRSA in infected wounds and intact skin of rats*

    PubMed Central

    Silva, Daniela Conceição Gomes Gonçalves e; Plapler, Helio; da Costa, Mateus Matiuzzi; Silva, Silvio Romero Gonçalves e; de Sá, Maria da Conceição Aquino; Silva, Benedito Sávio Lima e

    2013-01-01

    BACKGROUND Laser therapy is a low cost, non-invasive procedure with good healing results. Doubts exist as to whether laser therapy action on microorganisms can justify research aimed at investigating its possible effects on bacteria-infected wounds. OBJECTIVE To assess the effect of low intensity laser on the rate of bacterial contamination in infected wounds in the skin of rats. METHODS An experimental study using 56 male Wistar rats. The animals were randomly divided into eight groups of seven each. Those in the "infected" groups were infected by Staphylococcus aureus MRSA in the dorsal region. Red laser diode (AlGaInP) 658nm, 5J/cm2 was used to treat the animals in the "treated" groups in scan for 3 consecutive days. Samples were drawn before inoculating bacteria and following laser treatment. For statistical analysis we used the nonparametric Wilcoxon (paired data) method with a significance level of p <0.05. RESULTS The statistical analysis of median values showed that the groups submitted to laser treatment had low bacterial proliferation. CONCLUSION The laser (AlGaInP), with a dose of 5J/cm2 in both intact skin and in wounds of rats infected with Staphylococcus aureus MRSA, is shown to reduce bacterial proliferation. PMID:23539003

  13. supply (i.e., diabetic foot ulcers) as well as in the prevention of postsurgical wound infections (Daum, 2007). Furthermore,

    E-print Network

    Simon, Scott I.

    of these models, euthanasia is required to determine the ex vivo bacterial burden using colony counts and longitudinally monitor the bacterial burden and infection induced inflammation without the need for euthanasia

  14. The effects of infection by Phytophthora infestans on the control of phenylpropanoid metabolism in wounded potato tissue

    Microsoft Academic Search

    B. G. Smith; P. H. Rubery

    1981-01-01

    During the first 24 h of in vitro incubation of excised potato tuber (Solanum tuberosum L.) discs, the appearance of phenylalanine ammonia-lyase (PAL; EC 3.4.1.5) and the accumulation of chlorogenic acid are both stimulated by infection with Phytophthora infestans (Mont.) de Bary. Whereas in control tissue the level of PAL reached a stable plateau value after 40 h, in infected

  15. Randomised controlled feasibility trial on the use of medical grade honey following microvascular free tissue transfer to reduce the incidence of wound infection.

    PubMed

    Robson, Val; Yorke, Janelle; Sen, Rachel A; Lowe, Derek; Rogers, Simon N

    2012-06-01

    The aim of this study was to assess the feasibility of using Leptospermum honey in a randomised trial to reduce the incidence of wound infection after microvascular free tissue reconstruction for cancer of the head and neck. During the one-year study period 70 consecutive patients were admitted to the regional maxillofacial ward for free tissue reconstruction. Of these, 56 (80%) consented to be randomised and 49 (70%) were actually randomised, 25 into the honey dressings group, and 24 into the conventional dressings group (control). Six patients were missed when consent was required, 8 did not consent, and 7 who had given consent were missed at the randomisation stage in theatre. Results of wound swabs were positive in 36% of the honey group and 38% of the control group. Methicillin-resistant Staphylococcus aureus (MRSA) was found in 28% and 25%, respectively. Of these, 38% were deemed to require intervention. Honey dressings were acceptable to both patients and nurses. There was a reduction (p<0.05) in duration of hospital stay in the honey group (median 12 days, IQR 10-21) compared with the control (median 18 days, IQR 13-28). The cost of standard and honey dressings was similar. This feasibility study has shown that a randomised controlled trial (RCT) is possible and that several hundreds of patients would be required to show a clinical benefit for honey. Further research is needed to confirm a shorter duration of hospital admission and if so, whether this is due to more rapid healing. PMID:21831489

  16. Wound Infection After Excision and Primary Midline Closure for Pilonidal Disease: Risk Factor Analysis to Improve Patient Selection

    Microsoft Academic Search

    Sotirios Popeskou; Dimitrios Christoforidis; Christiane Ruffieux; Nicolas Demartines

    2011-01-01

    Background  Excision and primary midline closure for pilonidal disease (PD) is a simple procedure; however, it is frequently complicated\\u000a by infection and prolonged healing. The aim of this study was to analyze risk factors for surgical site infection (SSI) in\\u000a this context.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  All consecutive patients undergoing excision and primary closure for PD from January 2002 through October 2008 were retrospectively\\u000a assessed.

  17. STUDY PROTOCOL Open Access Use of biological mesh versus standard wound

    E-print Network

    Boyer, Edmond

    STUDY PROTOCOL Open Access Use of biological mesh versus standard wound care in infected incisional, controlled trial comparing the use of a biological mesh versus traditional wound care in patients with an IVH. The primary end point is 6-month infectious and/or wound morbidity. Secondary end points are wound infection

  18. Design and production of gentamicin/dextrans microparticles by supercritical assisted atomisation for the treatment of wound bacterial infections.

    PubMed

    Aquino, Rita P; Auriemma, Giulia; Mencherini, Teresa; Russo, Paola; Porta, Amalia; Adami, Renata; Liparoti, Sara; Della Porta, Giovanna; Reverchon, Ernesto; Del Gaudio, Pasquale

    2013-01-20

    In this work, the supercritical assisted atomisation (SAA) is proposed, for the first time, for the production of topical carrier microsystems based on alginate-pectin blend. Gentamicin sulphate (GS) was loaded as high soluble and hygroscopic antibiotic model with poor flowability. Particularly, different water solutions of GS/alginate/pectin were processed by SAA to produce spherical microparticles (GAP) of narrow size (about 2 ?m). GS loading was varied between 20% and 33% (w/w) with an encapsulation efficiency reaching about 100%. The micronised powders also showed high flow properties, good stability and constant water content after 90 days in accelerated storage conditions. The release profiles of the encapsulated drug were monitored using vertical diffusion Franz cells to evaluate the application of GAP microsystems as self-consistent powder formulation or in specific fibres or gels for wound dressing. All formulations showed an initial burst effect in the first 6h of application (40-65% of GS loaded), and in particular GAP4 produced with a GS/alginate/pectin ratio of 1:3:1, exhibited the ability to release GS continuously over 6 days. Antimicrobial tests against Staphylococcus aureus indicated that GS antibiotic activity was preserved at 6 days and higher than pure GS at 12 and 24 days for all SAA formulations, especially for GAP1. PMID:22917746

  19. Fungus gnat (Bradysia impatiens) feeding and mechanical wounding inhibit Pythium aphanidermatum infection of geranium seedlings (Pelargonium x hortorum)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A series of laboratory tests were conducted to investigate potential effects of fungus gnat (Bradysia impatiens) feeding damage on susceptibility of geranium seedlings (Pelargonium x hortorum) to infection by the root rot pathogen Pythium aphanidermatum. Effects were compared to those from similar t...

  20. Current wound healing procedures and potential care.

    PubMed

    Dreifke, Michael B; Jayasuriya, Amil A; Jayasuriya, Ambalangodage C

    2015-03-01

    In this review, we describe current and future potential wound healing treatments for acute and chronic wounds. The current wound healing approaches are based on autografts, allografts, and cultured epithelial autografts, and wound dressings based on biocompatible and biodegradable polymers. The Food and Drug Administration approved wound healing dressings based on several polymers including collagen, silicon, chitosan, and hyaluronic acid. The new potential therapeutic intervention for wound healing includes sustained delivery of growth factors, and siRNA delivery, targeting microRNA, and stem cell therapy. In addition, environment sensors can also potentially utilize to monitor and manage microenvironment at wound site. Sensors use optical, odor, pH, and hydration sensors to detect such characteristics as uric acid level, pH, protease level, and infection - all in the hopes of early detection of complications. PMID:25579968

  1. A case of wound dual infection with Pasteurella dagmatis and Pasteurella Canis resulting from a dog bite - limitations of Vitek-2 system in exact identification of Pasteurella species

    PubMed Central

    2011-01-01

    Background Pasteurella species, widely known as indigenous orgganisms in the oral and gastrointestinal floras of many wild and domestic animals, are important pathogens in both animals and humans. Human infections due to Pasteurella species are in most cases associated with infected injuries following animal bites. We encountered a rare case of dual infections caused by different two Pasteurella species occurred in a previously healthy 25-year-old female sustaining injury by a dog-bite. Methodology Exudates from the open wound of her dog-bite site, together with the saliva of the dog were submitted for bacteriological examination. Predominantly appearing grayish-white smooth colonies with almost the same colonial properties but slightly different glistening grown on chocolate and sheep blood agar plates were characterized morphologically by Gram's stain, biochemically by automated instrument using Vitek 2 system using GN cards together with commercially available kit system, ID-Test HN-20 rapid panels, and genetically by sequencing the 16S rRNA genes of the organism using a Taq DyeDeoxy Terminator Cycle Sequencing and a model 3100 DNA sequencer instrument. Results The causative isolates from the dog-bite site were finally identified as P. canis and P. dagmatis from the findings of the morphological, cultural, and biochemical properties together with the comparative sequences of the 16S rRNA genes. Both the isolates were highly susceptible to many antibiotics and the patient was successfully treated with the administration of so-called the first generation cephalosporin, cefazolin followed by so-called the third generation cephalosporin, cefcapene pivoxil. The isolate from the dog was subsequently identified as P. canis, the same species as the isolate from the patient. Conclusions To the best of our knowledge, this was the second report of a dual infection with Pasteurella species consisting of P. dagmatis and P. canis resulting from a dog-bite, followed by the first report of dual infections due to P. dagmatis and P. multocida in 1988. Our isolate finally identified as P. dagmatis was misidentified as P. pneumotripica by means of the Vitek 2 system. The species name "P. dagmatis" was not included in the database of the system. It is also important for routine clinical microbiology laboratories to know the limitation of the automated Vitek 2 system for the accurate identification of Pasteurella species especially P. dagmatis. It should be emphasized that there still exists much room for improvement in Vitek 2 system. Significant improvement of Vitek 2 system especially in the identification of Pasteurella species is urgently desired. PMID:22112359

  2. Management of gunshot wounds

    SciTech Connect

    Ordog, G.; Drew, R.

    1987-01-01

    Management of Gunshot Wounds provides a review of wound ballistics and a systemic review of gunshot wound management of all major body areas and systems. This volume includes information on pre-hospital care, nursing care, and care of infants, children, and the elderly patient with gunshot wounds. This volume also features information on: lead toxicity; complications of gunshot wounds; socioeconomic aspects of gunshot wounds; the forensic and pathological aspects of gunshot wounds; future directions in the care of gunshot wounds.

  3. Hyperbaric oxygen and wound healing.

    PubMed

    Bhutani, Sourabh; Vishwanath, Guruswamy

    2012-05-01

    Hyperbaric oxygen therapy (HBOT) is the use of 100% oxygen at pressures greater than atmospheric pressure. Today several approved applications and indications exist for HBOT. HBOT has been successfully used as adjunctive therapy for wound healing. Non-healing wounds such as diabetic and vascular insufficiency ulcers have been one major area of study for hyperbaric physicians where use of HBOT as an adjunct has been approved for use by way of various studies and trials. HBOT is also indicated for infected wounds like clostridial myonecrosis, necrotising soft tissue infections, Fournier's gangrene, as also for traumatic wounds, crush injury, compartment syndrome, compromised skin grafts and flaps and thermal burns. Another major area of application of HBOT is radiation-induced wounds, specifically osteoradionecrosis of mandible, radiation cystitis and radiation proctitis. With the increase in availability of chambers across the country, and with increasing number of studies proving the benefits of adjunctive use for various kinds of wounds and other indications, HBOT should be considered in these situations as an essential part of the overall management strategy for the treating surgeon. PMID:23162231

  4. Hyperbaric oxygen and wound healing

    PubMed Central

    Bhutani, Sourabh; Vishwanath, Guruswamy

    2012-01-01

    Hyperbaric oxygen therapy (HBOT) is the use of 100% oxygen at pressures greater than atmospheric pressure. Today several approved applications and indications exist for HBOT. HBOT has been successfully used as adjunctive therapy for wound healing. Non-healing wounds such as diabetic and vascular insufficiency ulcers have been one major area of study for hyperbaric physicians where use of HBOT as an adjunct has been approved for use by way of various studies and trials. HBOT is also indicated for infected wounds like clostridial myonecrosis, necrotising soft tissue infections, Fournier's gangrene, as also for traumatic wounds, crush injury, compartment syndrome, compromised skin grafts and flaps and thermal burns. Another major area of application of HBOT is radiation-induced wounds, specifically osteoradionecrosis of mandible, radiation cystitis and radiation proctitis. With the increase in availability of chambers across the country, and with increasing number of studies proving the benefits of adjunctive use for various kinds of wounds and other indications, HBOT should be considered in these situations as an essential part of the overall management strategy for the treating surgeon. PMID:23162231

  5. Bacterial Strain Diversity Within Wounds

    PubMed Central

    Kirkup, Benjamin C.

    2015-01-01

    Significance: Rare bacterial taxa (taxa of low relative frequency) are numerous and ubiquitous in virtually any sample—including wound samples. In addition, even the high-frequency genera and species contain multiple strains. These strains, individually, are each only a small fraction of the total bacterial population. Against the view that wounds contain relatively few kinds of bacteria, this newly recognized diversity implies a relatively high rate of migration into the wound and the potential for diversification during infection. Understanding the biological and medical importance of these numerous taxa is an important new element of wound microbiology. Recent Advances: Only recently have these numerous strains been discovered; the technology to detect, identify, and characterize them is still in its infancy. Multiple strains of both gram-negative and gram-positive bacteria have been found in a single wound. In the few cases studied, the distribution of the bacteria suggests microhabitats and biological interactions. Critical Issues: The distribution of the strains, their phenotypic diversity, and their interactions are still largely uncharacterized. The technologies to investigate this level of genomic detail are still developing and have not been largely deployed to investigate wounds. Future Directions: As advanced metagenomics, single-cell genomics, and advanced microscopy develop, the study of wound microbiology will better address the complex interplay of numerous individually rare strains with both the host and each other. PMID:25566411

  6. Combination of Silver Nanoparticles and Drosera binata Extract as a Possible Alternative for Antibiotic Treatment of Burn Wound Infections Caused by Resistant Staphylococcus aureus

    PubMed Central

    Krychowiak, Marta; Grinholc, Mariusz; Banasiuk, Rafal; Krauze-Baranowska, Miroslawa; G?ód, Daniel; Kawiak, Anna; Królicka, Aleksandra

    2014-01-01

    Staphylococcus aureus is the most common infectious agent involved in the development of skin infections that are associated with antibiotic resistance, such as burn wounds. As drug resistance is a growing problem it is essential to establish novel antimicrobials. Currently, antibiotic resistance in bacteria is successfully controlled by multi-drug therapies. Here we demonstrate that secondary metabolites present in the extract obtained from Drosera binata in vitro cultures are effective antibacterial agents against S. aureus grown in planktonic culture and in biofilm. Moreover, this is the first report demonstrating the synergistic interaction between the D. binata extract and silver nanoparticles (AgNPs), which results in the spectacular enhancement of the observed bactericidal activity, while having no cytotoxic effects on human keratinocytes. Simultaneous use of these two agents in significantly reduced quantities produces the same effect, i.e. by killing 99.9% of bacteria in inoculum or eradicating the staphylococcal biofilm, as higher amounts of the agents used individually. Our data indicates that combining AgNPs with either the D. binata extract or with its pure compound (3-chloroplumbagin) may provide a safe and highly effective alternative to commonly used antibiotics, which are ineffective towards the antibiotic-resistant S. aureus. PMID:25551660

  7. The Cost-Effectiveness of Wound-Edge Protection Devices Compared to Standard Care in Reducing Surgical Site Infection after Laparotomy: An Economic Evaluation alongside the ROSSINI Trial

    PubMed Central

    Gheorghe, Adrian; Roberts, Tracy E.; Pinkney, Thomas D.; Bartlett, David C.; Morton, Dion; Calvert, Melanie

    2014-01-01

    Background Wound-edge protection devices (WEPDs) have been used in surgery for more than 40 years to reduce surgical site infection (SSI). No economic evaluation of WEPDs against any comparator has ever been conducted. The aim of the paper was to assess whether WEPDs are cost-effective in reducing SSI compared to standard care alone in the United Kingdom. Methods and Findings An economic evaluation was conducted alongside the ROSSINI trial. The study perspective was that of the UK National Health Service and the time horizon was 30 days post-operatively. The study was conducted in 21 UK hospitals. 760 patients undergoing laparotomy were randomised to either WEPD or standard care and 735 were included in the primary analysis. The main economic outcome was cost-effectiveness based on incremental cost (£) per quality adjusted life year (QALY) gained. Patients in the WEPD arm accessed health care worth £5,420 on average and gained 0.02131 QALYs, compared to £5,130 and 0.02133 QALYs gained in the standard care arm. The WEPD strategy was more costly and equally effective compared to standard care, but there was significant uncertainty around incremental costs and QALYs. The findings were robust to a range of sensitivity analyses. Conclusions There is no evidence to suggest that WEPDs can be considered a cost effective device to reduce SSI. Their continued use is a waste of limited health care resources. PMID:24748154

  8. Comparative in vitro activity of ceftaroline, ceftaroline-avibactam, and other antimicrobial agents against aerobic and anaerobic bacteria cultured from infected diabetic foot wounds.

    PubMed

    Goldstein, Ellie J C; Citron, Diane M; Merriam, C Vreni; Tyrrell, Kerin L

    2013-07-01

    Foot infections are the most common infectious complication of diabetes. Moderate to severe diabetic foot infections (DFI) are typically polymicrobial with both aerobic and anaerobic organisms. The role of MRSA in these wounds has become an increasing concern. To determine if the addition of avibactam, a novel non-beta-lactam beta-lactamase inhibitor, to ceftaroline would be more active than ceftaroline alone, we tested 316 aerobic pathogens and 154 anaerobic recovered from patients with moderate to severe DFI, and compared ceftaroline with and without avibactam to other agents. Testing on aerobes was done by broth microdilution and by agar dilution for anaerobes, according to CLSI M11-A8, and M7-A8 standards. Ceftaroline-avibactam MIC90 for all Staphylococcus spp. including MRSA was 0.5 ?g/mL, and for enterococci was 1 ?g/mL. The MIC90s for enteric Gram-negative rods was 0.125 ?g/mL. The addition of avibactam to ceftaroline reduced the ceftaroline MICs for 2 strains of resistant Enterobacter spp. and for 1 strain of Morganella. Against anaerobic Gram-positive cocci ceftaroline-avibactam had an MIC90 0.125 ?g/mL and for clostridia 1 ?g/mL. Avibactam improved ceftaroline's MIC90s for Bacteroides fragilis from >32 to 2 ?g/mL and for Prevotella spp. from >32 to 1 ?g/mL. Ceftaroline alone demonstrates excellent in vitro activity against most of the aerobes found in moderate to severe DFI. The addition of avibactam provides an increased spectrum of activity including the beta-lactamase producing Prevotella, Bacteroides fragilis and ceftaroline resistant gram-negative enteric organisms. PMID:23623385

  9. Cytoskeleton Responses in Wound Repair

    PubMed Central

    Abreu-Blanco, Maria Teresa; Watts, James J.; Verboon, Jeffrey M.; Parkhurst, Susan M.

    2012-01-01

    Wound repair on the cellular and multicellular levels is essential to the survival of complex organisms. In order to avoid further damage, prevent infection, and restore normal function, cells and tissues must rapidly seal and remodel the wounded area. The cytoskeleton is an important component of wound repair, needed for actomyosin contraction, recruitment of repair machineries, and cell migration. Recent use of model systems and high-resolution microscopy has provided new insight into molecular aspects of the cytoskeletal response during wound repair. Here we discuss the role of the cytoskeleton in single cell, embryonic, and adult repair, as well as the striking resemblance of these processes to normal developmental events and many diseases. PMID:22349211

  10. Wound bed preparation from a clinical perspective

    PubMed Central

    Halim, A. S.; Khoo, T. L.; Saad, A. Z. Mat

    2012-01-01

    Wound bed preparation has been performed for over two decades, and the concept is well accepted. The ‘TIME’ acronym, consisting of tissue debridement, infection or inflammation, moisture balance and edge effect, has assisted clinicians systematically in wound assessment and management. While the focus has usually been concentrated around the wound, the evolving concept of wound bed preparation promotes the treatment of the patient as a whole. This article discusses wound bed preparation and its clinical management components along with the principles of advanced wound care management at the present time. Management of tissue necrosis can be tailored according to the wound and local expertise. It ranges from simple to modern techniques like wet to dry dressing, enzymatic, biological and surgical debridement. Restoration of the bacterial balance is also an important element in managing chronic wounds that are critically colonized. Achieving a balance moist wound will hasten healing and correct biochemical imbalance by removing the excessive enzymes and growth factors. This can be achieved will multitude of dressing materials. The negative pressure wound therapy being one of the great breakthroughs. The progress and understanding on scientific basis of the wound bed preparation over the last two decades are discussed further in this article in the clinical perspectives. PMID:23162216

  11. Isolation of gram-positive rods that resemble but are clearly distinct from Actinomyces pyogenes from mixed wound infections.

    PubMed Central

    Wüst, J; Lucchini, G M; Lüthy-Hottenstein, J; Brun, F; Altwegg, M

    1993-01-01

    Beginning in 1990, gram-positive rods resembling Actinomyces pyogenes were found with increasing frequency in mixed cultures from various infectious processes, most of them from patients with otitis, empyema, pilonidal cysts, perianal abscesses, and decubitus ulcers. Ribotyping and hybridization showed that these gram-positive rods could be divided into five groups not related to known Actinomyces species. Biochemical markers for reliable differentiation into these groups, however, could not be found. Therefore, naming new species is not warranted unless parameters are discovered that allow identification without DNA hybridization. These gram-positive rods have been isolated only in mixed cultures with anaerobes, Staphylococcus aureus, Streptococcus "milleri," enterococci, and gram-negative rods. Their exact role in these possibly synergistic infections needs further investigation. Images PMID:8501213

  12. GhWRKY40, a Multiple Stress-Responsive Cotton WRKY Gene, Plays an Important Role in the Wounding Response and Enhances Susceptibility to Ralstonia solanacearum Infection in Transgenic Nicotiana benthamiana

    PubMed Central

    Wang, Xiuling; Yan, Yan; Li, Yuzhen; Chu, Xiaoqian; Wu, Changai; Guo, Xingqi

    2014-01-01

    WRKY transcription factors form one of the largest transcription factor families and function as important components in the complex signaling processes that occur during plant stress responses. However, relative to the research progress in model plants, far less information is available on the function of WRKY proteins in cotton. In the present study, we identified the GhWRKY40 gene in cotton (Gossypium hirsutum) and determined that the GhWRKY40 protein is targeted to the nucleus and is a stress-inducible transcription factor. The GhWRKY40 transcript level was increased upon wounding and infection with the bacterial pathogen Ralstonia solanacearum. The overexpression of GhWRKY40 down-regulated most of the defense-related genes, enhanced the wounding tolerance and increased the susceptibility to R. solanacearum. Consistent with a role in multiple stress responses, we found that the GhWRKY40 transcript level was increased by the stress hormones salicylic acid (SA), methyl jasmonate (MeJA) and ethylene (ET). Moreover, GhWRKY40 interacted with the MAPK kinase GhMPK20, as shown using yeast two-hybrid and bimolecular fluorescence complementation systems. Collectively, these results suggest that GhWRKY40 is regulated by SA, MeJA and ET signaling and coordinates responses to wounding and R. solanacearum attack. These findings highlight the importance of WRKYs in regulating wounding- and pathogen-induced responses. PMID:24747610

  13. Regulatory involvement of ABA in potato tuber wound-healing

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Rapid wound-healing is crucial in protecting potato tubers from infection and dehydration. Wound-induced suberization and the accumulation of hydrophobic barriers to reduce water vapor conductance/loss are principle protective wound-healing processes. However, little is known about the biological ...

  14. Small fragment wounds: biophysics and pathophysiology.

    PubMed

    Bowyer, G W; Cooper, G J; Rice, P

    1996-03-01

    This paper considers the wounding effects of small fragments in modern warfare. Small fragment wounds may be expected to predominate on a future conventional battlefield; however, studies and models of "military" wounds have tended to focus on bullets as the wounding projectile. This paper discusses briefly the types of fragment projectile expected from modern munitions. It goes on to define a model for such projectiles, and describes the interaction with soft tissue simulants. The extent of penetration, temporary cavitation, and contamination by foreign material are all considered. This work with simulants is validated by experimental shots against animal tissue. A wound model in an experimental animal is described. This model was used to investigate the hematologic, biochemical, and histologic effects of a small fragment wound. The effects on skin and skeletal muscle are described. By sampling at various times (up to 1 week) after wounding, the natural progress of these wounds has been ascertained. The results from 28 experimental animals, with untreated fragment wounds, are reported. The most important findings are that the skin damage is very localized and that the muscle damage is limited, with little necrotic tissue in the track. Furthermore, the extent of the muscle damage, peripheral to the wound track, improves with time, healing within a few days, provided the wound remains free from infection. There was no clinical or microbiologic evidence of infection in those animals followed for up to 3 days. However, of eight animals followed to 1 week, three developed infected wounds. This work has implications for the management of soft tissue wounds caused by fragmentation munitions. The conventional military approach has been to treat penetrating war wounds by exploration, debridement, excision of dead tissue, and delayed primary closure; conservative treatment has largely been regarded as inappropriate. The work presented here shows that the potential culture medium within the wound is small and can be removed by the normal bodily responses. There is no need for surgery, provided that infection can be prevented. It may be inferred that if bacterial colonization can be prevented in the early stages by the timely use of antibiotics, surgery may be unnecessary. Further studies are planned to investigate this possibility. PMID:8606400

  15. Proper Care for Wounds

    MedlinePLUS Videos and Cool Tools

    ... Motor Vehicle Safety En Español About Emergencies Wound Care Proper Care For Wounds Most cuts are minor but it is still important to properly care for them. Wound Care Dr. David Ross, emergency ...

  16. Four new Ceratocystis spp. associated with wounds on Eucalyptus, Schizolobium and Terminalia

    E-print Network

    Four new Ceratocystis spp. associated with wounds on Eucalyptus, Schizolobium and Terminalia trees commonly infect wounds on trees. In this study, artificially induced wounds were made on the stems. sublaevis sp. nov. Keywords Fungal phylogenetics . Tree disease . Wounds Introduction Ceratocystis spp

  17. A Look at Bioengineering: Wound Dressings

    E-print Network

    Virginia Tech

    A Look at Bioengineering: Wound Dressings................................................................................................................................................. 3 Wound dressing kit contents ............................................................................................................. 4 INTRODUCTION Wounds and Wound Dressings 101

  18. Honey: a potent agent for wound healing?

    PubMed

    Lusby, P E; Coombes, A; Wilkinson, J M

    2002-11-01

    Although honey has been used as a traditional remedy for burns and wounds, the potential for its inclusion in mainstream medical care is not well recognized. Many studies have demonstrated that honey has antibacterial activity in vitro, and a small number of clinical case studies have shown that application of honey to severely infected cutaneous wounds is capable of clearing infection from the wound and improving tissue healing. The physicochemical properties (eg, osmotic effects and pH) of honey also aid in its antibacterial actions. Research has also indicated that honey may possess antiinflammatory activity and stimulate immune responses within a wound. The overall effect is to reduce infection and to enhance wound healing in burns, ulcers, and other cutaneous wounds. It is also known that honeys derived from particular floral sources in Australia and New Zealand (Leptospermum spp) have enhanced antibacterial activity, and these honeys have been approved for marketing as therapeutic honeys (Medihoney and Active Manuka honey). This review outlines what is known about the medical properties of honey and indicates the potential for honey to be incorporated into the management of a large number of wound types. PMID:12439453

  19. Practices in Wound Healing Studies of Plants

    PubMed Central

    Thakur, Rupesh; Jain, Nitika; Pathak, Raghvendra; Sandhu, Sardul Singh

    2011-01-01

    Wounds are the result of injuries to the skin that disrupt the other soft tissue. Healing of a wound is a complex and protracted process of tissue repair and remodeling in response to injury. Various plant products have been used in treatment of wounds over the years. Wound healing herbal extracts promote blood clotting, fight infection, and accelerate the healing of wounds. Phytoconstituents derived from plants need to be identified and screened for antimicrobial activity for management of wounds. The in vitro assays are useful, quick, and relatively inexpensive. Small animals provide a multitude of model choices for various human wound conditions. The study must be conducted after obtaining approval of the Ethics Committee and according to the guidelines for care and use of animals. The prepared formulations of herbal extract can be evaluated by various physicopharmaceutical parameters. The wound healing efficacies of various herbal extracts have been evaluated in excision, incision, dead space, and burn wound models. In vitro and in vivo assays are stepping stones to well-controlled clinical trials of herbal extracts. PMID:21716711

  20. [Chronic wounds: differential diagnosis].

    PubMed

    Situm, Mirna; Koli?, Maja

    2013-10-01

    Wound is a disruption of anatomic and physiologic continuity of the skin. According to the healing process, wounds are classified as acute and chronic wounds. A wound is considered chronic if standard medical procedures do not lead to the expected healing, or if the wound does not heal within six weeks. Chronic wounds are classified as typical and atypical. Typical wounds include ischemic, neurotrophic and hypostatic wounds. Diabetic foot and decubitus ulcers stand out as a specific entity among typical wounds. About 80 percent of chronic wounds localized on lower leg are the result of chronic venous insufficiency, in 5-10 percent the cause is of arterial etiology, whereas the remainder are mostly neuropathic ulcers. About 95 percent of chronic wounds manifest as one of the above-mentioned entities. Other forms of chronic wounds are atypical chronic wounds, which can be caused by autoimmune disorders, infectious diseases, vascular diseases and vasculopathies, metabolic and genetic diseases, neoplasm, external factors, psychiatric disorders, drug related reactions, etc. Numerous systemic diseases can present with atypical wounds. The primary cause of the wound can be either systemic disease itself (Crohn's disease) or aberrant immune response due to systemic disease (pyoderma gangrenosum, paraneoplastic syndrome). Although atypical wounds are a rare cause of chronic wounds, it should always be taken in consideration during diagnostic procedure. PMID:24371971

  1. The tip of the iceberg: Post caesarean wound dehiscence presenting as abdominal wound sepsis

    PubMed Central

    Bharatam, Kaundinya Kiran; Sivaraja, P.K.; Abineshwar, N.J.; Thiagarajan, Vasundhara; Thiagarajan, D.A.; Bodduluri, Sudeep; Sriraman, K.B.; Vasantha Ragavan, A.; Priya, Shanmuga

    2015-01-01

    Introduction Uterine scar dehiscence can complicate caesarean section with complications like post partum hemorrhage, endomyometritis, localized/generalized peritonitis, and sepsis. Presentation of case Our patient had abdominal wound infection after LSCS surgery and features of sepsis. The wound infection was actually the presentation of a uterine scar dehiscence and localized peritonitis. Discussion Incidence of uterine scar dehiscence is around 0.6%. Presentation can be post partum hemorrhage, endomyometritis, and generalized/localized peritonitis. Peritonitis caused by uterine incisional necrosis must be dealt surgically. A high index of suspicion with appropriate investigations can highlight such problems for early treatment and cure with least morbidity especially related to further pregnancies. Conclusion Uterine scar dehiscence with infection requires high index of suspicion as rare cause for post partum localized/generalized peritonitis with sepsis. Severe abdominal wound infection after caesarean section may be associated with uterine wound dehiscence, which poses a grave risk to the mother in a future pregnancy. PMID:25728672

  2. High-Dose Continuous Oxacillin Infusion Results in Achievement of Pharmacokinetics Targets in Critically Ill Patients with Deep Sternal Wound Infections following Cardiac Surgery

    PubMed Central

    Verdier, Marie-Clémence; Launey, Yoann; Malherbe, Alexandre; Dermu, Marine; Piau, Caroline; Flécher, Erwan; Tribut, Olivier; Mallédant, Yannick; Seguin, Philippe

    2014-01-01

    Knowledge regarding antimicrobial therapy strategies in deep sternal wound infections (DSWI) following cardiac surgery is limited. Therefore, we aimed to determine the steady-state plasma and mediastinal concentrations of oxacillin administered by continuous infusion in critically ill patients with DSWI and to compare these concentrations with the susceptibility of staphylococci recovered. A continuous infusion of oxacillin (150 to 200 mg/kg of body weight/24 h) was administered after a loading dose (50 mg/kg). Plasma and mediastinal concentrations of total and unbound oxacillin were determined 4 h after the loading dose (H4) and then at day 1 (H24) and day 2 (H48). Twelve patients were included. Nine patients exhibited bacteremia, 5 were in septic shock, 8 were positive for Staphylococcus aureus, and 4 were positive for coagulase-negative staphylococci. The median MIC (first to third interquartile range) was 0.25 (0.24 to 0.41) mg/liter. Median plasma concentrations of total and unbound oxacillin at H4, H24, and H48 were, respectively, 64.4 (41.4 to 78.5) and 20.4 (12.4 to 30.4) mg/liter, 56.9 (31.4 to 80.6) and 21.7 (6.5 to 27.3) mg/liter, and 57.5 (32.2 to 85.1) and 20 (14.3 to 35.7) mg/liter. The median mediastinal concentrations of total and unbound oxacillin at H4, H24, and H48 were, respectively, 2.3 (0.7 to 25.9) and 0.9 (<0.5 to 15) mg/liter, 29.1 (19.7 to 38.2) and 12.6 (5.9 to 19.8) mg/liter, and 31.6 (14.9 to 42.9) and 17.1 (6.7 to 26.7) mg/liter. High-dose oxacillin delivered by continuous infusion is a valuable strategy to achieve our pharmacokinetic target (4× MIC) at the site of action at H24. But concerns remain in cases of higher MICs, emphasizing the need for clinicians to obtain the MICs for the bacteria and to monitor oxacillin concentrations, especially the unbound forms, at the target site. PMID:24982092

  3. [Use of negative pressure therapy in the treatment of primary infected traumatic wounds of the foot caused by high energy impact].

    PubMed

    Marinovi?, Marin; Spanjol, Josip; Laginja, Stanislava; Grzalja, Nikola; Stigli?, Damir; Ekl, Darko; Fumi?, Nera; Sepac, Brigita

    2013-10-01

    Foot injuries caused by firearms and high pressure washing machines are not common, but due to high energy can be very destructive and contaminated with microorganisms. Due to the anatomical specificity of the foot, injures of the specific structure such as blood vessels, nerves and tendon-ligament apparatus are frequent. Soft tissue defect is often present. Functional and aesthetic recovery of the foot is a challenge for the surgeon. Direct and indirect effect of the negative pressure therapy helps in wound healing and provides good preparation for definitive surgical management of wounds. PMID:24371982

  4. Biofilms and Inflammation in Chronic Wounds

    PubMed Central

    Zhao, Ge; Usui, Marcia L.; Lippman, Soyeon I.; James, Garth A.; Stewart, Philip S.; Fleckman, Philip; Olerud, John E.

    2013-01-01

    Significance The incidence, cost, morbidity, and mortality associated with non-healing of chronic skin wounds are dramatic. With the increasing numbers of people with obesity, chronic medical conditions, and an increasing life expectancy, the healthcare cost of non-healing ulcers has recently been estimated at $25 billion annually in the United States. The role played by bacterial biofilm in chronic wounds has been emphasized in recent years, particularly in the context of the prolongation of the inflammatory phase of repair. Recent Advances Rapid high-throughput genomic approaches have revolutionized the ability to identify and quantify microbial organisms from wounds. Defining bacterial genomes and using genetic approaches to knock out specific bacterial functions, then studying bacterial survival on cutaneous wounds is a promising strategy for understanding which genes are essential for pathogenicity. Critical Issues When an animal sustains a cutaneous wound, understanding mechanisms involved in adaptations by bacteria and adaptations by the host in the struggle for survival is central to development of interventions that favor the host. Future Directions Characterization of microbiomes of clinically well characterized chronic human wounds is now under way. The use of in vivo models of biofilm-infected cutaneous wounds will permit the study of the mechanisms needed for biofilm formation, persistence, and potential synergistic interactions among bacteria. A more complete understanding of bacterial survival mechanisms and how microbes influence host repair mechanisms are likely to provide targets for chronic wound therapy. PMID:24527355

  5. Abdominal stab wounds: self-inflicted wounds versus assault wounds.

    PubMed

    Venara, Aurélien; Jousset, Nathalie; Airagnes, Guillaume; Arnaud, Jean-Pierre; Rougé-Maillart, Clotilde

    2013-05-01

    Intentional penetrating wounds, self inflicted or inflicted by others, are increasingly common. As a result, it can be difficult for the forensic examiner to determine whether the cause is self-inflicted or not. This type of trauma has been studied from a psychological perspective and from a surgical perspective but the literature concerning the forensic perspective is poorer. The objective of this study was to compare the epidemiology of abdominal stab wounds so as to distinguish specific features of each type. This could help the forensic scientist to determine the manner of infliction of the wound. We proposed a retrospective monocentric study that included all patients with an abdominal wound who were managed by the visceral surgery department at Angers University Hospital. Demographic criteria, patient history, circumstances and location of the wound were noted and compared. A comparison was drawn between group 1 (self inflicted wound) and group 2 (assault). This study showed that the only significant differences are represented by the patient's prior history and the circumstances surrounding the wound, i.e. the scene and time of day. In our study, neither the site, nor the injuries sustained reveal significant clues as to the origin of the wound. According to our findings, in order to determine the cause, the forensic examiner should thus carefully study the circumstances and any associated injuries. PMID:23622473

  6. Chronic Morphine Administration Delays Wound Healing by Inhibiting Immune Cell Recruitment to the Wound Site

    PubMed Central

    Martin, Josephine L.; Koodie, Lisa; Krishnan, Anitha G.; Charboneau, Richard; Barke, Roderick A.; Roy, Sabita

    2010-01-01

    Patients prescribed morphine for the management of chronic pain, and chronic heroin abusers, often present with complications such as increased susceptibility to opportunistic infections and inadequate healing of wounds. We investigated the effect of morphine on wound-healing events in the presence of an infection in an in vivo murine model that mimics the clinical manifestations seen in opioid user and abuser populations. We show for the first time that in the presence of an inflammatory inducer, lipopolysaccharide, chronic morphine treatment results in a marked decrease in wound closure, compromised wound integrity, and increased bacterial sepsis. Morphine treatment resulted in a significant delay and reduction in both neutrophil and macrophage recruitment to the wound site. The delay and reduction in neutrophil reduction was attributed to altered early expression of keratinocyte derived cytokine and was independent of macrophage inflammatory protein 2 expression, whereas suppression of macrophage infiltration was attributed to suppressed levels of the potent macrophage chemoattractant monocyte chemotactic protein-1. When the effects of chronic morphine on later wound healing events were investigated, a significant suppression in angiogenesis and myofibroblast recruitment were observed in animals that received chronic morphine administration. Taken together, our findings indicate that morphine treatment results in a delay in the recruitment of cellular events following wounding, resulting in a lack of bacterial clearance and delayed wound closure. PMID:20042674

  7. Deficient cytokine expression and neutrophil oxidative burst contribute to impaired cutaneous wound healing in diabetic, biofilm-containing chronic wounds.

    PubMed

    Nguyen, Khang T; Seth, Akhil K; Hong, Seok J; Geringer, Matthew R; Xie, Ping; Leung, Kai P; Mustoe, Thomas A; Galiano, Robert D

    2013-01-01

    Diabetic patients exhibit dysregulated inflammatory and immune responses that predispose them to chronic wound infections and the threat of limb loss. The molecular underpinnings responsible for this have not been well elucidated, particularly in the setting of wound biofilms. This study evaluates host responses in biofilm-impaired wounds using the TallyHo mouse, a clinically relevant polygenic model of type 2 diabetes. No differences in cytokine or Toll-like receptor (TLR) expression were noted in unwounded skin or noninoculated wounds of diabetic and wild-type mice. However, diabetic biofilm-containing wounds had significantly less TLR 2, TLR 4, interleukin-1?, and tumor necrosis factor-? expression than wild-type wounds with biofilm (all p < 0.001). Both groups had similar bacterial burden and neutrophil infiltration after development of biofilms at 3 days postwounding, but diabetic wounds had significantly less neutrophil oxidative burst activity. This translated into a log-fold greater bacterial burden and significant delay of wound epithelization for biofilm-impaired diabetic wounds at 10 days postwounding. These results suggest that impaired recognition of bacterial infection via the TLR pathway leading to inadequate cytokine stimulation of antimicrobial host responses may represent a potential mechanism underlying diabetic susceptibility to wound infection and ulceration. PMID:24118295

  8. Silk sericin ameliorates wound healing and its clinical efficacy in burn wounds.

    PubMed

    Aramwit, Pornanong; Palapinyo, Sirinoot; Srichana, Teerapol; Chottanapund, Suthat; Muangman, Pornprom

    2013-09-01

    The aim of this study was to evaluate the effect of silk sericin, a protein from silkworm cocoon, on scratch wound healing in vitro. For applicable result in clinical use, we also study the efficacy of sericin added to a standard antimicrobial cream, silver zinc sulfadiazine, for open wound care in the treatment of second-degree burn wounds. In vitro scratch assays show that sericin at concentration 100 ?g/mL can promote the migration of fibroblast L929 cells similar to epidermal growth factor (positive control) at 100 ?g/mL. After 1 day of treatment, the length of scratch in wounds treated with sericin was significantly shorter than the length of negative control wounds (culture medium without sericin). For clinical study, a total of 29 patients with 65 burn wounds which covered no less than 15 % of total body surface area were randomly assigned to either control (wounds treated with silver zinc sulfadiazine cream) or treatment (wounds treated with silver zinc sulfadiazine with added sericin cream) group in this randomized, double-blind, standard-controlled study. The results showed that the average time to reach 70 % re-epithelialization of the burned surface and complete healing in the treatment group was significantly shorter, approximately 5-7 days, than in the control group. Regarding time for complete healing, control wounds took approximately 29.28 ± 9.27 days, while wounds treated with silver zinc sulfadiazine with added sericin cream took approximately 22.42 ± 6.33 days, (p = 0.001). No infection or severe reaction was found in any wounds. This is the first clinical study to show that silk sericin is safe and beneficial for burn wound treatment when it is added to silver sulfadiazine cream. PMID:23748948

  9. Induction and accumulation of caffeine in young, actively growing leaves of cocoa ( Theobroma cacao L.) by wounding or infection with Crinipellis perniciosa

    Microsoft Academic Search

    Madhu Aneja; Thomas Gianfagna

    2001-01-01

    Crinipellis perniciosa, the causal agent of witches' broom disease, attacks young actively growing shoots, flowers and developing fruits of cocoa (Theobroma cacao L.). Infected shoots become fasciated and a profusion of hypertrophic shoots with small leaves develop from the lateral buds. This is followed by desiccation and death of the infected stem and leaves. Infected stem tissue contains significant amounts

  10. Gunshot wounds - aftercare

    MedlinePLUS

    ... 11(9):546-551. Leong M, Phillips LG. Wound Healing. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery . 19th ed. ... Of Gunshot Wounds To The Limbs: A Review. The Internet Journal ...

  11. Inflammation and wound repair.

    PubMed

    LeBert, Danny C; Huttenlocher, Anna

    2014-08-01

    Wound repair requires the integration of complex cellular networks to restore tissue homeostasis. Defects in wound repair are associated with human disease including pyoderma gangrenosum, a heterogeneous disorder that is characterized by unhealed wounds and chronic inflammation of unclear etiology. Despite its clinical importance, there remain significant gaps in understanding how different types of cells communicate to integrate inflammation and wound repair. Recent progress in wound and regenerative biology has been gained by studying genetically tractable model organisms, like zebrafish, that retain the ability to regenerate. The optical transparency and ease of genetic manipulation make zebrafish an ideal model system to dissect multi-cellular and tissue level interactions during wound repair. The focus of this review is on recent advances in understanding how inflammation and wound repair are orchestrated and integrated to achieve wound resolution and tissue regeneration using zebrafish. PMID:24853879

  12. CCMR: Wound Dressing Tool and Wound Analysis

    NSDL National Science Digital Library

    Men, Shannon

    2005-08-17

    The goal of our project is to develop a Wound Dressing Tool (WDT) that in addition to extracting overabundant chemicals like the VAC system does, can also allow for variable rates of mass transfer as well as a way for clinicians to monitor the fluid chemical composition of the wound bed during the healing and treatment processes.

  13. [Thoracic and abdominal wounds].

    PubMed

    Martinod, E; Lang-Lazdunski, L; Liard, O; Jancovici, R

    1997-05-01

    Thoracic and abdominal wounds are characterized by their diversity, their possible danger and the necessity of a successful diagnosis and therapy strategy. Management of thoracic wounds and indications of surgical treatment are conditioned by airway and hemodynamic states, paraclinical exams and chest drainage. The approach of abdominal wounds is based upon their possible penetrating character. Surgical indications, even if very discussed, are still wider. Thoraco-abdominal wounds could concern the diaphragm and are remarkable for their surgical strategy. PMID:9208685

  14. Novel Composite Antibiotic-Eluting Structures for Wound Healing Applications

    Microsoft Academic Search

    Jonathan J. Elsner; Israela Berdicevsky; Adaya Shefy-Peleg; Meital Zilberman

    \\u000a There are various wounds with tissue loss. These include burn wounds, wounds caused as a result of trauma, diabetic ulcers\\u000a and pressure sores. Every year in the United States more than 1.25 million people experience burns and 6.5 million experience\\u000a various chronic skin ulcers. In burns, infection is the major complication after the initial period of shock and it is

  15. Curcumin as a wound healing agent.

    PubMed

    Akbik, Dania; Ghadiri, Maliheh; Chrzanowski, Wojciech; Rohanizadeh, Ramin

    2014-10-22

    Turmeric (Curcuma longa) is a popular Indian spice that has been used for centuries in herbal medicines for the treatment of a variety of ailments such as rheumatism, diabetic ulcers, anorexia, cough and sinusitis. Curcumin (diferuloylmethane) is the main curcuminoid present in turmeric and responsible for its yellow color. Curcumin has been shown to possess significant anti-inflammatory, anti-oxidant, anti-carcinogenic, anti-mutagenic, anti-coagulant and anti-infective effects. Curcumin has also been shown to have significant wound healing properties. It acts on various stages of the natural wound healing process to hasten healing. This review summarizes and discusses recently published papers on the effects of curcumin on skin wound healing. The highlighted studies in the review provide evidence of the ability of curcumin to reduce the body's natural response to cutaneous wounds such as inflammation and oxidation. The recent literature on the wound healing properties of curcumin also provides evidence for its ability to enhance granulation tissue formation, collagen deposition, tissue remodeling and wound contraction. It has become evident that optimizing the topical application of curcumin through altering its formulation is essential to ensure the maximum therapeutical effects of curcumin on skin wounds. PMID:25200875

  16. Gene Expression Associated with Tuber Wound-Healing/Suberization

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Wounding of potatoes during harvest and handling operations results in tuber shrinkage, market quality defects and infection. Suberization and other wound-healing processes that mitigate these losses are of great agricultural importance. Previously, we determined that suberin poly(phenolics) and s...

  17. Wound contraction effects and antibacterial properties of Tualang honey on full-thickness burn wounds in rats in comparison to hydrofibre

    PubMed Central

    2010-01-01

    Background Full-thickness burn wounds require excision and skin grafting. Multiple surgical procedures are inevitable in managing moderate to severe full-thickness burns. Wound bed preparations prior to surgery are necessary in order to prevent wound infection and promote wound healing. Honey can be used to treat burn wounds. However, not all the honey is the same. This study aims to evaluate the wound contraction and antibacterial properties of locally-produced Tualang honey on managing full-thickness burn wounds in vivo. Methods Thirty-six female Sprague Dawley rats were randomly divided into three groups. Under anaesthesia, three full-thickness burn wounds were created on the dorsum of the rats. The full-thickness burn wounds were inoculated with a specific organism (104), namely Pseudomonas aeruginosa (n = 12), Klebsiella pneumoniae (n = 12), or Acinetobacter baumannii (n = 12). The three burn wounds were dressed with Tualang honey, hydrofibre and hydrofibre silver respectively. Swab samples were obtained every 3 days (day 3, 6, 9, 12, 15, 18 and 21) for quantitative and semi-quantitative microbiological analyses. Clinical assessments, including observations concerning the appearance and wound size, were measured at the same time. Results There was a rapid 32.26% reduction in wound size by day 6 (p = 0.008) in the Tualang honey-treated wounds, and 49.27% by day 15 (p = 0.005). The wounds remained smaller by day 18 (p < 0.032). Tualang honey-treated rats demonstrated a reduction in bacterial growth in Pseudomonas aeruginosa inoculated wounds (p = 0.005). However, hydrofibre silver and hydrofibre-treated wounds are superior to honey-treated wounds with Acinetobacter baumannii (p = 0.035). There was no statistical significant of antibacterial property in Klebsiella pneumonia inoculated wounds. Conclusions Tualang honey has better results with regards to its control of Pseudomonas aeruginosa and its wound contraction effects on full-thickness burn wound in vivo. PMID:20815896

  18. [Toilet of chronic wound].

    PubMed

    Strok, Nevenka; Huljev, Dubravko

    2013-10-01

    Chronic wound toilet, with appropriate care of the surrounding skin, is one of the basic steps that must be performed in the treatment of patients with chronic wound. On wound cleaning and bandaging, it is of utmost importance to choose an appropriate technique of cleansing, select an appropriate solution for leaching and choose an appropriate wound dressing. In this way, the wound is protected from dirt from the environment and microorganisms, while protecting the surrounding tissue from the wound exudate, providing optimal conditions for better and faster wound healing and contributing to improved patient quality of life. The frequency of dressing change is individual and must be tailored to each patient in correlation with the psychosocial status of the patient, the type of the wound, the amount and type of wound exudate, as well as what is to be put on the wound. One of the most important elements in wound toilet is appropriate care for the surrounding skin. Basic guidelines for skin care must meet three basic criteria: adequate washing and cleansing of the skin, maintain the physiological balance of the skin and protect the skin from external damage. PMID:24371977

  19. [Principles of wound treatment].

    PubMed

    Bruhin, A; Metzger, J

    2007-09-01

    New techniques and devices have revolutionized the treatment of wounds during the last years. For the treatment of wounds we have nowadays a great variety of new gadgets, tools and methods. Complex wounds require specific skills, given the fact that a great number of different promising methods are on the market to enable an optimal wound management. Well educated "wound experts" are required to overcome the problems of very complicated and chronic wound problems. The importance of an interdisciplinary team increases while facing the problems of special wound disorders such as a diabetic food, food ulcers or the problems of open abdomen in case of severe peritonitis. In this overview the main principles of modern wound treatment are outlined. The aim of this article is to present a good summary of wound judgement and treatment for the practioner. Increasingly important is it to point out the situation of complexe wounds which should be judgded and treated with the help of a "wound expert". PMID:18075140

  20. Improved wound management by regulated negative pressure-assisted wound therapy and regulated, oxygen- enriched negative pressure-assisted wound therapy through basic science research and clinical assessment.

    PubMed

    Topaz, Moris

    2012-05-01

    Regulated negative pressure-assisted wound therapy (RNPT) should be regarded as a state-of-the-art technology in wound treatment and the most important physical, nonpharmaceutical, platform technology developed and applied for wound healing in the last two decades. RNPT systems maintain the treated wound's environment as a semi-closed, semi-isolated system applying external physical stimulations to the wound, leading to biological and biochemical effects, with the potential to substantially influence wound-host interactions, and when properly applied may enhance wound healing. RNPT is a simple, safe, and affordable tool that can be utilized in a wide range of acute and chronic conditions, with reduced need for complicated surgical procedures, and antibiotic treatment. This technology has been shown to be effective and safe, saving limbs and lives on a global scale. Regulated, oxygen-enriched negative pressure-assisted wound therapy (RO-NPT) is an innovative technology, whereby supplemental oxygen is concurrently administered with RNPT for their synergistic effect on treatment and prophylaxis of anaerobic wound infection and promotion of wound healing. Understanding the basic science, modes of operation and the associated risks of these technologies through their fundamental clinical mechanisms is the main objective of this review. PMID:23162229

  1. Standard abdominal wound edge protection with surgical dressings vs coverage with a sterile circular polyethylene drape for prevention of surgical site infections (BaFO): study protocol for a randomized controlled trial

    PubMed Central

    2012-01-01

    Background Postoperative surgical site infections cause substantial morbidity, prolonged hospitalization, costs and even mortality and remain one of the most frequent surgical complications. Approximately 14% to 30% of all patients undergoing elective open abdominal surgery are affected and methods to reduce surgical site infection rates warrant further investigation and evaluation in randomized controlled trials. Methods/design To investigate whether the application of a circular plastic wound protector reduces the rate of surgical site infections in general and visceral surgical patients that undergo midline or transverse laparotomy by 50%. BaFO is a randomized, controlled, patient-blinded and observer-blinded multicenter clinical trial with two parallel surgical groups. The primary outcome measure will be the rate of surgical site infections within 45?days postoperative assessed according to the definition of the Center for Disease Control. Statistical analysis of the primary endpoint will be based on the intention-to-treat population. The global level of significance is set at 5% (2 sided) and sample size (n?=?258 per group) is determined to assure a power of 80% with a planned interim analysis for the primary endpoint after the inclusion of 340 patients. Discussion The BaFO trial will explore if the rate of surgical site infections can be reduced by a single, simple, inexpensive intervention in patients undergoing open elective abdominal surgery. Its pragmatic design guarantees high external validity and clinical relevance. Trial registration http://www.clinicaltrials.gov NCT01181206. Date of registration: 11 August 2010; date of first patient randomized: 8 September 2010 PMID:22587425

  2. Infections

    MedlinePLUS

    ... Infections Warts West Nile Virus What Is "PANS"? Whooping Cough (Pertussis) Yersiniosis Ear Infections Can Chronic Ear Infections ... Scarlet Fever Sinusitis Strep Throat Tuberculosis Walking Pneumonia Whooping Cough (Pertussis) Medical Tests A Directory of Medical Tests ...

  3. Benefit and harm of iodine in wound care: a systematic review

    Microsoft Academic Search

    H. Vermeulen; S. J. Westerbos; D. T. Ubbink

    2010-01-01

    Nowadays many products are available to combat infections and thus to promote wound healing. Iodine is one of these products, but reports are conflicting as to the effectiveness and adverse effects of iodine in the treatment of wounds. A systematic review was performed of 27 randomised clinical trials, reporting on chronic, acute, burn wounds, pressure sores, and skin grafts. Main

  4. Modified NPWT using round channel drain for pacemaker pocket non-healing complex wound: a case report.

    PubMed

    Petit-Clair, N; Smith, M; Chernev, I

    2014-09-01

    Infection of cardiovascular implantable electronic devices poses a serious medical problem. Management of infected pocket wounds may be challenging for the physician and cause prolonged morbidity for the patient. The mainstay of treatment for infected cardiovascular implantable electronic devices is complete removal of the infected device and appropriate antibiotic therapy. In contrast, removal is not required for superficial or incisional infection at the pocket site if there is no involvement of the device. Here, we describe a modified negative pressure wound therapy (NPWT) technique using a round channel drain for pacemaker pocket non-healing complex wound, which started as a superficial incisional wound infection. PMID:25284298

  5. 3M: Monocots, Mechanical wounding, and Mass spectrometry.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Mechanical wounding, one of the first steps in both pathogen infection and herbivore attack, activates signal transduction pathways dedicated to defense and recovery. The signaling pathways include reversible protein phosphorylation, changes in intracellular calcium levels, alarmone production, and...

  6. [Errors in wound management].

    PubMed

    Filipovi?, Marinko; Novinscak, Tomislav

    2014-10-01

    Chronic ulcers have adverse effects on the patient quality of life and productivity, thus posing financial burden upon the healthcare system. Chronic wound healing is a complex process resulting from the interaction of the patient general health status, wound related factors, medical personnel skill and competence, and therapy related products. In clinical practice, considerable improvement has been made in the treatment of chronic wounds, which is evident in the reduced rate of the severe forms of chronic wounds in outpatient clinics. However, in spite of all the modern approaches, efforts invested by medical personnel and agents available for wound care, numerous problems are still encountered in daily practice. Most frequently, the problems arise from inappropriate education, of young personnel in particular, absence of multidisciplinary approach, and inadequate communication among the personnel directly involved in wound treatment. To perceive them more clearly, the potential problems or complications in the management of chronic wounds can be classified into the following groups: problems mostly related to the use of wound coverage and other etiology related specificities of wound treatment; problems related to incompatibility of the agents used in wound treatment; and problems arising from failure to ensure aseptic and antiseptic performance conditions. PMID:25326993

  7. Burn wound management.

    PubMed

    Davies, M R; Rode, H; Cywes, S; van der Riet, R L

    1981-01-01

    In this chapter the local therapy for burns is discussed. Between 400 and 500 children with burns are treated every year at the Red Cross War Memorial Children's Hospital in Cape Town, but in only 10% of them do the burns affect over 20% of the body surface. These latter patients are treated in special rooms equipped for intensive therapy. Open and closed methods of treatment for burns used in addition to early excision are compared. The first aim is early skin cover for areas with skin loss preserving as much function as possible and achieving the best possible cosmetic result. Local therapy must be atraumatic to prevent extension of the skin lesion. Bacterial contamination must be prevented as far as possible by keeping the wound clean. Emergency treatment and the course of wound healing up to the third week after the injury using the appropriate dressings are described. Early excision until the fifth day after the accident should be used mainly for burns of the hand, deep second degree burns of up to 10% of the body surface, deep second degree burns over the joints and deep second degree burns of the neck. It must be admitted that the depth of the burn can only be definitely estimated between the seventh and tenth day after the accident. If no autografts are available homografts or grafts from animals are used. The age of the patient, associated injuries, associated diseases and the extent of the burn all play a role in determining the prognosis. Furthermore endogenous bacterial infections, absorption of local therapeutic agents and the state of the surrounding skin do also influence the healing process. Finally the various local therapeutic agents like sulphamylon, silver sulphadiazine and betadine are discussed. A 0.05% solution of silver nitrate is also active against gram-negative infections. Skin transplants are disinfected with a solution containing one third 0.25% acetic acid, one third 3% cent hydrogen peroxide and one third saline. Hydrogen peroxide must not be applied to burns that are healing spontaneously. A classification of burns to help to choose the appropriate local therapy is proposed. PMID:7012931

  8. Influence of Bilateral Skeletonized Harvesting on Occurrence of Deep Sternal Wound Infection in 1,000 Consecutive Patients Undergoing Bilateral Internal Thoracic Artery Grafting

    PubMed Central

    Pevni, Dmitry; Mohr, Rephael; Lev-Run, Oren; Locer, Chaim; Paz, Yosef; Kramer, Amir; Shapira, Itzhak

    2003-01-01

    Objective To evaluate the risk of deep sternal infection in a large patient cohort following bilateral internal thoracic artery (BITA) grafting using skeletonized BITA dissection. Summary Background Data Complete myocardial revascularization using BITAs improves long-term survival and lowers the rate of repeat operations. Harvesting of ITAs as skeletonized vessels preserves sternal collateral blood supply, thus enabling rapid sternal healing with less risk of deep sternal infection. Methods One thousand consecutive patients (763 men, 340 patients >70 years old, 304 diabetics) underwent skeletonized BITA grafting from April 1996 to July 1999. Results The 30-day mortality rate was 3.4%. There were 10 perioperative infarcts, 16 strokes, and 22 deep sternal infections. There was an increased risk of deep sternal infection in repeat coronary artery bypass grafting (CABG) operations (15%), chronic obstructive pulmonary disease (COPD) (6.2%), congestive heart failure (4.7%), left ventricular dysfunction (ejection fraction < 35%, 4.5%), and longer aortic cross-clamping time. After adjustment for other demographic, clinical, and surgical predictors, the only independent predictors of deep sternal infection were repeat operations, COPD, and duration of aortic cross-clamping. No patients in the reoperation subgroup died, but three of six COPD patients with deep sternal infection died, and COPD was an independent predictor of overall (early + late) mortality. Conclusions Skeletonized BITA grafting carries an acceptable risk of deep sternal infection but is not recommended for repeat CABG or for patients with COPD. PMID:12560787

  9. Extended negative pressure wound therapy-assisted dermatotraction for the closure of large open fasciotomy wounds in necrotizing fasciitis patients

    PubMed Central

    2014-01-01

    Background Necrotizing fasciitis (NF) is a rapid progressive infection of the subcutaneous tissue or fascia and may result in large open wounds. The surgical options to cover these wounds are often limited by the patient condition and result in suboptimal functional and cosmetic wound coverage. Dermatotraction can restore the function and appearance of the fasciotomy wound and is less invasive in patients with comorbidities. However, dermatotraction for scarred, stiff NF fasciotomy wounds is often ineffective, resulting in skin necrosis. The authors use extended negative pressure wound therapy (NPWT) as an assist in dermatotraction to close open NF fasciotomy wounds. The authors present the clinical results, followed by a discussion of the clinical basis of extended NPWT-assisted dermatotraction. Methods A retrospective case series of eight patients with NF who underwent open fasciotomy was approved for the study. After serial wound preparation, dermatotraction was applied in a shoelace manner using elastic vessel loops. Next, the extended NPWT was applied over the wound. The sponge was three times wider than the wound width, and the transparent covering drape almost encircled the anatomical wound area. The negative pressure of the NPWT was set at a continuous 100 mmHg by suction barometer. The clinical outcome was assessed based on wound area reduction after treatment and by the achievement of direct wound closure. Results After the first set of extended NPWT-assisted dermatotraction procedures, the mean wound area was significantly decreased (658.12 cm2 to 29.37 cm2; p?=?0.002), as five out of eight patients achieved direct wound closure. One patient with a chest wall defect underwent latissimus dorsi musculocutaneous flap coverage, with primary closure of the donor site. Two Fournier’s gangrene patients underwent multiple sets of treatment and finally achieved secondary wound closure with skin grafts. The patients were followed up for 18.3 months on average and showed satisfactory results without wound recurrence. Conclusions Extended NPWT-assisted dermatotraction advances scarred, stiff fasciotomy wound margins synergistically in NF and allows direct closure of the wound without complications. This method can be another good treatment option for the NF patient with large open wounds whose general condition is unsuitable for extensive reconstructive surgery. PMID:24731449

  10. Combined laser and photodynamic treatment in extensive purulent wounds

    NASA Astrophysics Data System (ADS)

    Solovieva, A. B.; Tolstih, P. I.; Melik-Nubarov, N. S.; Zhientaev, T. M.; Kuleshov, I. G.; Glagolev, N. N.; Ivanov, A. V.; Karahanov, G. I.; Tolstih, M. P.; Timashev, P. S.

    2010-05-01

    Recently, photodynamic therapy (PDT) has been used for the treatment of festering wounds and trophic ulcers. An important advantage of PDT is its ability to affect bacterial cultures that are resistant to antibiotics. However the use of PDT alone does not usually guarantee a stable antiseptic effect and cannot prevent an external infection of wounds and burns. In this work attention is focused on the healing of the extensive soft tissues wounds with combined laser therapy (LT) and PDT treatment. At the first stage of this process festering tissues (for example spacious purulent wounds with area more than 100 cm2) were illuminated with high-energy laser beam (with power 20 W) in continues routine. The second stage involves “softer” PDT affect, which along with the completion stages of destruction pathological cells, stimulating the process of wound granulation and epithelization. Also, according to our previous results, photosensitizer (photoditazin) is introduced inside the wound with different amphiphilic polymers for increasing the PDT efficacy.

  11. Integrated Detection of Pathogens and Host Biomarkers for Wounds

    SciTech Connect

    Jaing, C

    2012-03-19

    The increasing incidence and complications arising from combat wounds has necessitated a reassessment of methods for effective treatment. Infection, excessive inflammation, and incidence of drug-resistant organisms all contribute toward negative outcomes for afflicted individuals. The organisms and host processes involved in wound progression, however, are incompletely understood. We therefore set out, using our unique technical resources, to construct a profile of combat wounds which did or did not successfully resolve. We employed the Lawrence Livermore Microbial Detection Array and identified a number of nosocomial pathogens present in wound samples. Some of these identities corresponded with bacterial isolates previously cultured, while others were not obtained via standard microbiology. Further, we optimized proteomics protocols for the identification of host biomarkers indicative of various stages in wound progression. In combination with our pathogen data, our biomarker discovery efforts will provide a profile corresponding to wound complications, and will assist significantly in treatment of these complex cases.

  12. Compromised wounds in Canada.

    PubMed

    Denny, Keith; Lawand, Christina; Perry, Sheril D

    2014-01-01

    Wounds are a serious healthcare issue with profound personal, clinical and economic implications. Using a working definition of compromised wounds, this study examines the prevalence of wounds by type and by healthcare setting using data from hospitals, home care, hospital-based continuing care and long-term care facilities within fiscal year 2011-2012 in Canada. It also evaluates several risk factors associated with wounds, such as diabetes, circulatory disease and age. Compromised wounds were reported in almost 4% of in-patient acute hospitalizations and in more than 7% of home care clients, almost 10% of long-term care clients and almost 30% of hospital-based continuing care clients. Patients with diabetes were much more likely to have a compromised wound than were patients without the disease. PMID:24844713

  13. Demonstration of the rat ischemic skin wound model.

    PubMed

    Trujillo, Andrea N; Kesl, Shannon L; Sherwood, Jacob; Wu, Mack; Gould, Lisa J

    2015-01-01

    The propensity for chronic wounds in humans increases with ageing, disease conditions such as diabetes and impaired cardiovascular function, and unrelieved pressure due to immobility. Animal models have been developed that attempt to mimic these conditions for the purpose of furthering our understanding of the complexity of chronic wounds. The model described herein is a rat ischemic skin flap model that permits a prolonged reduction of blood flow resulting in wounds that become ischemic and resemble a chronic wound phenotype (reduced vascularization, increased inflammation and delayed wound closure). It consists of a bipedicled dorsal flap with 2 ischemic wounds placed centrally and 2 non-ischemic wounds lateral to the flap as controls. A novel addition to this ischemic skin flap model is the placement of a silicone sheet beneath the flap that functions as a barrier and a splint to prevent revascularization and reduce contraction as the wounds heal. Despite the debate of using rats for wound healing studies due to their quite distinct anatomic and physiologic differences compared to humans (i.e., the presence of a panniculus carnosus muscle, short life-span, increased number of hair follicles, and their ability to heal infected wounds) the modifications employed in this model make it a valuable alternative to previously developed ischemic skin flap models. PMID:25866964

  14. Novel in vitro Approaches for the Simulation and Analysis of Human Skin Wounds.

    PubMed

    Planz, Viktoria; Franzen, Lutz; Windbergs, Maike

    2015-01-01

    Considering the increasing incidence of chronic wounds and severe wound infections, effective drug delivery to wounded skin is of high importance. The rational development of novel therapeutic systems requires appropriate in vitro testing methodologies. In this context, suitable and reliable in vitro models simulating human wounds and advanced analytical techniques for precise wound characterization are urgently needed. In this study, we introduce a novel in vitro model based on excised human skin. In contrast to the established wound models, our novel approach has a coffin-shaped, linear, rectangular geometry with defined wound edges exhibiting consistent appearance along the entire wound bed. In addition, we introduce optical profilometry as a novel technique for nondestructive wound analysis. We successfully demonstrate the applicability of this optical imaging method based on white light reflection for three-dimensional visualization of different wound models. Furthermore, we create virtual noninvasive cross sections of these wounds to assess wound geometry in direct comparison to conventional histological analysis. Imaging analysis of our novel coffin-shaped model resulted in reproducible virtual sections along the entire wound bed. Our findings indicate the potential of our novel in vitro model for improved simulation of human wounds. Further, we successfully overcome the limitations of conventional histological analysis by the employment of optical profilometry for nondestructive three-dimensional wound characterization. © 2014 S. Karger AG, Basel. PMID:25341368

  15. Telemedicine for wound management

    PubMed Central

    Chittoria, Ravi K.

    2012-01-01

    The escalating physiological, psychological, social and financial burdens of wounds and wound care on patients, families and society demand the immediate attention of the health care sector. Many forces are affecting the changes in health care provision for patients with chronic wounds, including managed care, the limited number of wound care therapists, an increasingly ageing and disabled population, regulatory and malpractice issues, and compromised care. The physician is also faced with a number of difficult issues when caring for chronic wound patients because their conditions are time consuming and high risk, represent an unprofitable part of care practice and raise issues of liability. Telemedicine enhances communication with the surgical wound care specialist. Digital image for skin lesions is a safe, accurate and cost-effective referral pathway. The two basic modes of telemedicine applications, store and forward (asynchronous transfer) and real-time transmission (synchronous transfer, e.g. video conference), are utilized in the wound care setting. Telemedicine technology in the hands of an experienced physician can streamline management of a problem wound. Although there is always an element of anxiety related to technical change, the evolution of wound care telemedicine technology has demonstrated a predictable maturation process. PMID:23162242

  16. Chitosan preparations for wounds and burns: antimicrobial and wound-healing effects

    PubMed Central

    Dai, Tianhong; Tanaka, Masamitsu; Huang, Ying-Ying; Hamblin, Michael R

    2011-01-01

    Since its discovery approximately 200 years ago, chitosan, as a cationic natural polymer, has been widely used as a topical dressing in wound management owing to its hemostatic, stimulation of healing, antimicrobial, nontoxic, biocompatible and biodegradable properties. This article covers the antimicrobial and wound-healing effects of chitosan, as well as its derivatives and complexes, and its use as a vehicle to deliver biopharmaceuticals, antimicrobials and growth factors into tissue. Studies covering applications of chitosan in wounds and burns can be classified into in vitro, animal and clinical studies. Chitosan preparations are classified into native chitosan, chitosan formulations, complexes and derivatives with other substances. Chitosan can be used to prevent or treat wound and burn infections not only because of its intrinsic antimicrobial properties, but also by virtue of its ability to deliver extrinsic antimicrobial agents to wounds and burns. It can also be used as a slow-release drug-delivery vehicle for growth factors to improve wound healing. The large number of publications in this area suggests that chitosan will continue to be an important agent in the management of wounds and burns. PMID:21810057

  17. Chitosan preparations for wounds and burns: antimicrobial and wound-healing effects.

    PubMed

    Dai, Tianhong; Tanaka, Masamitsu; Huang, Ying-Ying; Hamblin, Michael R

    2011-07-01

    Since its discovery approximately 200 years ago, chitosan, as a cationic natural polymer, has been widely used as a topical dressing in wound management owing to its hemostatic, stimulation of healing, antimicrobial, nontoxic, biocompatible and biodegradable properties. This article covers the antimicrobial and wound-healing effects of chitosan, as well as its derivatives and complexes, and its use as a vehicle to deliver biopharmaceuticals, antimicrobials and growth factors into tissue. Studies covering applications of chitosan in wounds and burns can be classified into in vitro, animal and clinical studies. Chitosan preparations are classified into native chitosan, chitosan formulations, complexes and derivatives with other substances. Chitosan can be used to prevent or treat wound and burn infections not only because of its intrinsic antimicrobial properties, but also by virtue of its ability to deliver extrinsic antimicrobial agents to wounds and burns. It can also be used as a slow-release drug-delivery vehicle for growth factors to improve wound healing. The large number of publications in this area suggests that chitosan will continue to be an important agent in the management of wounds and burns. PMID:21810057

  18. Surgical antibiotic prophylaxis: effect in postoperative infections

    Microsoft Academic Search

    A. Hita Fernández; V. Monge; M. A. Garcinuño

    2001-01-01

    Objective: to assess the risk of surgical wound infection and hospital acquired infections among patients with and without adequate antibiotic prophylaxis. Also, to provide models to predict the contributing factors of hospital infection and surgical wound infection. Design: survey study. Prospective cohort study over 14 months, with data collected by a nurse and a epidemiologist through visits to the surgical

  19. Wound-Periderm Formation

    Microsoft Academic Search

    Idit Ginzberg

    Herbivores, and particularly chewing insects, cause substantial damage to the plant. In addition to lost tissue, there are great concerns of pathogen invasion and water loss at the site of the attack. One of the plant’s defense strategies is the formation of wound periderm at the boundaries of the invaded or damaged region to isolate it from non-wounded healthy tissue.

  20. Wound repair and regeneration

    Microsoft Academic Search

    Geoffrey C. Gurtner; Sabine Werner; Yann Barrandon; Michael T. Longaker

    2008-01-01

    The repair of wounds is one of the most complex biological processes that occur during human life. After an injury, multiple biological pathways immediately become activated and are synchronized to respond. In human adults, the wound repair process commonly leads to a non-functioning mass of fibrotic tissue known as a scar. By contrast, early in gestation, injured fetal tissues can

  1. Thickness of Subcutaneous Fat as a Strong Risk Factor for Wound Infections in Elective Colorectal Surgery: Impact of Prediction Using Preoperative CT

    Microsoft Academic Search

    Takaaki Fujii; Soichi Tsutsumi; Asuka Matsumoto; Takaharu Fukasawa; Yuichi Tabe; Reina Yajima; Takayuki Asao; Hiroyuki Kuwano

    2010-01-01

    Background\\/Aims:In this study, we have attempted to identify and assess factors that would be most predictive of postoperative incisional surgical site infection (SSI) in colorectal surgery, including representative markers for nutrition or obesity. Methods: 152 patients who underwent elective colorectal resection were identified for inclusion in this study. The outcome of interest was incisional SSI. Variables thought to be predictive

  2. Wound biofilms: lessons learned from oral biofilms

    PubMed Central

    Mancl, Kimberly A.; Kirsner, Robert S.; Ajdic, Dragana

    2013-01-01

    Biofilms play an important role in the development and pathogenesis of many chronic infections. Oral biofilms, more commonly known as dental plaque,are a primary cause of oral diseases including caries, gingivitis and periodontitis. Oral biofilms are commonly studied as model biofilm systems as they are easily accessible, thus biofilm research in oral diseases is advanced with details of biofilm formation and bacterial interactions being well-elucidated. In contrast, wound research has relatively recently directed attentionto the role biofilms have in chronic wounds. This review discusses the biofilms in periodontal disease and chronic wounds with comparisons focusing on biofilm detection, biofilm formation, the immune response to biofilms, bacterial interaction and quorum sensing. Current treatment modalities used by both fields as well as future therapies are also discussed. PMID:23551419

  3. Wound care in the geriatric client

    PubMed Central

    Gist, Steve; Tio-Matos, Iris; Falzgraf, Sharon; Cameron, Shirley; Beebe, Michael

    2009-01-01

    With our aging population, chronic diseases that compromise skin integrity such as diabetes, peripheral vascular disease (venous hypertension, arterial insufficiency) are becoming increasingly common. Skin breakdown with ulcer and chronic wound formation is a frequent consequence of these diseases. Types of ulcers include pressure ulcers, vascular ulcers (arterial and venous hypertension), and neuropathic ulcers. Treatment of these ulcers involves recognizing the four stages of healing: coagulation, inflammation, proliferation, and maturation. Chronic wounds are frequently stalled in the inflammatory stage. Moving past the inflammation stage requires considering the bacterial burden, necrotic tissue, and moisture balance of the wound being treated. Bacterial overgrowth or infection needs to be treated with topical or systemic agents. In most cases, necrotic tissue needs to be debrided and moisture balance needs to be addressed by wetting dry tissue and drying wet tissue. Special dressings have been developed to accomplish these tasks. They include films, hydrocolloids, hydrogel dressings, foams, hydrofibers, composite and alginate dressings. PMID:19554098

  4. Evidence-based Management Strategies for Treatment of Chronic Wounds

    PubMed Central

    Werdin, Frank; Tennenhaus, Mayer; Schaller, Hans-Eberhardt; Rennekampff, Hans-Oliver

    2009-01-01

    The care and management of patients with chronic wounds and their far-reaching effects challenge both the patient and the practitioner. Further complicating this situation is the paucity of evidence-based treatment strategies for chronic wound care. After searching both MEDLINE and Cochrane databases, we reviewed currently available articles concerning chronic wound care. Utilizing this information, we have outlined a review of current, evidence-based concepts as they pertain to the treatment of chronic wounds, focusing on fundamental treatment principles for the management of venous, arterial, diabetic, and pressure ulcers. Individualized treatment options as well as general wound management principles applicable to all varieties of chronic wounds are described. Classification and treatment guidelines as well as the adoption of the TIME acronym facilitate an organized conceptional approach to wound care. In so doing, individual aspects of generalized wound care such as debridement, infection, and moisture control as well as attention to the qualities of the wound edge are comprehensively evaluated, communicated, and addressed. Effective adjuvant agents for the therapy of chronic wounds including nutritional and social support measures are listed, as is a brief review of strategies helpful for preventing recurrence. An appreciation of evidence-based treatment pathways and an understanding of the pathophysiology of chronic wounds are important elements in the management of patients with chronic wounds. To achieve effective and long-lasting results, a multidisciplinary approach to patient care, focused on the education and coordination of patient, family as well as medical and support staff can prove invaluable. PMID:19578487

  5. Mesenchymal stem cells for chronic wounds therapy.

    PubMed

    Zahorec, Peter; Koller, Jan; Danisovic, Lubos; Bohac, Martin

    2015-03-01

    Wound healing is a complex process that involves interaction of soluble mediators, extracellular matrix and infiltrating blood cells. Chronic and non-healing skin defects contribute significantly to morbidity and mortality of many patients. Recently, despite the current medical progress, the chronic and non-healing wounds still represent a serious medical problem. In many cases, conventional therapeutic approaches, such as dermal substitutes and growth factor therapy failed and do not produce the expected results, patients are exposed to a high risk of infection, sepsis or amputation. For that reason clinicians and researchers are forced to searching for alternative methods to induce healing process which may result into complete wound closure. Mesenchymal stem cells (MSCs) represent a unique tool of tissue engineering and regenerative medicine and a promising therapeutic strategy. Due to their unique biological properties, MSCs seem to be the perspective modality method for these patients. Many preclinical and clinical studies suggest the possibility of using these cells in tissue regeneration, healing acute and chronic wounds and scar remodelling. The objective of the present review is to summarize the current information and preclinical data about MSCs, their biological characteristics and mode of action during regenerative and healing processes, as well as their clinical application in chronic wounds treatment. PMID:24651970

  6. Accelerated healing of complex open pilonidal wounds using MatriStem extracellular matrix xenograft: nine cases

    PubMed Central

    Sasse, Kent C.; Brandt, Jared; Lim, Dionne C.; Ackerman, Ellen

    2013-01-01

    Complex open pilonidal wounds represent a challenging wound healing problem. Nine cases of complex open pilonidal wounds are described. Each of them was treated at the time of primary wide excision with placement of xenograft extracellular matrix material derived from urinary bladder (MatriStem, ACell Corporation). The patients left the xenograft material and dressings intact and returned to our clinic at weekly intervals for inspection of the wounds. All of the cases of complex open pilonidal wounds healed without infection and without requiring re-operation. The average time to healing in this series was 7 weeks. Treatment of complex open pilonidal wounds with MatriStem extracellular matrix derived from urinary bladder in this fashion results in favorable wound healing of complex open pilonidal wounds. PMID:24964433

  7. Evaluation of wound healing activity of ferulic acid in diabetic rats.

    PubMed

    Ghaisas, Mahesh M; Kshirsagar, Shashank B; Sahane, Rajkumari S

    2014-10-01

    In diabetic patients, there is impairment in angiogenesis, neovascularisation and failure in matrix metalloproteineases (MMPs), keratinocyte and fibroblast functions, which affects wound healing mechanism. Hence, diabetic patients are more prone to infections and ulcers, which finally result in gangrene. Ferulic acid (FA) is a natural antioxidant found in fruits and vegetables, such as tomatoes, rice bran and sweet corn. In this study, wound healing activity of FA was evaluated in streptozotocin-induced diabetic rats using excision wound model. FA-treated wounds were found to epithelise faster as compared with diabetic wound control group. The hydroxyproline and hexosamine content increased significantly when compared with diabetic wound control. FA effectively inhibited the lipid peroxidation and elevated the catalase, superoxide dismutase, glutathione and nitric oxide levels along with the increase in the serum zinc and copper levels probably aiding the wound healing process. Hence, the results indicate that FA significantly promotes wound healing in diabetic rats. PMID:23236955

  8. Management of radiation wounds

    SciTech Connect

    Reinisch, J.F.; Puckett, C.L.

    1984-08-01

    Radiation wounds caused by newer high-voltage radiotherapy techniques are very difficult to manage. Recent developments in flap design and transfer aid the surgeon in successfully treating these difficult problems.

  9. Bacterial Wound Culture

    MedlinePLUS

    ... include: A wound that is slow to heal Heat, redness and swelling at the site Tenderness at ... 08. (2008 May 13, Updated). Fact Sheet: Trauma, Shock, Burn, and Injury: Facts, Figures, and Resources. National ...

  10. New advances in instillation therapy in wounds at risk for compromised healing.

    PubMed

    Gabriel, Allen; Kahn, Kevin M

    2014-03-01

    Combined use of adjunctive negative pressure wound therapy (NPWT) and instillation of topical wound solutions and suspensions (NPWTi) has proven to be an effective next-generation NPWT technique for wounds at risk for compromised healing. Fluid instillation has been shown to enhance exudate and debris removal, provide regular cleansing of the wound bed, and add moisture to the wound. Positive results have been demonstrated with NPWTi in assisting healing of stalled wounds and treating painful wounds as well as wounds at high risk for amputation. NPWTi has been used instead of conventional NPWT in wounds with thick exudate and slough content, acute traumatic wounds, wounds acutely debrided due to infected soft tissue, large areas of post-debrided exposed bone, and cases of critical bacterial colonization. Instilled solutions have included topical solutions such as saline, topical wound cleansers, and antiseptics. While various systems that combine instillation or irrigation with NPWT have been commercialized during the past decade, until very recently these have been relatively cumbersome to use and limited in their ability to regulate solution volume delivery. Recent advances in NPWTi technology (V.A.C. VeraFlo™ Therapy, KCI, San Antonio, TX) include automated volumetrically controlled delivery of fluids and upgraded foam dressing technology to provide better control and delivery of solutions to the wound bed. This article describes the latest NPWTi technology and provides recommendations for successful application of NPWTi in an effort to inform clinicians about product decision-making and practice. PMID:24700215

  11. Wound Healing Potential of Formulated Extract from Hibiscus Sabdariffa Calyx

    PubMed Central

    Builders, P. F.; Kabele-Toge, B.; Builders, M.; Chindo, B. A.; Anwunobi, Patricia A.; Isimi, Yetunde C.

    2013-01-01

    Wound healing agents support the natural healing process, reduce trauma and likelihood of secondary infections and hasten wound closure. The wound healing activities of water in oil cream of the methanol extract of Hibiscus sabdariffa L. (Malvaceae) was evaluated in rats with superficial skin excision wounds. Antibacterial activities against Pseudomonas aeroginosa, Staphylococcus aureus and Echerichia coli were determined. The total flavonoid content, antioxidant properties and thin layer chromatographic fingerprints of the extract were also evaluated. The extract demonstrated antioxidant properties with a total flavonoid content of 12.30±0.09 mg/g. Six reproducible spots were obtained using methanol:water (95:5) as the mobile phase. The extract showed no antimicrobial activity on the selected microorganisms, which are known to infect and retard wound healing. Creams containing H. sabdariffa extract showed significant (P<0.05) and concentration dependent wound healing activities. There was also evidence of synergism with creams containing a combination of gentamicin and H. sabdariffa extract. This study, thus, provides evidence of the wound healing potentials of the formulated extract of the calyces of H. sabdariffa and synergism when co-formulated with gentamicin. PMID:23901160

  12. Effects of Cerium Oxide Nanoparticles on the Growth of Keratinocytes, Fibroblasts and Vascular Endothelial Cells in Cutaneous Wound Healing

    PubMed Central

    Chigurupati, Srinivasulu; Mughal, Mohamed R.; Okun, Eitan; Das, Soumen; Kumar, Amit; McCaffery, Michael; Seal, Sudipta; Mattson, Mark P.

    2012-01-01

    Rapid and effective wound healing requires a coordinated cellular response involving fibroblasts, keratinocytes and vascular endothelial cells (VECs). Impaired wound healing can result in multiple adverse health outcomes and, although antibiotics can forestall infection, treatments that accelerate wound healing are lacking. We now report that topical application of water soluble cerium oxide nanoparticles (Nanoceria) accelerates the healing of full-thickness dermal wounds in mice by a mechanism that involves enhancement of the proliferation and migration of fibroblasts, keratinocytes and VECs. The Nanoceria penetrated into the wound tissue and reduced oxidative damage to cellular membranes and proteins, suggesting a therapeutic potential for topical treatment of wounds with antioxidant nanoparticles. PMID:23266256

  13. Best practice wound care.

    PubMed

    O'Brien, Melissa L; Lawton, Joanna E; Conn, Chris R; Ganley, Helen E

    2011-04-01

    This article describes the barriers, changes and achievements related to implementing one element of a wound care programme being best practice care. With the absence of a coordinated approach to wound care, clinical practice within our Area Health Service (AHS) was diverse, inconsistent and sometimes outdated. This was costly and harmful, leading to overuse of unhelpful care, underuse of effective care and errors in execution. The major aim was to improve the outcomes and quality of life for patients with wound care problems within our community. A collaborative across ten sites/services developed, implemented and evaluated policies and guidelines based on evidence-based bundles of care. Key barriers were local resistance and lack of experience in implementing structural and cultural changes. This was addressed by appointing a wound care programme manager, commissioning of a strategic oversight committee and local wound care committees. The techniques of spread and adoption were used, with early adopters making changes observable and allowing local adaption of guidelines, where appropriate. Deployment and improvement results varied across the sites, ranging from activity but no changes in practice to modest improvement in practice. Evaluating implementation of the leg ulcer guideline as an exemplar, it was demonstrated that there was a statistically significant improvement in overall compliance from 26% to 84%. However, only 7·7% of patients received all interventions to which they were entitled. Compliance with the eight individual interventions of the bundle ranged from 26% to 84%. Generic performance was evaluated against the wound assessment, treatment and evaluation plan with an average compliance of 70%. Early results identified that 20% of wounds were healed within the target of 10 days. As more standardised process are implemented, clinical outcomes should continue to improve and costs decrease. PMID:21272244

  14. Multispecies biofilm in an artificial wound bed--A novel model for in vitro assessment of solid antimicrobial dressings.

    PubMed

    Kucera, J; Sojka, M; Pavlik, V; Szuszkiewicz, K; Velebny, V; Klein, P

    2014-08-01

    Wound infections represent a major problem, particularly in patients with chronic wounds. Bacteria in the wound exist mainly in the form of biofilms and are thus resistant to most antibiotics and antimicrobials. A simple and cost-effective in vitro model of chronic wound biofilms applied for testing treatments and solid devices, especially wound dressings, is presented in this work. The method is based on the well-established Lubbock chronic wound biofilm transferred onto an artificial agar wound bed. The biofilm formed by four bacterial species (Staphylococcus aureus, Enterococcus faecalis, Bacillus subtilis and Pseudomonas aeruginosa) was stable for up to 48h post-transplant. The applicability of the model was evaluated by testing two common iodine wound treatments. These observations indicate that this method enables assessing the effects of treatments on established resilient wound biofilms and is clinically highly relevant. PMID:24880129

  15. Applications of modern sensors and wireless technology in effective wound management.

    PubMed

    Mehmood, Nasir; Hariz, Alex; Fitridge, Robert; Voelcker, Nicolas H

    2014-05-01

    The management of chronic wounds has emerged as a major health care challenge during the 21st century consuming, significant portions of health care budgets. Chronic wounds such as diabetic foot ulcers, leg ulcers, and pressure sores have a significant negative impact on the quality of life of affected individuals. Covering wounds with suitable dressings facilitates the healing process and is common practice in wound management plans. However, standard dressings do not provide insights into the status of the wound underneath. Parameters such as moisture, pressure, temperature and pH inside the dressings are indicative of the healing rate, infection, and wound healing phase. But owing to the lack of information available from within the dressings, these are often changed to inspect the wound, disturbing the normal healing process of wounds in addition to causing pain to the patient. Sensors embedded in the dressing would provide clinicians and nurses with important information that would aid in wound care decision making, improve patient comfort, and reduce the frequency of dressing changes. The potential benefits of this enabling technology would be seen in terms of a reduction in hospitalization time and health care cost. Modern sensing technology along with wireless radio frequency communication technology is poised to make significant advances in wound management. This review discusses issues related to the design and implementation of sensor technology and telemetry systems both incorporated in wound dressings to devise an automated wound monitoring technology, and also surveys the literature available on current sensor and wireless telemetry systems. PMID:24142514

  16. Bio-Conjugated Polycaprolactone Membranes: A Novel Wound Dressing

    PubMed Central

    Cai, Elijah Zhengyang; Teo, Erin Yiling; Jing, Lim; Koh, Yun Pei; Qian, Tan Si; Wen, Feng; Lee, James Wai Kit; Hing, Eileen Chor Hoong; Yap, Yan Lin; Lee, Hanjing; Lee, Chuen Neng; Teoh, Swee-Hin; Lim, Jane

    2014-01-01

    Background The combination of polycaprolactone and hyaluronic acid creates an ideal environment for wound healing. Hyaluronic acid maintains a moist wound environment and accelerates the in-growth of granulation tissue. Polycaprolactone has excellent mechanical strength, limits inflammation and is biocompatible. This study evaluates the safety and efficacy of bio-conjugated polycaprolactone membranes (BPM) as a wound dressing. Methods 16 New Zealand white rabbits were sedated and local anaesthesia was administered. Two 3.0×3.0 cm full-thickness wounds were created on the dorsum of each rabbit, between the lowest rib and the pelvic bone. The wounds were dressed with either BPM (n=12) or Mepitel (n=12) (control), a polyamide-silicon wound dressing. These were evaluated macroscopically on the 7th, 14th, 21st, and 28th postoperative days for granulation, re-epithelialization, infection, and wound size, and histologically for epidermal and dermal regeneration. Results Both groups showed a comparable extent of granulation and re-epithelialization. No signs of infection were observed. There was no significant difference (P>0.05) in wound size between the two groups. BPM (n=6): 8.33 cm2, 4.90 cm2, 3.12 cm2, 1.84 cm2; Mepitel (n=6): 10.29 cm2, 5.53 cm2, 3.63 cm2, 2.02 cm2; at the 7th, 14th, 21st, and 28th postoperative days. The extents of epidermal and dermal regeneration were comparable between the two groups. Conclusions BPM is comparable to Mepitel as a safe and efficacious wound dressing. PMID:25396174

  17. INTRODUCTION Mechanically wounding confluent cell monolayers induces

    E-print Network

    Machen, Terry E.

    INTRODUCTION Mechanically wounding confluent cell monolayers induces movement and proliferation of wounds learn about nearby injury? One perspective suggests that it is simply release from contact in paracrine cell communication during wound healing. Mechanical wounding might remove inhibitory signals

  18. Wound care with antibacterial honey (Medihoney) in pediatric hematology-oncology.

    PubMed

    Simon, Arne; Sofka, Kai; Wiszniewsky, Gertrud; Blaser, Gisela; Bode, Udo; Fleischhack, Gudrun

    2006-01-01

    The physiologic process of wound healing is impaired and prolonged in pediatric patients receiving chemotherapy. Due to profound immunosuppression, wound infection can easily spread and act as the source of sepsis. Referring to in vitro studies, which confirmed the antibacterial potency of special honey preparations against typical isolates of nosocomially acquired wound infections (including Methicillin-resistant Staphylococcus aureus and Vancomycin-resistant enterococci) and considering the encouraging reports from other groups, Medihoney has now been used in wound care at the Department of Pediatric Oncology, Children's Hospital, University of Bonn for 3 years. Supplemented with clinical data from pediatric oncology patients, this article reviews the scientific background and our promising experience with Medihoney in wound care issues at our institution. To collect and analyze the available experience, we prepare an internet-based data documentation module for pediatric wound care with Medihoney. PMID:16075253

  19. Wound Drainage Culture (For Parents)

    MedlinePLUS

    ... A A A Text Size What's in this article? What It Is Why It's ... It Is A wound drainage culture is a test to detect germs such as bacteria, fungi, or viruses in an open wound or abscess (boil). Open ...

  20. SCALE Wounds: Unavoidable Pressure Injury.

    PubMed

    Krasner, Diane L; Stewart, Thomas P

    2015-04-01

    Skin Changes at Life's End (SCALE) wounds include wounds of many underlying etiologies that accompany the dying process. These wounds occur due to unmodifiable intrinsic and extrinsic factors unique to each individual. This article describes the case of a dying patient who sustained a skin tear that deteriorated into a SCALE wound that meets the criteria for a National Pressure Ulcer Advisory Panel unavoidable pressure injury. PMID:25855852

  1. Optical measurements of tissue oxygen saturation in lower limb wound healing.

    PubMed

    Harrison, David K

    2003-01-01

    This review has highlighted the role of oxygen in wound healing and in the mechanism of preventing infection. Optical measurements of tissue SO2 in wounds can provide valuable information, not only about the inflammatory state of the wound, but also about healing potential in ulcers and critical limb ischaemia. The technique is fast, non-invasive and can be used without the necessity for contact with the skin. PMID:15174629

  2. Evaluation of fungicides as potential grapevine pruning wound protectants against Botryosphaeria species

    Microsoft Academic Search

    W. Bester; P. W. Crous; P. H. Fourie

    2007-01-01

    Protection of wounds against infection by trunk disease pathogens is the most efficient and cost-effective means to prevent\\u000a grapevine trunk diseases. Studies done to determine the effectiveness of chemical pruning wound protectants have mostly focused\\u000a on the control of Eutypa lata. However, other important wound pathogens, such as Phaeomoniella chlamydospora, Phaeoacremonium spp., Phomopsis spp. and species of Botryosphaeriaceae (including Botryosphaeria

  3. The History of Wound Care

    PubMed Central

    Shah, Jayesh B.

    2012-01-01

    The history of wound healing is, in a sense, the history of humankind. This brief history of wound healing has been compiled for the benefit of readers. It is amazing to see that some of the basic principles of wound healing have been known since 2000 bc. PMID:24525756

  4. [Useful wound management at home].

    PubMed

    Mizuhara, Akihiro; Taguchi, Akemi; Sato, Mikako; Shindo, Kazuko

    2014-12-01

    In wound care, close observation of the quantity and nature of exudate from a wound, and selection of appropriate dressing and/or medication are crucial. Care should be taken to prevent wounds with excessive exudate from becoming too moist. Furthermore, wound care at home must be easy, which is achievable through the use of readily available materials and medications. 1 ) A wound with little to moderate exudate should be treated using wrap therapy with perforated polyethylene sheets. This therapy can be used to treat pressure ulcers, wounds, wounds with slough, and burns. 2 ) An 18-gauge needle can be used to perforate wounds with little exudate, such as mild pressure ulcers or wounds with slough, and polyurethane film can then be applied. 3 ) Polyurethane film should be applied to blisters, pressure ulcers, or similar skin injuries with little exudate. 4 ) A hydrocolloid dressing should be used on wounds with light exudate. 5 ) An ointment containing steroids should be applied to critically colonized wounds. 6 ) Melolin dressings, Moiskin Pads, or a disposable diaper should be used to manage wounds with heavy exudate. PMID:25595088

  5. Application of the Single Use Negative Pressure Wound Therapy Device (PICO) on a Heterogeneous Group of Surgical and Traumatic Wounds

    PubMed Central

    Payne, Caroline; Edwards, Daren

    2014-01-01

    Objectives: Traumatic wounds and surgery inherently have their complications. Localized infections, wound dehiscence, and excessive wound leakage can be devastating to the patient with a prolonged recovery, but it is also costly to the hospital with an increased length of stay, extra workload, and dressing changes. The single use PICO (Smith and Nephew Healthcare, Hull, United Kingdom) negative pressure wound therapy (NPWT) dressing has revolutionized our management of various acute, chronic, and high output wounds. It requires fewer dressing changes than conventional practice, is used in the outpatient setting, and is a necessary adjuvant therapy to hasten wound healing. Aims: To observe the efficacy of the PICO vacuum-assisted healing within a cost improvement programme. Settings: Plastic surgery department, Royal London Hospital. Materials and Methods: Twenty-one patients with a diversity of postoperative or posttraumatic wounds were considered suitable for PICO application and treated totally on an outpatient basis once the PICO dressing was applied. All wounds were then subjected to continued PICO dressings until healed. Results: All patients tolerated the PICO well with no dressing failure or failure to comply. The number of dressings per patient ranged from 1 to 7. The cost per patient of treatment ranged from £120 to £1578. Estimated cost of all PICO dressing for 21 patients including plastic surgery dressing clinic appointments = £13,345. Median length of treatment to healing (days) = 16; standard deviation = 9.5. Eight patients would have had an inpatient bed stay with conventional therapy, total 24 bed days saved at Bartshealth @£325 per day. Conclusions: The outpatient application of a disposable NPWT can benefit a wide range of clinical wounds that optimizes patient care, promotes rapid wound healing, and importantly helps manage costs. PMID:24917894

  6. Stress and Wound Healing

    Microsoft Academic Search

    Lisa M. Christian; Jennifer E. Graham; David A. Padgett; Ronald Glaser; Janice K. Kiecolt-Glaser

    2006-01-01

    Over the past decade it has become clear that stress can significantly slow wound healing: stressors ranging in magnitude and duration impair healing in humans and animals. For example, in humans, the chronic stress of caregiving as well as the relatively brief stress of academic examinations impedes healing. Similarly, restraint stress slows healing in mice. The interactive effects of glucocorticoids

  7. Spiral wound extraction cartridge

    DOEpatents

    Wisted, Eric E. (Apple Valley, MN); Lundquist, Susan H. (White Bear Township, MN)

    1999-01-01

    A cartridge device for removing an analyte from a fluid comprises a hollow core, a sheet composite comprising a particulate-loaded porous membrane and optionally at least one reinforcing spacer sheet, the particulate being capable of binding the analyte, the sheet composite being formed into a spiral configuration about the core, wherein the sheet composite is wound around itself and wherein the windings of sheet composite are of sufficient tightness so that adjacent layers are essentially free of spaces therebetween, two end caps which are disposed over the core and the lateral ends of the spirally wound sheet composite, and means for securing the end caps to the core, the end caps also being secured to the lateral ends of the spirally wound sheet composite. A method for removing an analyte from a fluid comprises the steps of providing a spirally wound element of the invention and passing the fluid containing the analyte through the element essentially normal to a surface of the sheet composite so as to bind the analyte to the particulate of the particulate-loaded porous membrane, the method optionally including the step of eluting the bound analyte from the sheet composite.

  8. Neoplastic wounds and degenerescence.

    PubMed

    Meaume, S; Fromantin, I; Teot, Luc

    2013-11-01

    Between 5% and 10% of cancer patients develop malignant wounds. Cancer wounds can occur as a clinical entity, especially over the breast, with the development of painful, spreading cancer invasions of the skin. Marjolin's ulcers develop in open wounds after a long period, and form rare malignancies arising from previously traumatised, chronically inflamed, or scarred skin. Marjolin's ulcer is associated with malignant transformation of chronic ulcers, sinus tracts, and burn scars. Squamous cell carcinoma may be linked to a wide variety of medical and surgical clinical situations, such as chronic ulcers, sinuses, chronic osteomyelitis, radiotherapy, burn scars, chronic pressure ulcers, as well as cystostomy sites, and Fournier's gangrene scars. Melanomas, lymphomas, and other cancers can also be observed. Basal cell carcinoma is more frequently observed in ulcers associated with venous insufficiency. According to some reports, the ulcer should have existed for at least 3 years to evoke a diagnosis of degenerescence as opposed ulcerated tumour. Epidermoid carcinomas represent between 0.21% and 0.34% of cancers that develop over leg ulcers, but large series are still lacking. The current lack of epidemiological data could be rectified by more frequent evocation of the diagnosis and a policy of systematic biopsy of chronically open wounds. PMID:24075006

  9. Spiral wound extraction cartridge

    DOEpatents

    Wisted, E.E.; Lundquist, S.H.

    1999-04-27

    A cartridge device for removing an analyte from a fluid comprises a hollow core, a sheet composite comprising a particulate-loaded porous membrane and optionally at least one reinforcing spacer sheet, the particulate being capable of binding the analyte, the sheet composite being formed into a spiral configuration about the core, wherein the sheet composite is wound around itself and wherein the windings of sheet composite are of sufficient tightness so that adjacent layers are essentially free of spaces therebetween, two end caps which are disposed over the core and the lateral ends of the spirally wound sheet composite, and means for securing the end caps to the core, the end caps also being secured to the lateral ends of the spirally wound sheet composite. A method for removing an analyte from a fluid comprises the steps of providing a spirally wound element of the invention and passing the fluid containing the analyte through the element essentially normal to a surface of the sheet composite so as to bind the analyte to the particulate of the particulate-loaded porous membrane, the method optionally including the step of eluting the bound analyte from the sheet composite. 4 figs.

  10. Wound care centers

    MedlinePLUS

    ... Radiation sores Foot ulcers due to diabetes, poor blood flow, or swollen legs Certain wounds may not heal well due to: Diabetes Poor circulation Nerve damage Being inactive or immobile Weak immune system Poor nutrition Excess alcohol use Smoking Non-healing ...

  11. Uric acid and xanthine oxidoreductase in wound healing.

    PubMed

    Fernandez, Melissa L; Upton, Zee; Shooter, Gary K

    2014-02-01

    Chronic wounds are an important health problem because they are difficult to heal and treatment is often complicated, lengthy and expensive. For a majority of sufferers the most common outcomes are long-term immobility, infection and prolonged hospitalisation. There is therefore an urgent need for effective therapeutics that will enhance ulcer healing and patient quality of life, and will reduce healthcare costs. Studies in our laboratory have revealed elevated levels of purine catabolites in wound fluid from patients with venous leg ulcers. In particular, we have discovered that uric acid is elevated in wound fluid, with higher concentrations correlating with increased wound severity. We have also revealed a corresponding depletion in uric acid precursors, including adenosine. Further, we have revealed that xanthine oxidoreductase, the enzyme that catalyses the production of uric acid, is present at elevated levels in wound fluid. Taken together, these findings provide evidence that xanthine oxidoreductase may have a function in the formation or persistence of chronic wounds. Here we describe the potential function of xanthine oxidoreductase and uric acid accumulation in the wound site, and the effect of xanthine oxidoreductase in potentiating the inflammatory response. PMID:24357442

  12. Gunshot Wound Contamination with Squirrel Tissue: Wound Care Considerations

    PubMed Central

    Maerz, Porter W.; Falgiani, Tricia B.; Hoelle, Robyn M.

    2014-01-01

    While report of animal bites contaminating wounds is reported commonly, direct wound contamination with squirrel flesh has never been reported in the literature. The patient suffered an accidental self-inflicted gunshot wound that drove squirrel flesh and buck shot deep within his right buttock. This case outlines his hospital course and wound treatment. The patient was treated with ten days of broad spectrum antibiotics, extensive debridement of the wound in the operating room, and further treatment of the wound with a vacuum dressing system. While squirrel tissue and buckshot had to be removed from the wound on day six of the hospital stay, the patient remained afebrile without signs or symptoms of systemic illness. PMID:24851187

  13. Seismology of the Wounded Sun

    E-print Network

    Cally, Paul S

    2013-01-01

    Active regions are open wounds in the Sun's surface. Seismic oscillations from the interior pass through them into the atmosphere, changing their nature in the process to fast and slow magneto-acoustic waves. The fast waves then partially reflect and partially mode convert to upgoing and downgoing Alfv\\'en waves. The reflected fast and downgoing Alfv\\'en waves then re-enter the interior through the active regions that spawned them, infecting the surface seismology with signatures of the atmosphere. Using numerical simulations of waves in uniform magnetic fields, we calculate the upward acoustic and Alfv\\'enic losses in the atmosphere as functions of field inclination and wave orientation as well as the Time-Distance `travel time' perturbations, and show that they are related. Travel time perturbations relative to quiet Sun can exceed 40 seconds in 1 kG magnetic field. It is concluded that active region seismology is indeed significantly infected by waves leaving and re-entering the interior through magnetic w...

  14. Swatting flies: modelling wound healing and inflammation in Drosophila

    PubMed Central

    Razzell, William; Wood, Will; Martin, Paul

    2011-01-01

    Aberrant wound healing can lead to a variety of human pathologies, from non-healing chronic wounds that can become dangerously infected, to exuberant fibrotic healing in which repair is accompanied by excessive inflammation. To guide therapeutic intervention, we need a better understanding of the fundamental mechanisms driving tissue repair; this will require complementary wound-healing studies in several model organisms. Drosophila has been used to model genetic aspects of numerous human pathologies, and is being used increasingly to gain insight into the molecular and genetic aspects of tissue repair and inflammation, which have classically been modelled in mice or cultured cells. This review discusses the advantages and disadvantages of Drosophila as a wound-healing model, as well as some exciting new research opportunities that will be enabled by its use. PMID:21810906

  15. Minimizing Wound Contamination in a ‘Clean’ Surgery: Comparison of Chlorhexidine-Ethanol and PovidoneIodine

    Microsoft Academic Search

    Sarath Chandra Sistla; Ganesh Prabhu; Sujatha Sistla; Jagdish Sadasivan

    2010-01-01

    Purpose: There is limited work analyzing the efficacy of different antiseptics in reducing wound contamination by the skin flora during hernia repair and its influence on the incidence of wound infection, which continues to be a major problem in the developing world. This study was designed to test if chlorhexidine-ethanol has superior antimicrobial efficacy compared with povidone-iodine. Methods: In a

  16. Clinical Use of Polihexanide on Acute and Chronic Wounds for Antisepsis and Decontamination

    Microsoft Academic Search

    T. Eberlein; O. Assadian

    2010-01-01

    Polihexanide is an antimicrobial compound suitable for clinical use in critically colonized or infected acute and chronic wounds. Its beneficial characteristic is attributable particularly to its broad antimicrobial spectrum, good cell and tissue tolerability, ability to bind to the organic matrix, low risk of contact sensitization, and wound healing promoting effect. In addition, no development of microorganism resistance during polihexanide

  17. Developing a Real Time Sensing System to Monitor Bacteria in Wound Dressings

    PubMed Central

    Farrow, Malcolm J.; Hunter, Iain S.; Connolly, Patricia

    2012-01-01

    Infection control is a key aspect of wound management strategies. Infection results in chemical imbalances and inflammation in the wound and may lead to prolonged healing times and degradation of the wound surface. Frequent changing of wound dressings may result in damage to healing tissues and an increased risk of infection. This paper presents the first results from a monitoring system that is being developed to detect presence and growth of bacteria in real time. It is based on impedance sensors that could be placed at the wound-dressing interface and potentially monitor bacterial growth in real time. As wounds can produce large volumes of exudate, the initial system reported here was developed to test for the presence of bacteria in suspension. Impedance was measured using disposable silver-silver chloride electrodes. The bacteria Staphylococcus aureus were chosen for the study as a species commonly isolated from wounds. The growth of bacteria was confirmed by plate counting methods and the impedance data were analysed for discernible differences in the impedance profiles to distinguish the absence and/or presence of bacteria. The main findings were that the impedance profiles obtained by silver-silver chloride sensors in bacterial suspensions could detect the presence of high cell densities. However, the presence of the silver-silver chloride electrodes tended to inhibit the growth of bacteria. These results indicate that there is potential to create a real time infection monitor for wounds based upon impedance sensing. PMID:25585709

  18. Wound Bed Preparation for Chronic Diabetic Foot Ulcers

    PubMed Central

    Mat Saad, Arman Zaharil; Khoo, Teng Lye; Halim, Ahmad Sukari

    2013-01-01

    The escalating incidence of diabetic mellitus has given rise to the increasing problems of chronic diabetic ulcers that confront the practice of medicine. Peripheral vascular disease, neuropathy, and infection contribute to the multifactorial pathogenesis of diabetic ulcers. Approaches to the management of diabetic ulcers should start with an assessment and optimization of the patient's general conditions, followed by considerations of the local and regional factors. This paper aims to address the management strategies for wound bed preparation in chronic diabetic foot ulcers and also emphasizes the importance of preventive measures and future directions. The “TIME” framework in wound bed preparation encompasses tissue management, inflammation and infection control, moisture balance, and epithelial (edge) advancement. Tissue management aims to remove the necrotic tissue burden via various methods of debridement. Infection and inflammation control restores bacterial balance with the reduction of bacterial biofilms. Achieving a moist wound healing environment without excessive wound moisture or dryness will result in moisture balance. Epithelial advancement is promoted via removing the physical and biochemical barriers for migration of epithelium from wound edges. These systematic and holistic approaches will potentiate the healing abilities of the chronic diabetic ulcers, including those that are recalcitrant. PMID:23476800

  19. Reconstructive challenges in war wounds

    PubMed Central

    Bhandari, Prem Singh; Maurya, Sanjay; Mukherjee, Mrinal Kanti

    2012-01-01

    War wounds are devastating with extensive soft tissue and osseous destruction and heavy contamination. War casualties generally reach the reconstructive surgery centre after a delayed period due to additional injuries to the vital organs. This delay in their transfer to a tertiary care centre is responsible for progressive deterioration in wound conditions. In the prevailing circumstances, a majority of war wounds undergo delayed reconstruction, after a series of debridements. In the recent military conflicts, hydrosurgery jet debridement and negative pressure wound therapy have been successfully used in the preparation of war wounds. In war injuries, due to a heavy casualty load, a faster and reliable method of reconstruction is aimed at. Pedicle flaps in extremities provide rapid and reliable cover in extremity wounds. Large complex defects can be reconstructed using microvascular free flaps in a single stage. This article highlights the peculiarities and the challenges encountered in the reconstruction of these ghastly wounds. PMID:23162233

  20. Optimizing Prevention of Healthcare-Acquired Infections After Cardiac Surgery (HAI)_2

    ClinicalTrials.gov

    2014-06-20

    Cardiovascular Disease; Healthcare Associated Infectious Disease; Sternal Superficial Wound Infection; Deep Sternal Infection; Mediastinitis; Thoracotomy; Conduit Harvest or Cannulation Site; Sepsis; Pneumonia

  1. Freshwater Algae Can Infect Wounds, Study Shows

    MedlinePLUS

    ... time that the algae -- a species common in rivers and lakes called Desmodesmus armatus -- has been conclusively ... Americans take any special precautions in the nation's rivers and streams, based on these cases? Ford thinks ...

  2. Total management of diabetic foot ulcerations--Kobe classification as a new classification of diabetic foot wounds.

    PubMed

    Terashi, Hiroto; Kitano, Ikuro; Tsuji, Yoriko

    2011-01-01

    Treatment must be conducted after proper assessment of diabetic foot wounds. This implies appropriate foot care and the use of proper footwear from the perspectives of prophylaxis and walking. Diabetic foot wounds have some wound impairment factors, including peripheral neuropathy (PN), peripheral arterial disease (PAD), and infection; such wounds comprise combinations of these lesions. An additional goal besides wound healing is gait salvage. Here, we propose a simple new four-level classification of diabetic foot ulcerations, which we have termed the Kobe classification, in order to assess the wounds more easily and treat them systematically; the classification is as follows: Type I, mainly PN; Type II, mainly PAD; Type III, mainly infection; Type IV, PN+PAD+infection. PMID:21460599

  3. A Pediatric Acute Wound Service (PAWS): A Novel Approach in Wound Management

    PubMed Central

    Bucher, BT; Seigel, J; Rosenblum, E; Nesslein, C; Keswani, S; Foglia, RP; Dillon, PA; Warner, BW; Keller, MS

    2010-01-01

    Introduction In 2001, in response to an overwhelming increase in patient visits for various pediatric abscesses, burns, and other wounds, an ambulatory burn and procedural sedation program (PAWS) was developed to minimize Operating Room utilization. The purpose of this study is to report our initial seven year experience with the PAWS program Methods The hospital records of all children managed through PAWS from 2001-2007 were reviewed. Outcomes measured include patient demographics, number and location of visits per patient, procedure information, cause of wounds, and reimbursement. Chi-Square test and linear regression was performed using GraphPad Prism. Results Overall, 7620 children (age 0-18 years) received wound care through PAWS from 2001-2007. There were no differences in patient age, race, and gender during this time period. Between 2001 and 2007, the percentage of patients seen as outpatients increased from 51% to 68% (p<0.05), and the average number of visits per patient decreased from 3.9 to 2.4 (p=0.05). In, 2007, forty-six percent of the children required only one visit. In 2007, 74% of the visits were for management of wound and soft tissue infections, compared to only 9% in 2001 (p<0.05). The contribution margin of a PAWS visit and total contribution margin in 2007 was $1052 and $4.0 million, respectively. Conclusion The creation of PAWS has allowed for the transition in management of most pediatric skin and soft tissue wounds and infections to an independent ambulatory setting, alleviating the need for Operating Room resources, while functioning at a profitable cost margin for the hospital. PMID:20105599

  4. Interaction of Microbiome and the Innate Immune Response in Chronic Wounds

    PubMed Central

    Grice, Elizabeth A.; Segre, Julia A.

    2012-01-01

    Microbes colonizing and/or infecting chronic wounds undoubtedly play a major and interactive role in impaired healing, especially in amplifying and perpetuating the host innate immune response. The development of molecular techniques to identify and quantify microbial organisms has revolutionized our view of the microbial world. These less-biased, high throughput methods greatly enable investigations regarding host-microbe interactions in the chronic wound environment. This review focuses on the mounting evidence implicating microbes and excessive inflammation in chronic wounds, as well as the challenges associated with understanding how microbes modulate wound healing and the innate immune response. PMID:21948362

  5. Clinical experience with Leptospermum honey use for treatment of hard to heal neonatal wounds: case series.

    PubMed

    Boyar, V; Handa, D; Clemens, K; Shimborske, D

    2014-02-01

    Preterm, critically ill neonates represent a challenge in wound healing. Many factors predispose infants to skin injuries, including decreased epidermal-dermal cohesion, deficient stratum corneum, relatively alkaline pH of skin surface, impaired nutrition and presence of multiple devices on the skin. We present a case series describing the use of medical-grade honey-Leptospermum honey (Medihoney), for successful treatment of slowly healing neonatal wounds, specifically stage 3 pressure ulcer, dehiscent and infected sternal wound, and full-thickness wound from an extravasation injury. PMID:24476663

  6. Proteases and Delayed Wound Healing

    PubMed Central

    McCarty, Sara M.; Percival, Steven L.

    2013-01-01

    Significance Proteases and their inhibitors contribute to the balance between extracellular matrix (ECM) degradation and deposition, creating an equilibrium that is essential for the timely and coordinated healing of cutaneous wounds. However, when this balance is disrupted, wounds are led into a state of chronicity characterized by abundant levels of proteases and decreased levels of protease inhibitors. Recent Advances Researchers have sought to investigate the roles of proteases within both acute and chronic wounds and how the manipulation of protease activity may aid healing. Indeed, numerous wound dressings have been developed that target such proteases in an attempt to promote wound healing. Critical Issues The normal tissue response to injury involves a complex interaction between cells and cellular mediators. In particular, the inflammatory response is augmented in chronic wounds which are characterized by elevated levels of proinflammatory cytokines and proteases. While controlling levels of inflammation and protease expression is a critical part of normal wound healing, elevated and prolonged expression of proteases produced during the inflammatory phase of healing can lead to excessive ECM degradation associated with impaired healing. Future Directions It seems plausible that future research should aim to investigate the ways in which proteases may be targeted as an alternative therapeutic approach to wound management and to assess the benefits and draw-backs of utilizing wound fluids to assess wound progression in terms of proteolytic activity. PMID:24688830

  7. Oxygen: Implications for Wound Healing

    PubMed Central

    Castilla, Diego M.; Liu, Zhao-Jun; Velazquez, Omaida C.

    2012-01-01

    Background Oxygen is vital for healing wounds. It is intricately involved in numerous biological processes including cell proliferation, angiogenesis, and protein synthesis, which are required for restoration of tissue function and integrity. Adequate wound tissue oxygenation can trigger healing responses and favorably influence the outcomes of other treatment modalities. The Problem Chronic ischemic wounds fail to heal appropriately secondary to extreme hypoxia that leads to cellular demise. Wound tissue hypoxia is typically greater at the center of the wound. Accordingly, oxygen requirements of the regenerating tissue will vary. Basic/Clinical Science Advances As oxygen levels decrease within the wound, cell response mechanisms (hypoxia inducible factor [HIF]) trigger the transcription of genes that promote cell survival and angiogenesis. HIF stabilizers are currently being tested to determine wound healing potential. Clinically, topical oxygen therapy (TOT) has been proved as an effective therapeutic modality for chronic wounds. TOT is reputed to have several advantages over hyperbaric oxygen therapy. Namely, TOT has a lower risk of oxygen toxicity, it is less expensive and is relatively easy to apply to target areas. Clinical Care Relevance Wound tissue oxygen is necessary for appropriate wound healing; however, the relative complexity of the healing process requires a multifaceted approach for successful healing outcomes. A key component of this multifaceted approach should be specific oxygen dosing as a function of tissue hypoxia. Conclusion New treatment approaches that exploit cell hypoxia sensing and response mechanisms and that enable the precise application of oxygen therapy to hypoxic areas of regenerating tissue are very promising. PMID:24527310

  8. Telemedicine in wound care.

    PubMed

    Chanussot-Deprez, Caroline; Contreras-Ruiz, José

    2008-12-01

    Telemedical wound care is one of the applications of teledermatology. We present our experience using telemedicine in the successful assessment and treatment of three patients with hard-to-heal ulcers. Three patients were seen at the PEMEX General Hospital in Veracruz, Mexico. The first patient was a 53-year-old man with hypertension, morbid obesity, chronic venous insufficiency, recurrent erysipelas, leg ulcers and lymphoedema. There was one ulcer on his left lower leg (20 x 10 cm) and one on his right leg (9 x 7 cm). The second patient was a 73-year-old woman with class III obesity and ulcers in her right leg, secondary to surgical debridement of bullous erysipelas. The third patient was a 51-year-old female with rheumatoid arthritis with one ulcer on each leg and chronic lymphostasis. Photographs with a digital camera were taken and sent weekly via email to a wound care specialist in Mexico City. The photographs allowed the expert to diagnose and evaluate the chronic wounds periodically. In the present cases, telemedicine allowed us to have a rapid evaluation, diagnosis and treatment. The images were of enough quality to be useful and small enough to be sent via regular email to the remote physician who immediately gave his feedback. The expert was confident to give therapeutic recommendations in this way, and we considered this method to be very cost-effective, saving the patient and the health care system, especially in transportation. PMID:18808429

  9. Management of a gunshot wound in a mare

    PubMed Central

    Mellish, Martha A.; Adreani, Christine M.

    2008-01-01

    A 5-year-old, Quarter horse mare was treated for severe cellulitis secondary to a gunshot wound near the right humerus. The bullet was not retrieved due to the risk of damaging the radial nerve or elbow joint. Despite the presence of the bullet, the mare resumed athletic soundness once the infection had resolved. PMID:18309749

  10. Shedding Light on a New Treatment for Diabetic Wound Healing: A Review on Phototherapy

    PubMed Central

    Houreld, Nicolette N.

    2014-01-01

    Impaired wound healing is a common complication associated with diabetes with complex pathophysiological underlying mechanisms and often necessitates amputation. With the advancement in laser technology, irradiation of these wounds with low-intensity laser irradiation (LILI) or phototherapy, has shown a vast improvement in wound healing. At the correct laser parameters, LILI has shown to increase migration, viability, and proliferation of diabetic cells in vitro; there is a stimulatory effect on the mitochondria with a resulting increase in adenosine triphosphate (ATP). In addition, LILI also has an anti-inflammatory and protective effect on these cells. In light of the ever present threat of diabetic foot ulcers, infection, and amputation, new improved therapies and the fortification of wound healing research deserves better prioritization. In this review we look at the complications associated with diabetic wound healing and the effect of laser irradiation both in vitro and in vivo in diabetic wound healing. PMID:24511283

  11. Attempts to accelerate wound healing.

    PubMed

    Kasuya, Akira; Tokura, Yoshiki

    2014-12-01

    Wound healing is a well-orchestrated process, where numerous factors are activated or inhibited in a sequence of steps. Immediately after the infliction of damage, the repair of wound stars. The initial step is an inflammatory change with activation of innate immunity, which is followed by proliferation phase, including fibroplasia, angiogenesis and re-epithelialization. Pathological impairment of wound healing process may lead to persistent ulceration as seen in diabetic patients. Various signaling pathways are involved in wound healing. TGF?/Smad pathway is a representative and well known to participate in fibroplasia, however, its comprehensive effect on wound healing is controversial. Experimental and clinical remedies have been being tried to promote wound healing. Advancement of cell engineering allows us to use stem cells and living skin equivalents. PMID:25468357

  12. WITA — Application for wound analysis and management

    Microsoft Academic Search

    Damir Filko; Davor Antonic; Dubravko Huljev

    2010-01-01

    Wound characterization is important task in chronic wounds treatment, because changes of the wound size and tissue types are indicators of the healing progress. Developed color image processing software analyze digital wound image and based on learned tissue samples performs tissue classification. Implemented statistical pattern recognition algorithm classifies individual pixels of the wound image based on color information. Classification parameters

  13. Obesity and the challenges of caesarean delivery: Prevention and management of wound complications.

    PubMed

    Ayres-de-Campos, Diogo

    2015-04-01

    Caesarean section in obese patients is associated with an increased risk of surgical wound complications, including haematoma, seroma, abscess and dehiscence. This review focusses on the available strategies to decrease wound complications in this population, and on the clinical management of these situations. Appropriate dose of prophylactic antibiotics, closure of the subcutaneous tissue, and avoidance of subcutaneous drains reduce the incidence of wound complications associated with caesarean section in obese patients. For treatment of superficial wound infection associated with dehiscence, there are data from general surgery patients to suggest that the use of vacuum-assisted devices leads to faster healing and that surgical reclosure is preferable to healing by secondary intention, when there are no signs of ongoing infection. There is a need for stronger evidence regarding the prevention and management of wound complications for caesarean section in obese women. PMID:25457856

  14. Antibacterial honey (Medihoney®) for wound care of immunocompromised pediatric oncology patients

    PubMed Central

    Simon, Arne; Sofka, Kai; Wieszniewsky, Gertrud; Blaser, Gisela

    2006-01-01

    The physiologic process of wound healing is impaired and prolonged in paediatic patients receiving chemotherapy. Due to profound immunosuppression, wound infection can easily spread and act as the source of sepsis. Referring to in vitro studies, which confirmed the antibacterial potency of special honey preparations against typical isolates of nosocomially acquired wound infections (including MRSA and VRE) and considering the encouraging reports from other groups, Medihoney™ has now been used in wound care at the Department of Pediatric Oncology, Children's Hospital, University of Bonn for three years. Supplemented with exemplary clinical data from pediatric oncology patients, this presentation reviews the scientific background and our promising experience with Medihoney™ in wound care issues at our institution. PMID:20204081

  15. Antibacterial honey (Medihoney) for wound care of immunocompromised pediatric oncology patients.

    PubMed

    Simon, Arne; Sofka, Kai; Wieszniewsky, Gertrud; Blaser, Gisela

    2006-01-01

    The physiologic process of wound healing is impaired and prolonged in paediatic patients receiving chemotherapy. Due to profound immunosuppression, wound infection can easily spread and act as the source of sepsis. Referring to in vitro studies, which confirmed the antibacterial potency of special honey preparations against typical isolates of nosocomially acquired wound infections (including MRSA and VRE) and considering the encouraging reports from other groups, Medihoney has now been used in wound care at the Department of Pediatric Oncology, Children's Hospital, University of Bonn for three years. Supplemented with exemplary clinical data from pediatric oncology patients, this presentation reviews the scientific background and our promising experience with Medihoney in wound care issues at our institution. PMID:20204081

  16. Bioengineering Techniques in Wound Assessment

    Microsoft Academic Search

    Marco Romanelli; Valentina Dini

    Wound measurement is essential in assessing the progress of wound healing in clinical practice. Such measurement provides\\u000a objective data that assists in establishing wound healing progress, alerts the clinician to evidence of deterioration, enhances\\u000a communication between healthcare providers as well as healthcare providers and patients, aids in the selection of advanced\\u000a treatment modalities and provides a concise account of the

  17. Wound-induced suberization genes are differentially expressed, patially and temporally, during closing layer and wound periderm formation

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Potato tuber (Solanum tuberosum L.) wounds incurred at harvest and upon seed cutting require rapid suberization as a major part of the healing process to prevent infection and desiccation. However, little is known about the induction and expression of genes that are essential for these processes an...

  18. Benefit and harm of iodine in wound care: a systematic review.

    PubMed

    Vermeulen, H; Westerbos, S J; Ubbink, D T

    2010-11-01

    Nowadays many products are available to combat infections and thus to promote wound healing. Iodine is one of these products, but reports are conflicting as to the effectiveness and adverse effects of iodine in the treatment of wounds. A systematic review was performed of 27 randomised clinical trials, reporting on chronic, acute, burn wounds, pressure sores, and skin grafts. Main outcome parameters were wound healing, bacterial count, and adverse effects. Iodine did not lead to a reduction or prolongation of wound-healing time compared with other (antiseptic) wound dressings or agents. In individual trials, iodine was significantly superior to other antiseptic agents (such as silver sulfadiazine cream) and non-antiseptic dressings, but seemed inferior to a local antibiotic (Rifamycin SV MMX(®)) and, when combined with alcohol, to crude honey in reducing bacterial count and/or wound size. Adverse effects, including thyroid function derailment, did not occur more frequently with iodine. Based on the available evidence from clinical trials, iodine is an effective antiseptic agent that shows neither the purported harmful effects nor a delay of the wound-healing process, particularly in chronic and burn wounds. The antiseptic effect of iodine is not inferior to that of other (antiseptic) agents and does not impair wound healing. Hence, iodine deserves to retain its place among the modern antiseptic agents. PMID:20619933

  19. Wound Healing and the Dressing*

    PubMed Central

    Scales, John T.

    1963-01-01

    The evolution of surgical dressings is traced from 1600 b.c. to a.d. 1944. The availability of an increasing variety of man-made fibres and films from 1944 onwards has stimulated work on wound dressings, and some of the more important contributions, both clinical and experimental, are discussed. The functions of a wound dressing and the properties which the ideal wound dressing should possess are given. The necessity for both histological and clinical evaluation of wound dressings in animals and in man is stressed. Wound dressings are the most commonly used therapeutic agents, but there is no means whereby their performance can be assessed. An attempt should be made either nationally or internationally to establish a standard method of assessing the performance of wound dressings. For this it is necessary to have an internationally agreed standard dressing which could be used as a reference or control dressing in all animal and human work. The only animal with skin morphologically similar to that of man is the domestic pig. Three types of wounds could be used: (1) partial-thickness wounds; (2) full-thickness excisions; and (3) third-degree burns. The development of standard techniques for the assessment of the efficiency of wound dressings would be of considerable benefit to the research worker, the medical profession, the patient, and the surgical dressings industry. PMID:13976490

  20. Healing in the irradiated wound

    SciTech Connect

    Miller, S.H.; Rudolph, R. (Univ. of California, San Diego (USA))

    1990-07-01

    Poor or nonhealing of irradiated wounds has been attributed to progressive obliterative endarteritis. Permanently damaged fibroblasts may also play an important part in poor healing. Regardless of the cause, the key to management of irradiated skin is careful attention to prevent its breakdown and conservative, but adequate, treatment when wounds are minor. When wounds become larger and are painful, complete excision of the wound or ulcer is called for and coverage should be provided by a well-vascularized nonparasitic distant flap.16 references.

  1. Survey of bacterial diversity in chronic wounds using Pyrosequencing, DGGE, and full ribosome shotgun sequencing

    PubMed Central

    Dowd, Scot E; Sun, Yan; Secor, Patrick R; Rhoads, Daniel D; Wolcott, Benjamin M; James, Garth A; Wolcott, Randall D

    2008-01-01

    Background Chronic wound pathogenic biofilms are host-pathogen environments that colonize and exist as a cohabitation of many bacterial species. These bacterial populations cooperate to promote their own survival and the chronic nature of the infection. Few studies have performed extensive surveys of the bacterial populations that occur within different types of chronic wound biofilms. The use of 3 separate16S-based molecular amplifications followed by pyrosequencing, shotgun Sanger sequencing, and denaturing gradient gel electrophoresis were utilized to survey the major populations of bacteria that occur in the pathogenic biofilms of three types of chronic wound types: diabetic foot ulcers (D), venous leg ulcers (V), and pressure ulcers (P). Results There are specific major populations of bacteria that were evident in the biofilms of all chronic wound types, including Staphylococcus, Pseudomonas, Peptoniphilus, Enterobacter, Stenotrophomonas, Finegoldia, and Serratia spp. Each of the wound types reveals marked differences in bacterial populations, such as pressure ulcers in which 62% of the populations were identified as obligate anaerobes. There were also populations of bacteria that were identified but not recognized as wound pathogens, such as Abiotrophia para-adiacens and Rhodopseudomonas spp. Results of molecular analyses were also compared to those obtained using traditional culture-based diagnostics. Only in one wound type did culture methods correctly identify the primary bacterial population indicating the need for improved diagnostic methods. Conclusion If clinicians can gain a better understanding of the wound's microbiota, it will give them a greater understanding of the wound's ecology and will allow them to better manage healing of the wound improving the prognosis of patients. This research highlights the necessity to begin evaluating, studying, and treating chronic wound pathogenic biofilms as multi-species entities in order to improve the outcomes of patients. This survey will also foster the pioneering and development of new molecular diagnostic tools, which can be used to identify the community compositions of chronic wound pathogenic biofilms and other medical biofilm infections. PMID:18325110

  2. Next Science Wound Gel Technology, a Novel Agent That Inhibits Biofilm Development by Gram-Positive and Gram-Negative Wound Pathogens

    PubMed Central

    Miller, Kyle G.; Tran, Phat L.; Haley, Cecily L.; Kruzek, Cassandra; Colmer-Hamood, Jane A.; Myntti, Matt

    2014-01-01

    Loss of the skin barrier facilitates the colonization of underlying tissues with various bacteria, where they form biofilms that protect them from antibiotics and host responses. Such wounds then become chronically infected. Topical antimicrobials are a major component of chronic wound therapy, yet currently available topical antimicrobials vary in their effectiveness on biofilm-forming pathogens. In this study, we evaluated the efficacy of Next Science wound gel technology (NxtSc), a novel topical agent designed to kill planktonic bacteria, penetrate biofilms, and kill the bacteria within. In vitro quantitative analysis, using strains isolated from wounds, showed that NxtSc inhibited biofilm development by Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae by inhibiting bacterial growth. The gel formulation NxtSc-G5, when applied to biofilms preformed by these pathogens, reduced the numbers of bacteria present by 7 to 8 log10 CFU/disc or CFU/g. In vivo, NxtSc-G5 prevented biofilm formation for 72 h when applied at the time of wounding and infection and eliminated biofilm infection when applied 24 h after wounding and infection. Storage of NxtSc-G5 at room temperature for 9 months did not diminish its efficacy. These results establish that NxtSc is efficacious in vitro and in vivo in preventing infection and biofilm development by different wound pathogens when applied immediately and in eliminating biofilm infection already established by these pathogens. This novel antimicrobial agent, which is nontoxic and has a usefully long shelf life, shows promise as an effective agent for the prevention and treatment of biofilm-related infections. PMID:24637684

  3. Ultraviolet Radiation in Wound Care: Sterilization and Stimulation

    PubMed Central

    Gupta, Asheesh; Avci, Pinar; Dai, Tianhong; Huang, Ying-Ying; Hamblin, Michael R.

    2013-01-01

    Significance Wound care is an important area of medicine considering the increasing age of the population who may have diverse comorbidities. Light-based technology comprises a varied set of modalities of increasing relevance to wound care. While low-level laser (or light) therapy and photodynamic therapy both have wide applications in wound care, this review will concentrate on the use of ultraviolet (UV) radiation. Recent Advances UVC (200–280?nm) is highly antimicrobial and can be directly applied to acute wound infections to kill pathogens without unacceptable damage to host tissue. UVC is already widely applied for sterilization of inanimate objects. UVB (280–315?nm) has been directly applied to the wounded tissue to stimulate wound healing, and has been widely used as extracorporeal UV radiation of blood to stimulate the immune system. UVA (315–400?nm) has distinct effects on cell signaling, but has not yet been widely applied to wound care. Critical Issues Penetration of UV light into tissue is limited and optical technology may be employed to extend this limit. UVC and UVB can damage DNA in host cells and this risk must be balanced against beneficial effects. Chronic exposure to UV can be carcinogenic and this must be considered in planning treatments. Future Directions New high-technology UV sources, such as light-emitting diodes, lasers, and microwave-generated UV plasma are becoming available for biomedical applications. Further study of cellular signaling that occurs after UV exposure of tissue will allow the benefits in wound healing to be better defined. PMID:24527357

  4. Novel bilayer wound dressing composed of silicone rubber with particular micropores enhanced wound re-epithelialization and contraction.

    PubMed

    Xu, Rui; Luo, Gaoxing; Xia, Hesheng; He, Weifeng; Zhao, Jian; Liu, Bo; Tan, Jianglin; Zhou, Junyi; Liu, Daisong; Wang, Yuzhen; Yao, Zhihui; Zhan, Rixing; Yang, Sisi; Wu, Jun

    2015-02-01

    Wound dressing is critical important for cutaneous wound healing. However, the application of current products is limited due to poor mechanical property, unsuitable water vapor transmission rate (WVTR), poor anti-infective property or poor biocompatibility, etc. In the present study, a microporous silicone rubber membrane bilayer (SRM-B) composed of two layers with different pore sizes was prepared. The physical properties, the influences of pore structure on the bacterial penetration, the cell adhesion and proliferation were studied. Lastly, the effects of the SRM-B on the healing of a mouse full-thickness wound were examined. The data showed that the small pore upper layer of SRM-B could effectively prevent the bacterial invasion, as well as properly keep the water vapor transmission rate; the large pore lower layer of SRM-B could promote the cell adhesion and proliferation. The in vivo results showed that SRM-B could significantly enhance wound re-epithelialization and contraction, which accelerated the wound healing. Our data suggested that the SRM-B, with different particular pore sizes, could serve as a kind of promising wound dressing. PMID:25498800

  5. Wounded Nucleons, Wounded Quarks, and Relativistic Ion Collisions

    E-print Network

    Helena Bialkowska

    2006-09-06

    A concept of wounded nucleons and/or wounded quarks plays an important role in parametrizing and to some extent explaining many a feature of the relativistic ion collisions. This will be illustrated in a historical perspective, up to and including the latest developpments.

  6. Wound tube heat exchanger

    DOEpatents

    Ecker, Amir L. (Duncanville, TX)

    1983-01-01

    What is disclosed is a wound tube heat exchanger in which a plurality of tubes having flattened areas are held contiguous adjacent flattened areas of tubes by a plurality of windings to give a double walled heat exchanger. The plurality of windings serve as a plurality of effective force vectors holding the conduits contiguous heat conducting walls of another conduit and result in highly efficient heat transfer. The resulting heat exchange bundle is economical and can be coiled into the desired shape. Also disclosed are specific embodiments such as the one in which the tubes are expanded against their windings after being coiled to insure highly efficient heat transfer.

  7. Evaluation of LHP® (1% hydrogen peroxide) cream versus petrolatum and untreated controls in open wounds in healthy horses: a randomized, blinded control study

    PubMed Central

    2011-01-01

    Background Treatment and protection of wounds in horses can be challenging; protecting bandages may be difficult to apply on the proximal extremities and the body. Unprotected wounds carry an increased risk of bacterial contamination and subsequent infection which can lead to delayed wound healing. Topical treatment with antimicrobials is one possibility to prevent bacterial colonization or infection, but the frequent use of antimicrobials ultimately leads to development of bacterial resistance which is an increasing concern in both human and veterinary medicine. Methods Standardized wounds were created in 10 Standardbred mares. Three wounds were made in each horse. Two wounds were randomly treated with LHP® or petrolatum and the third wound served as untreated control. All wounds were assessed daily until complete epithelization. Protocol data were recorded on day 2, 6, 11, 16, 21 and 28. Data included clinical scores for inflammation and healing, photoplanimetry for calculating wound areas and swab cytology to assess bacterial colonization and inflammation. Bacterial cultures were obtained on day 2, 6 and 16. Results Mean time to complete healing for LHP® treated wounds was 32 days (95%CI = 26.9-37.7). Mean time to complete healing for petrolatum and untreated control wounds were 41.6 days (95%CI = 36.2-47.0) and 44.0 days (95%CI = 38.6-49.4) respectively. Wound healing occurred significantly faster in LHP® wounds compared to both petrolatum (p = 0.0004) and untreated controls (p < 0.0001). There was no significant difference in time for healing between petrolatum and untreated controls. Total scores for bacteria and neutrophils were significantly (p < 0.0001) lower for LHP® treated wounds compared to petrolatum from day 16 and onwards. Staphylococcus aureus and Streptococcus zooepidemicus were only found in cultures from petrolatum treated wounds and untreated controls. Conclusions Treatment with LHP® reduced bacterial colonization and was associated with earlier complete wound healing. LHP® cream appears to be safe and effective for topical wound treatment or wound protection. PMID:21718487

  8. Characterization of Bacterial Communities in Venous Insufficiency Wounds by Use of Conventional Culture and Molecular Diagnostic Methods?

    PubMed Central

    Tuttle, Marie S.; Mostow, Eliot; Mukherjee, Pranab; Hu, Fen Z.; Melton-Kreft, Rachael; Ehrlich, Garth D.; Dowd, Scot E.; Ghannoum, Mahmoud A.

    2011-01-01

    Microbial infections delay wound healing, but the effect of the composition of the wound microbiome on healing parameters is unknown. To better understand bacterial communities in chronic wounds, we analyzed debridement samples from lower-extremity venous insufficiency ulcers using the following: conventional anaerobic and aerobic bacterial cultures; the Ibis T5000 universal biosensor (Abbott Molecular); and 16S 454 FLX titanium series pyrosequencing (Roche). Wound debridement samples were obtained from 10 patients monitored clinically for at least 6 months, at which point 5 of the 10 sampled wounds had healed. Pyrosequencing data revealed significantly higher bacterial abundance and diversity in wounds that had not healed at 6 months. Additionally, Actinomycetales was increased in wounds that had not healed, and Pseudomonadaceae was increased in wounds that had healed by the 6-month follow-up. Baseline wound surface area, duration, or analysis by Ibis or conventional culture did not reveal significant differences between wounds that healed after 6 months and those that did not. Thus, pyrosequencing identified distinctive baseline characteristics of wounds that did not heal by the 6-month follow-up, furthering our understanding of potentially unique microbiome characteristics of chronic wounds. PMID:21880958

  9. Wound Warning Signs

    MedlinePLUS

    ... Campaigns Read Patient Stories Health News About Emergencies Childhood / Student Emergencies Diseases & Infections Disaster Preparedness Elderly Safety Holiday & Seasonal Injury Prevention Travel & Motor Vehicle Safety En Español ER ...

  10. Nanofiber Microenvironment and Diabetic Wound Healing

    Cancer.gov

    Diabetic nonhealing wounds represent a major public health problem. Diabetic wounds are characterized by altered wound microenvironment, unbalanced proteolytic activity, prolonged inflammation, and insufficient neovascularization. The efficacy of conventional therapies is unsatisfactory and often results in recurrence of wounds at characteristically predisposed sites, as a direct consequence of poor wound repair. Skin substitutes based on novel biocomposite materials represent the most promising bioengineering technology today and may offer an exciting new treatment strategy in management of chronic wounds.

  11. miRNA in Diabetic Wound Healing

    Cancer.gov

    Impairment of dermal wound healing is a debilitating complication commonly encountered during diabetes mellitus. Dysregulated inflammatory and angiogenesis phases are key players in the impairment of diabetic wound healing. Emerging studies indicate that miRNAs play a key role in regulating several hubs that orchestrate the wound inflammation and angiogenesis processes. Our laboratory first reported dysfunction in wound macrophage efferocytosis function leading to impaired resolution of wound inflammation in diabetic wounds.

  12. Wound healing properties and kill kinetics of Clerodendron splendens G. Don, a Ghanaian wound healing plant

    PubMed Central

    Gbedema, Stephen Y.; Emelia, Kisseih; Francis, Adu; Kofi, Annan; Eric, Woode

    2010-01-01

    As part of our general objective of investigating indigenous plants used in wound healing in Ghana, we hereby report our findings from some in vitro and in vivo studies related to wound healing activities of Clerodendron splendens G. Don (Verbanaceae). Methanolic extract of the aerial parts of the plant was tested for antimicrobial activity against Gram positive bacteria (Bacillus subtilis, Staphylococcus aureus, Streptococcus faecalis, Micrococcus flavus, as well as resistant strains of Staph. aureus SA1199B, RN4220 and XU212), Gram negative bacteria (Escherichia coli, Pseudomonas aeruginosa, Proteous mirabilis, Klebsiella pneumoniae) and Candida albicans using the micro-well dilution method. Survivor–time studies of the microorganisms, radical scavenging activity using 2,2’-diphenylpicrylhydrazyl (DPPH) and various in vivo wound healing activity studies were also conducted on the extract. The extract exhibited biostatic action against all the test microorganisms with a Minimum Inhibition Concentration (MIC) ranging between 64 and 512 ?g/ml and a free radical scavenging property with an IC50 value of 103.2 ?g/ml. The results of the in vivo wound healing tests showed that upon application of C. splendens ointment, there was a reduction in the epithelization period from 26.7 days (control) to 13.6 days along with a marked decrease in the scar area from 54.2 mm2 (control) to 25.2 mm2. Significant increase in the tensile strength and hydroxyproline content were also observed as compared to the control and was comparable to nitrofurazone. The above results appear to justify the traditional use of C. splendens in wound healing and treatment of skin infections in Ghana. PMID:21808542

  13. Skin Substitutes and Wound Healing

    Microsoft Academic Search

    F. A. Auger; D. Lacroix; L. Germain

    2009-01-01

    Medical science has vastly improved on the means and methods available for the treatment of wounds in the clinic. The production and use of various types of skin substitutes has led to dramatic improvements in the odds of survival for severely burned patients, but they have also shown promise for many other applications, including cases involving chronic wounds that are

  14. Transcriptional regulation of wound inflammation.

    PubMed

    Haertel, Eric; Werner, Sabine; Schäfer, Matthias

    2014-08-01

    The attraction and activation of immune cells is an important response of the skin to injury and allows an efficient defense against invading pathogens. In addition, immune cells fulfill various functions that are important for the repair process. An exaggerated inflammatory response, however, is a hallmark of chronic, non-healing wounds. Therefore, it is essential to strictly control and coordinate the levels and activities of various immune cells in normal and wounded skin. Recent studies provided insight into the molecular mechanisms underlying the inflammatory response after wounding, and various transcriptional regulators involved in this process have been identified. This review summarizes our current knowledge on the function of different transcription factors in wound repair, with particular emphasis on proteins with a documented role in the control of wound inflammation. PMID:24556599

  15. Hyperbaric oxygen for chronic wounds.

    PubMed

    Goldstein, Lee J

    2013-01-01

    Hyperbaric oxygen therapy (HBOT), the administration of pressurized 100% oxygen, is used as an adjunct to aid healing in selected chronic wounds. Though the therapy has had a controversial history, research is now elucidating the mechanisms by which HBOT helps to heal wounds. HBOT increases growth factors and local wound signaling, while also promoting a central stem cell release of endothelial progenitor cells from the bone marrow via nitric oxide pathways. The clinical data continue to accumulate in support of HBOT to help hasten wound healing, and reduce the amputation rate in diabetic ulcers. In appropriate patients, HBOT is an effective, noninvasive, adjunct modality that can be used to hasten chronic wound healing. PMID:23742281

  16. Use of Incisional Negative Pressure Wound Therapy on Closed Median Sternal Incisions after Cardiothoracic Surgery: Clinical Evidence and Consensus Recommendations

    PubMed Central

    Dohmen, Pascal M.; Markou, Thanasie; Ingemansson, Richard; Rotering, Heinrich; Hartman, Jean M.; van Valen, Richard; Brunott, Maaike; Segers, Patrique

    2014-01-01

    Negative pressure wound therapy is a concept introduced initially to assist in the treatment of chronic open wounds. Recently, there has been growing interest in using the technique on closed incisions after surgery to prevent potentially severe surgical site infections and other wound complications in high-risk patients. Negative pressure wound therapy uses a negative pressure unit and specific dressings that help to hold the incision edges together, redistribute lateral tension, reduce edema, stimulate perfusion, and protect the surgical site from external infectious sources. Randomized, controlled studies of negative pressure wound therapy for closed incisions in orthopedic settings (which also is a clean surgical procedure in absence of an open fracture) have shown the technology can reduce the risk of wound infection, wound dehiscence, and seroma, and there is accumulating evidence that it also improves wound outcomes after cardiothoracic surgery. Identifying at-risk individuals for whom prophylactic use of negative pressure wound therapy would be most cost-effective remains a challenge; however, several risk-stratification systems have been proposed and should be evaluated more fully. The recent availability of a single-use, closed incision management system offers surgeons a convenient and practical means of delivering negative pressure wound therapy to their high-risk patients, with excellent wound outcomes reported to date. Although larger, randomized, controlled studies will help to clarify the precise role and benefits of such a system in cardiothoracic surgery, limited initial evidence from clinical studies and from the authors’ own experiences appears promising. In light of the growing interest in this technology among cardiothoracic surgeons, a consensus meeting, which was attended by a group of international experts, was held to review existing evidence for negative pressure wound therapy in the prevention of wound complications after surgery and to provide recommendations on the optimal use of negative pressure wound therapy on closed median sternal incisions after cardiothoracic surgery. PMID:25280449

  17. Collecting And Measuring Wound Exudate Biochemical Mediators In Surgical Wounds

    PubMed Central

    Carvalho, Brendan; Clark, David J; Yeomans, David; Angst, Martin S

    2012-01-01

    We describe a methodology by which we are able to collect and measure biochemical inflammatory and nociceptive mediators at the surgical wound site. Collecting site-specific biochemical markers is important to understand the relationship between levels in serum and surgical wound, determine any associations between mediator release, pain, analgesic use and other outcomes of interest, and evaluate the effect of systemic and peripheral drug administration on surgical wound biochemistry. This methodology has been applied to healthy women undergoing elective cesarean delivery with spinal anesthesia. We have measured wound exudate and serum mediators at the same time intervals as patient's pain scores and analgesics consumption for up to 48 hours post-cesarean delivery. Using this methodology we have been able to detect various biochemical mediators including nerve growth factor (NGF), prostaglandin E2 (PG-E2) substance P, IL-1?, IL-2, IL-4, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IL-17, TNF?, INF?, G-CSF, GM-CSF, MCP-1 and MIP-1?. Studies applying this human surgical wound bioassay have found no correlations between wound and serum cytokine concentrations or their time-release profile (J Pain. 2008; 9(7):650-7).1 We also documented the utility of the technique to identify drug-mediated changes in wound cytokine content (Anesth Analg 2010; 111:1452-9).2 PMID:23117346

  18. Wounding in the plant tissue: the defense of a dangerous passage

    PubMed Central

    Savatin, Daniel V.; Gramegna, Giovanna; Modesti, Vanessa; Cervone, Felice

    2014-01-01

    Plants are continuously exposed to agents such as herbivores and environmental mechanical stresses that cause wounding and open the way to the invasion by microbial pathogens. Wounding provides nutrients to pathogens and facilitates their entry into the tissue and subsequent infection. Plants have evolved constitutive and induced defense mechanisms to properly respond to wounding and prevent infection. The constitutive defenses are represented by physical barriers, i.e., the presence of cuticle or lignin, or by metabolites that act as toxins or deterrents for herbivores. Plants are also able to sense the injured tissue as an altered self and induce responses similar to those activated by pathogen infection. Endogenous molecules released from wounded tissue may act as Damage-Associated Molecular Patterns (DAMPs) that activate the plant innate immunity. Wound-induced responses are both rapid, such as the oxidative burst and the expression of defense-related genes, and late, such as the callose deposition, the accumulation of proteinase inhibitors and of hydrolytic enzymes (i.e., chitinases and gluganases). Typical examples of DAMPs involved in the response to wounding are the peptide systemin, and the oligogalacturonides, which are oligosaccharides released from the pectic component of the cell wall. Responses to wounding take place both at the site of damage (local response) and systemically (systemic response) and are mediated by hormones such as jasmonic acid, ethylene, salicylic acid, and abscisic acid. PMID:25278948

  19. Indications and practical implementation of microbiologic diagnostics in patients with chronic wounds.

    PubMed

    Schwarzkopf, Andreas; Dissemond, Joachim

    2015-03-01

    Microbiology diagnostics are frequently performed in patients with chronic wounds. However, there is currently a lack of uniformity with respect to indications as well as the practical implementation of such workup. The fact that diagnostic results may be significantly affected by the sampling technique used as well as the preceding (wound) preparation underscores the need for uniform standards, which have been missing so far. In Germany, bacteriologic wound swabs are routinely performed, particularly with the intent to screen for multiresistant pathogens. For this indication, prior wound cleansing should be avoided, and sampling using the Essen Rotary technique provides a quick and easy-to-use option. If there is clinical suspicion of an infection, wound cleansing with sterile saline solution (0.9 %) and/or sterile cotton gauze should be carried out prior to obtaining bacteriologic swabs. While routine diagnostic biopsies are generally not required in chronic wound patients, they may be useful in case of clinically suspected wound infections, particularly in patients with deep ulcerations, diabetic foot syndrome, severe soft tissue infection, or fistula tissue. Moreover, biopsies are indispensable in the microbiology workup of specific pathogens such as mycobacteria, Leishmania, actinomycetes, Nocardia ssp. or molds. PMID:25721627

  20. Reduced antimicrobial peptide expression in human burn wounds.

    PubMed

    Milner, S M; Ortega, M R

    1999-08-01

    Severely burned skin ceases to perform its natural protective role and surrenders itself as a nidus and portal for bacterial invasion. Antimicrobial peptides are part of a non-specific chemical defence system, separate from cellular and humoral immunity. Two of these peptides, human beta-defensins 1 and 2 have been recently found in skin and are produced by keratinocytes. Beta defensins have potent bactericidal activity against a wide spectrum of bacterial and fungal organisms commonly responsible for burn wound infections. To date, expression of beta defensins has not been examined in the human burn wound. Our findings demonstrate that expression of hBD-2 is greatly decreased in the burn wound whereas hBD-1 appears to be preserved. These results may have important implications in the pathogenesis and treatment of invasive burn sepsis. PMID:10439149

  1. Ciprofloxacin-Collagen Conjugate in the Wound Healing Treatment

    PubMed Central

    Puoci, Francesco; Piangiolino, Cristiana; Givigliano, Francesco; Parisi, Ortensia Ilaria; Cassano, Roberta; Trombino, Sonia; Curcio, Manuela; Iemma, Francesca; Cirillo, Giuseppe; Spizzirri, Umile Gianfranco; Restuccia, Donatella; Muzzalupo, Rita; Picci, Nevio

    2012-01-01

    The synthesis of a novel functional biomaterial for wound healing treatment was carried out by adopting a free-radical grafting procedure in aqueous media. With this aim, ciprofloxacin (CFX) was covalently incorporated into collagen (T1C) chains employing an ascorbic acid/hydrogen peroxide redox pair as biocompatible initiator system. The covalent insertion of CFX in the polymeric chains was confirmed by FT-IR and UV analyses, while an antibacterial assay demonstrated the activity of the synthesized conjugate against Staphylococcus aureus and Escherichia coli, microorganisms that commonly infect wounds. A catechin blended conjugate was also tested in order to evaluate the ability to influence fibroblast cell growth. The observed antibacterial activity and stimulation of fibroblast growth support the applicability of CFX-T1C conjugate in wound treatment encouraging the healing process. PMID:24955537

  2. Type of skin incision and wound complications in the obese parturient.

    PubMed

    McLean, Mamie; Hines, Rachel; Polinkovsky, Margaret; Stuebe, Alison; Thorp, John; Strauss, Robert

    2012-04-01

    We examined the relationship between type of skin incision at time of cesarean delivery and postoperative wound complications in the obese parturient. Women with a body mass index (BMI) of greater than 29 who had undergone cesarean delivery at The University of North Carolina were identified from the Pregnancy, Infection and Nutrition study. Inpatient and outpatient medical records were reviewed for maternal demographics as well as intrapartum and intraoperative characteristics. The exposure of interest was type of incision, classified as vertical or transverse. The primary outcome was wound complication, defined as partial or complete wound separation. Logistic regression analysis was used to create a final model of risk factors for wound complications while controlling for potentially confounding variables. From 1998 to 2005, 238 women with a BMI greater than 29 who underwent cesarean delivery were identified. Of these 238 women, a vertical skin incision was performed in 25 (11%) and a transverse skin incision in 213 (89%). The overall incidence of wound complications in this group was 13%. BMI was associated with wound complications (p < 0.01). After controlling for confounding factors, no difference in wound complication based on type of skin incision was apparent. The type of skin incision does not appear to be associated with wound complications in the obese parturient; however, larger studies would be needed to confirm this finding. Increased BMI is associated with a higher rate of wound complications. PMID:22105439

  3. Preparation of SMART wound dressings based on colloidal microgels and textile fibres

    NASA Astrophysics Data System (ADS)

    Cornelius, Victoria J.; Majcen, Natasa; Snowden, Martin J.; Mitchell, John C.; Voncina, Bojana

    2007-01-01

    Wound dressings and other types of wound healing technologies are experiencing fast-paced development and rapid growth. As the population ages, demand will continue to rise for advanced dressings used to treat chronic wounds, such as pressure ulcers, venous stasis ulcers, and diabetic ulcers. Moist wound dressings, which facilitate natural wound healing in a cost-effective manner, will be increasingly important. In commercially available hydrogel / gauze wound dressings the gel swells to adsorb wound excreta and provide an efficient non adhesive particle barrier. An alternative to hydrogels are microgels. Essentially discrete colloidal gel particles, as a result of their very high surface area to volume ratio compared to bulk gels, they have a much faster response to external stimuli such as temperature or pH. In response to either an increase or decrease in solvent quality these porous networks shrink and swell reversibly. When swollen the interstitial regions within the polymer matrix are available for further chemistry; such as the incorporation of small molecules. The reversible shrinking and swelling as a function of external stimuli provides a novel drug release system. As the environmental conditions of a wound change over its lifetime, tending to increase in pH if there is an infection combining these discrete polymeric particles with a substrate such as cotton, results in a smart wound dressing.

  4. Forces driving epithelial wound healing

    NASA Astrophysics Data System (ADS)

    Brugués, Agustí; Anon, Ester; Conte, Vito; Veldhuis, Jim H.; Gupta, Mukund; Colombelli, Julien; Muñoz, José J.; Brodland, G. Wayne; Ladoux, Benoit; Trepat, Xavier

    2014-09-01

    A fundamental feature of multicellular organisms is their ability to self-repair wounds through the movement of epithelial cells into the damaged area. This collective cellular movement is commonly attributed to a combination of cell crawling and `purse-string’ contraction of a supracellular actomyosin ring. Here we show by direct experimental measurement that these two mechanisms are insufficient to explain force patterns observed during wound closure. At early stages of the process, leading actin protrusions generate traction forces that point away from the wound, showing that wound closure is initially driven by cell crawling. At later stages, we observed unanticipated patterns of traction forces pointing towards the wound. Such patterns have strong force components that are both radial and tangential to the wound. We show that these force components arise from tensions transmitted by a heterogeneous actomyosin ring to the underlying substrate through focal adhesions. The structural and mechanical organization reported here provides cells with a mechanism to close the wound by cooperatively compressing the underlying substrate.

  5. Wound-healing potential of the root extract of Albizzia lebbeck.

    PubMed

    Joshi, Apurva; Sengar, Nidhi; Prasad, Satyendra K; Goel, Raj Kumar; Singh, Akanksha; Hemalatha, Siva

    2013-06-01

    The present investigation is an attempt to scientifically validate the traditional use of the roots of the plant Albizzia lebbeck in Ayurvedic system of medicine for curing wounds. The study included phytochemical standardization of the ethanol root extract of A. lebbeck, which was further subjected to oral acute toxicity study. Wound-healing activity of the ethanol root extract was evaluated using incision and excision wound models. Biochemical parameters such as hydroxyproline, hexuronic acid, hexosamine, and antioxidant enzymes like superoxide dismutase, reduced glutathione and free radical parameters including lipid peroxidation and nitric oxide were evaluated on the 10th post-wounding day following dead space method. For confirmation of activity, histopathology of the wounds and granulation tissues from excision and dead space wound model were performed. The study also included assessment of antibacterial activity of ethanol root extract against strains implicated in wound infection. The ethanol root extract was found to be highly rich in flavonoids, saponins, phenols, and tannins, while the amount of rutin was found to be 4.66 % w/w. It significantly increased the wound breaking strength showing a ceiling effect at 500 mg/kg p. o. The ethanol root extract at 500 mg/kg p. o. depicted an optimum wound contraction on the 18th day, while complete wound contraction was observed at the 22nd post wound day. It also demonstrated a significant increase in dry tissue weight, total protein, hydroxyproline, hexosamine, hexuronic acid, superoxide dismutase, and reduced glutathione levels, whereas a decrease in the levels of lipid peroxidation and nitric oxide was also observed with a potential antibacterial activity. Histopathological studies revealed a normal epithelization and fibrosis which was evidenced through an increase in collagen density. Thus, the study scientifically validated the wound-healing activity of the ethanol root extract along with a potential antibacterial property which may be attributed to the enhanced collagen synthesis and a potential antioxidant activity. PMID:23677526

  6. Phytochemicals and Naturally Derived Substances for Wound Healing

    PubMed Central

    Sivamani, Raja K.; Ma, Brian R.; Wehrli, Lisa N.; Maverakis, Emanual

    2012-01-01

    Background Complementary and alternative medicines (CAMs) are widely used by the general public. Natural products including plant-derived extracts (phytochemicals) and naturally derived substances, such as honey, are an important component of CAM. Here, we review the evidence for their use in wound care. The Problem Wound healing is complex and disruption of this process can lead to considerable morbidity, including chronic wounds, infection, and scarring. Natural products have a long history of use in wound care, but there are only a few rigorous studies. With the growing interest in the use of natural products and the belief that they are safer than standard therapies, it is vital to understand the current knowledge of their efficacy and side effects. Basic/Clinical Science Advances Natural products possess antioxidant, anti-inflammatory, angiogenic, and cell synthesis-modulating components among many others. However, this complex composition of chemicals may increase the risk for irritant or allergic side effects. Clinical Care Relevance Natural products can be much cheaper than conventional treatments, but further study is needed to better understand their efficacy. The type of wound and the potential for side effects need to be carefully considered when choosing a treatment. Conclusion The research to date is supportive of the use of natural products in wound care. Patients need to be cautioned of potential side effects. Collaborative research between allopathic medicine and medical systems that frequently employ phytochemicals and naturally derived substances, such as Ayurveda and naturopathy, will provide a better understanding of how to integrate natural products into wound care. PMID:24527308

  7. Anaerobic Infections in Children with Neurological Impairments.

    ERIC Educational Resources Information Center

    Brook, Itzhak

    1995-01-01

    Children with neurological impairments are prone to develop serious infection with anaerobic bacteria. The most common anaerobic infections are decubitus ulcers; gastrostomy site wound infections; pulmonary infections (aspiration pneumonia, lung abscesses, and tracheitis); and chronic suppurative otitis media. The unique microbiology of each of…

  8. [Thoracic ballistic traumatisms. Wounding agents and wound ballistic].

    PubMed

    Duhamel, P; Bonnet, P M; Pons, F; Jourdan, P; Jancovici, R

    2003-04-01

    The adequate care of thoracic ballistic traumatisms implies a good preliminary knowledge of wounding agents, and of the principles governing lesion-based ballistic, in particular the role played by the meeting with an obstacle which modifies the ballistic behaviour of the projectile, with worsened wounding effects. Authors describe the principal types of involved projectiles and their wound profile applied to the thorax, while stressing the need to treat systematically the wound and not the weapon, and on the importance of the choice of the surgical exploration way of these lesions, which conditions, as from the initial stage, the later choices of the parietal closure and rebuilding methods. The importance of parietal disrepair is therefore an essential decisional factor in the assumption of responsibility and the definition of the therapeutic strategy of these casualties. PMID:12801552

  9. Material couture for wound healing and regeneration: an overview.

    PubMed

    Kaur, Indu Pal; Sandhu, Simarjot Kaur; Deol, Parneet Kaur; Sharma, Gaurav; Yadav, Monika; Singh, Mandeep

    2015-01-01

    Wound healing is a complex regenerative process of great importance in clinical medicine, controlled by temporal interactions between cells, extracellular matrix components and signalling molecules. Localised delivery of therapeutic active agents viz. antimicrobials, soothing minerals and/or vitamins and growth factors at the site of injury/trauma/wound are expected to be more effective and will always manifest milder toxic concerns than those observed upon systemic administration of these agents. Since ancient times, search is on for suitable materials which may restore or reproduce a favourable and a natural milieu required for skin regeneration, so as to prevent infections, and make the process fast and less painful. The journey started with the use of natural materials with a simple function of covering or dressing the wounds to more advanced materials of present times, which are designed for specific and extraordinary functions. Natural and modified or synthetic polymers; alone or in combination are commonly used as dressing (couture) materials for wound healing. This article offers a review of materials that have been used to design and develop wound dressings. PMID:25594412

  10. Epidermal Differentiation in Barrier Maintenance and Wound Healing

    PubMed Central

    Wikramanayake, Tongyu Cao; Stojadinovic, Olivera; Tomic-Canic, Marjana

    2014-01-01

    Significance: The epidermal barrier prevents water loss and serves as the body's first line of defense against toxins, chemicals, and infectious microbes. Disruption of the barrier, either through congenital disorders of barrier formation or through wounds, puts the individual at risk for dehydration, hypersensitivity, infection, and prolonged inflammation. Epidermal barrier disorders affect millions of patients in the United States, causing loss of productivity and diminished quality of life for patients and their families, and represent a burden to the health-care system and society. Recent Advances: The genetic basis of many congenital barrier disorders has been identified in recent years, and great advances have been made in the molecular mechanisms of the formation and homeostasis of epidermal barrier, as well as acute and chronic wound healing. Progress in stem cell (SC) biology, particularly in induced pluripotent stem cells (iPSCs) and allogeneic mesenchymal stem cells (MSCs), has opened new doors for cell-based therapy of chronic wounds. Critical Issues: Understanding of the molecular mechanisms of barrier homeostasis in health and disease, as well as contributions of iPSCs and allogeneic MSCs to wound healing, will lead to the identification of novel targets for developing therapeutics for congenital barrier and wound healing disorders. Future Directions: Future studies should focus on better understanding of molecular mechanisms leading to disrupted homeostasis of epidermal barrier to identify potential therapeutic targets to combat its associated diseases. PMID:24669361

  11. Contact dermatitis presenting as non-healing wound: case report

    PubMed Central

    2011-01-01

    Topical antiseptics are commonly used in the management of minor wounds, burns, and infected skin. These agents are widely used by health professionals and are often self-prescribed by patients as they are easily available over-the-counter. This case illustrates a 73 year old man who presented with a non-healing wound on his right forearm for 4 weeks. The wound started from an insect bite and progressively enlarged with increasing pruritus and burning sensation. Clinically an ill-defined ulcer with surrounding erythema and erosion was noted. There was a yellow crust overlying the center of the ulcer and the periphery was scaly. Further inquiry revealed history of self treatment with a yellow solution to clean his wound for 3 weeks. Patient was provisionally diagnosed to have allergic contact dermatitis secondary to acriflavine. Topical acriflavine was stopped and the ulcer resolved after treatment with non-occlusive saline dressing. Skin patch test which is the gold standard for detection and confirmation of contact dermatitis showed a positive reaction (2+) to acriflavine. Acriflavine is widely used as a topical antiseptic agent in this part of the world. Hence, primary care physicians managing a large variety of poorly healing wounds should consider the possibility of contact allergy in recalcitrant cases, not responding to conventional treatment. Patient education is an important aspect of management as this would help curb the incidence of future contact allergies. PMID:21575147

  12. Water-filtered infrared-A (wIRA) in acute and chronic wounds

    PubMed Central

    Hoffmann, Gerd

    2009-01-01

    Water-filtered infrared-A (wIRA), as a special form of heat radiation with a high tissue penetration and a low thermal load to the skin surface, can improve the healing of acute and chronic wounds both by thermal and thermic as well as by non-thermal and non-thermic effects. wIRA increases tissue temperature (+2.7°C at a tissue depth of 2 cm), tissue oxygen partial pressure (+32% at a tissue depth of 2 cm) and tissue perfusion. These three factors are decisive for a sufficient supply of tissue with energy and oxygen and consequently also for wound healing and infection defense. wIRA can considerably alleviate pain (without any exception during 230 irradiations) with substantially less need for analgesics (52–69% less in the groups with wIRA compared to the control groups). It also diminishes exudation and inflammation and can show positive immunomodulatory effects. The overall evaluation of the effect of irradiation as well as the wound healing and the cosmetic result (assessed on visual analogue scales) were markedly better in the group with wIRA compared to the control group. wIRA can advance wound healing (median reduction of wound size of 90% in severely burned children already after 9 days in the group with wIRA compared to 13 days in the control group; on average 18 versus 42 days until complete wound closure in chronic venous stasis ulcers) or improve an impaired wound healing (reaching wound closure and normalization of the thermographic image in otherwise recalcitrant chronic venous stasis ulcers) both in acute and in chronic wounds including infected wounds. After major abdominal surgery there was a trend in favor of the wIRA group to a lower rate of total wound infections (7% versus 15%) including late infections following discharge from hospital (0% versus 8%) and a trend towards a shorter postoperative hospital stay (9 versus 11 days). Even the normal wound healing process can be improved. The mentioned effects have been proven in six prospective studies, with most of the effects having an evidence level of Ia/Ib. wIRA represents a valuable therapy option and can generally be recommended for use in the treatment of acute as well as of chronic wounds. PMID:20204090

  13. Antibacterial photodynamic therapy with 808-nm laser and indocyanine green on abrasion wound models.

    PubMed

    Topaloglu, Nermin; Güney, Melike; Yuksel, Sahru; Gülsoy, Murat

    2015-02-01

    Infections with pathogens could cause serious health problems, such as septicemia and subsequent death. Some of these deaths are caused by nosocomial, chronic, or burn-related wound infections. Photodynamic therapy (PDT) can be useful for the treatment of these infections. Our aim was to investigate the antibacterial effect of indocyanine green (ICG) and 808-nm laser on a rat abrasion wound model infected with the multidrug resistant Staphylococcus aureus strain. Abrasion wounds were infected with a multidrug resistant clinical isolate of S. aureus. ICG concentrations of 500, 1000, and 2000 ?g?ml were applied with a 450 J?cm2 energy dose. Temperature change was monitored by a thermocouple system. The remaining bacterial burden was determined by the serial dilution method after each application. Wounds were observed for 11 days posttreatment. The recovery process was assessed macroscopically. Tissue samples were also examined histologically by hematoxylin–eosin staining. Around a 90% reduction in bacterial burden was observed after applications. In positive control groups (ICG-only and laser-only groups), there was no significant reduction. The applied energy dose did not cause any thermal damage to the target tissue or host environment. Results showed that ICG together with a 808-nm laser might be a promising antibacterial method to eliminate infections in animals and accelerate the wound-healing process. PMID:25692539

  14. Antibacterial photodynamic therapy with 808-nm laser and indocyanine green on abrasion wound models

    NASA Astrophysics Data System (ADS)

    Topaloglu, Nermin; Güney, Melike; Yuksel, Sahru; Gülsoy, Murat

    2015-02-01

    Infections with pathogens could cause serious health problems, such as septicemia and subsequent death. Some of these deaths are caused by nosocomial, chronic, or burn-related wound infections. Photodynamic therapy (PDT) can be useful for the treatment of these infections. Our aim was to investigate the antibacterial effect of indocyanine green (ICG) and 808-nm laser on a rat abrasion wound model infected with the multidrug resistant Staphylococcus aureus strain. Abrasion wounds were infected with a multidrug resistant clinical isolate of S. aureus. ICG concentrations of 500, 1000, and 2000 ?g/ml were applied with a 450 J/cm2 energy dose. Temperature change was monitored by a thermocouple system. The remaining bacterial burden was determined by the serial dilution method after each application. Wounds were observed for 11 days posttreatment. The recovery process was assessed macroscopically. Tissue samples were also examined histologically by hematoxylin-eosin staining. Around a 90% reduction in bacterial burden was observed after PDT applications. In positive control groups (ICG-only and laser-only groups), there was no significant reduction. The applied energy dose did not cause any thermal damage to the target tissue or host environment. Results showed that ICG together with a 808-nm laser might be a promising antibacterial method to eliminate infections in animals and accelerate the wound-healing process.

  15. The Elastodynamics of Embryonic Epidermal Wound Closure

    E-print Network

    Wan, Frederic Yui-Ming

    The Elastodynamics of Embryonic Epidermal Wound Closure By Alexander Sadovsky and Frederic Y. M. Wan This paper is concerned with the elastodynamics of embryonic epidermal wound closing. Underlying the recovery process for this type of wounds is a mechanism of wound recognition through directed cell

  16. EGF containing gelatin-based wound dressings

    Microsoft Academic Search

    Kezban Ulubayram; A. Nur Cakar; Petek Korkusuz; Cemile Ertan; Nesrin Hasirci

    2001-01-01

    In case of bulk loss of tissue or non-healing wounds such as burns, trauma, diabetic, decubitus and venous stasis ulcers, a proper wound dressing is needed to cover the wound area, protect the damaged tissue, and if possible to activate the cell proliferation and stimulate the healing process. In this study, synthesis of a novel polymeric bilayer wound dressing containing

  17. Leptospirosis: Skin Wounds and Control Strategies, Thailand, 1999

    PubMed Central

    Phraisuwan, Phran; Whitney, Ellen A. Spotts; Tharmaphornpilas, Piyanit; Guharat, Suriya; Thongkamsamut, Samart; Aresagig, Suphaporn; Liangphongphanthu, Jayteeya; Junthima, Kanlayanee; Sokampang, Apirat

    2002-01-01

    After an outbreak of leptospirosis in workers who participated in cleaning a pond during September 1999 in Thailand, a serologic survey was conducted. Among a cohort of 104 persons from one village who participated in pond cleaning activity, 43 (41.3%) were seropositive for immunoglobulin M antibodies against Leptospira, indicating recent infection. Only 17 (39.5%) of 43 seropositive persons reported a recent febrile illness; the remaining seropositive persons were considered asymptomatic, suggesting that asymptomatic leptospirosis infection may be common where leptospirosis is endemic. Multivariable logistic regression indicated that wearing long pants or skirts was independently protective against leptospirosis infection (ORadjusted = 0.217), while the presence of more than two wounds on the body was independently associated with infection (ORadjusted = 3.97). Educational efforts should be enhanced in areas where leptospirosis is endemic to encourage the use of protective clothing. In addition wound management and avoidance of potentially contaminated water when skin wounds are present should be included in health education programs. PMID:12498663

  18. A new porous polyetherurethane wound covering.

    PubMed

    Bruin, P; Jonkman, M F; Meijer, H J; Pennings, A J

    1990-02-01

    A polyetherurethane (PEU) wound covering with non-interconnected micropores up to approximately 5 microns has been prepared by means of a phase inversion process. This highly elastic, very thin (15-20 microns), pliable wound covering showed good, immediate adherence to wet wound surfaces and high water vapor permeability, but was impermeable to bacteria. In guinea pigs epidermal wound healing of partial-thickness wounds under PEU wound coverings was accelerated compared with uncovered controls and an occlusive wound covering, OpSite. Water in liquid form or wound exudate could not leak through the PEU covering, but its high water vapor permeability induced concentration of the wound exudate into a jellylike clot layer, which apparently accelerated reepithelialization. The main conclusion from a clinical study on 20 donor sites was that the use of the PEU covering reduced pain, besides prevention of fluid retention. No differences in epithelialization were seen in comparison to tulle gras-treated wounds. PMID:2329116

  19. Gene Therapy and Wound Healing

    PubMed Central

    Eming, Sabine A.; Krieg, Thomas; Davidson, Jeffrey M

    2007-01-01

    Wound repair involves the sequential interaction of various cell types, extracellular matrix molecules, and soluble mediators. During the past 10 years, much new information on signals controlling wound cell behavior has emerged. This knowledge has led to a number of novel_therapeutic strategies. In particular, the local delivery of pluripotent growth factor molecules to the injured tissue has been intensively investigated over the past decade. Limited success of clinical trails indicates that a crucial aspect of the growth factor wound-healing strategy is the effective delivery of these polypeptides to the wound site. A molecular approach in which genetically modified cells synthesize and deliver the desired growth factor in regulated fashion has been used to overcome the limitations associated with the (topical) application of recombinant growth factor proteins. We have summarized the molecular and cellular basis of repair mechanisms and their failure, and we give an overview of techniques and studies applied to gene transfer in tissue repair. PMID:17276205

  20. Systolic pressure in wound scarring

    PubMed Central

    DE GODOY, J.M. PEREIRA

    2014-01-01

    The recommended goal of a systolic pressure under 13 mmHg in hypertensive diabetic patients results in a significant drop in blood pressure that often has caused conflicts in respect to maintaining a minimum systolic pressure for wound scaring in patients with peripheral artery disease. This, as long as the patient remains asymptomatic, is no problem, however if the patient has a peripheral wound, the low systolic pressures may affect scarring. PMID:25644733

  1. Management of necrotic neck wounds with a sandwich pectoralis myocutaneous flap

    SciTech Connect

    Goldstein, R.D.; Komisar, A.; Silver, C.; Strauch, B.

    1988-03-01

    A modified pectoralis major myocutaneous flap was used to stabilize necrotic neck wounds rapidly in irradiated patients. The flap was a sandwich flap that included an overlying parasternal pectoral skin paddle for pharyngeal reconstruction, the pectoralis muscle for carotid protection, and a meshed skin graft applied to the undersurface of the muscle to replace cervical skin. This flap has been used to reconstruct seven patients with severe wound necrosis from pharyngeal fistula and infection. All patients had carotid exposure in the infected wound. Reconstruction in all patients accomplished restoration of pharyngeal continuity, carotid protection, and cervical skin replacement. Some patients required more than one procedure for closure. There were no carotid blowouts in any of the patients. This technique enables the head and neck surgeon to stabilize these contaminated wounds rapidly and to reconstruct complex defects of the pharynx and cervical skin.

  2. A study of the effect of povidone-iodine on wound healing.

    PubMed Central

    Gilmore, O. J.; Reid, C.; Strokon, A.

    1977-01-01

    The effect of dry powder povidone-iodine (Disadine D.P.) on wound healing was assessed experimentally and clinically. It did not interfere with wound healing macroscopically, histologically or mechanically in Wistar rats. One hundred and one patients undergoing 'clean' elective surgery were included in the controlled clinical study and povidone-iodine did not affect wound healing in any way. In the control group 4% of patients developed infection compared with none of those sprayed with povidone-iodine. No adverse reaction to povidone-iodine was seen in either study. This antiseptic offers a safe alternative to antibiotics for use at operation whenever there is risk of wound infection from operative bacterial contamination. PMID:323835

  3. [Current problems in hospital infection].

    PubMed

    Popkirov, S; Fitschev, G

    1980-01-01

    (1) In surgical infections staphylococci are still dominating. (2) Following nosocomial infections gramnegative pathogens become more and more important. (3) Systemic administration of antibiotics favour the selection of gramnegative bacteria and the increase of resistence. (4) Antibiotics do not substitute asepsis and antisepsis. (5) The systemic administration of antibiotics in surgical infections should be clearly reduced. (6) No prophylactic use of antibiotics in surgery to prevent wounds infections. PMID:6774512

  4. A Novel Model of Chronic Wounds: Importance of Redox Imbalance and Biofilm-Forming Bacteria for Establishment of Chronicity

    PubMed Central

    Dhall, Sandeep; Do, Danh; Garcia, Monika; Wijesinghe, Dayanjan Shanaka; Brandon, Angela; Kim, Jane; Sanchez, Antonio; Lyubovitsky, Julia; Gallagher, Sean; Nothnagel, Eugene A.; Chalfant, Charles E.; Patel, Rakesh P.; Schiller, Neal; Martins-Green, Manuela

    2014-01-01

    Chronic wounds have a large impact on health, affecting ?6.5 M people and costing ?$25B/year in the US alone [1]. We previously discovered that a genetically modified mouse model displays impaired healing similar to problematic wounds in humans and that sometimes the wounds become chronic. Here we show how and why these impaired wounds become chronic, describe a way whereby we can drive impaired wounds to chronicity at will and propose that the same processes are involved in chronic wound development in humans. We hypothesize that exacerbated levels of oxidative stress are critical for initiation of chronicity. We show that, very early after injury, wounds with impaired healing contain elevated levels of reactive oxygen and nitrogen species and, much like in humans, these levels increase with age. Moreover, the activity of anti-oxidant enzymes is not elevated, leading to buildup of oxidative stress in the wound environment. To induce chronicity, we exacerbated the redox imbalance by further inhibiting the antioxidant enzymes and by infecting the wounds with biofilm-forming bacteria isolated from the chronic wounds that developed naturally in these mice. These wounds do not re-epithelialize, the granulation tissue lacks vascularization and interstitial collagen fibers, they contain an antibiotic-resistant mixed bioflora with biofilm-forming capacity, and they stay open for several weeks. These findings are highly significant because they show for the first time that chronic wounds can be generated in an animal model effectively and consistently. The availability of such a model will significantly propel the field forward because it can be used to develop strategies to regain redox balance that may result in inhibition of biofilm formation and result in restoration of healthy wound tissue. Furthermore, the model can lead to the understanding of other fundamental mechanisms of chronic wound development that can potentially lead to novel therapies. PMID:25313558

  5. Diabetic Wound Care

    MedlinePLUS

    ... of the foot. Of those who develop a foot ulcer, 6 percent will be hospitalized due to infection or other ... develop a foot ulcer will require an amputation. Foot ulceration precedes 85 percent of diabetes-related amputations. Research has shown, however, ...

  6. A Comparative Study of the Wound Healing Properties of Moist Exposed Burn Ointment (MEBO) and Silver Sulphadiazine.

    PubMed

    Jewo, P I; Fadeyibi, I O; Babalola, O S; Saalu, L C; Benebo, A S; Izegbu, M C; Ashiru, O A

    2009-06-30

    Burns expose the deeper tissues of the skin or body to invasive microbes. Topical preparations for treating burn wounds, to be useful, should ideally have antibiotic power and promote healing. Silver compounds have been the mainstay of topical burn treatment for decades. However, most chemical substances retard wound healing. Several natural agents such as honey and moist exposed burn ointment (MEBO) are believed to protect wounds from infection and promote healing without causing any of the adverse effects of purified chemicals. In this study, we compared the wound healing properties of MEBO, a herbal preparation of Chinese origin, with silver sulphadiazine (SSD), a long-standing conventional burn dressing. Ten adult Sprague Dawley rats were divided into two groups. They were housed in separate cages and received partial-thickness burn wounds on their dorsal skin. They were then treated with MEBO and SSD. The wounds were inspected daily until day 8, when all the animals were sacrificed, perfused with normal saline, and had their wounds excised and prepared for histology. It was found that animals in both groups were well preserved. No clinical infections occurred. Wound healing was at an advanced stage by day 8 in all the animals. Clinical and histological examination showed that the two agents gave the animals comparable protection and healing possibilities. It is concluded that MEBO is a suitable and efficacious alternative to conventional silver-based topical therapies for treating partial-thickness burn wounds. PMID:21991159

  7. A Comparative Study of the Wound Healing Properties of Moist Exposed Burn Ointment (MEBO) and Silver Sulphadiazine

    PubMed Central

    Jewo, P.I.; Fadeyibi, I.O.; Babalola, O.S.; Saalu, L.C.; Benebo, A.S.; Izegbu, M.C.; Ashiru, O.A.

    2009-01-01

    Summary Burns expose the deeper tissues of the skin or body to invasive microbes. Topical preparations for treating burn wounds, to be useful, should ideally have antibiotic power and promote healing. Silver compounds have been the mainstay of topical burn treatment for decades. However, most chemical substances retard wound healing. Several natural agents such as honey and moist exposed burn ointment (MEBO) are believed to protect wounds from infection and promote healing without causing any of the adverse effects of purified chemicals. In this study, we compared the wound healing properties of MEBO, a herbal preparation of Chinese origin, with silver sulphadiazine (SSD), a long-standing conventional burn dressing. Ten adult Sprague Dawley rats were divided into two groups. They were housed in separate cages and received partial-thickness burn wounds on their dorsal skin. They were then treated with MEBO and SSD. The wounds were inspected daily until day 8, when all the animals were sacrificed, perfused with normal saline, and had their wounds excised and prepared for histology. It was found that animals in both groups were well preserved. No clinical infections occurred. Wound healing was at an advanced stage by day 8 in all the animals. Clinical and histological examination showed that the two agents gave the animals comparable protection and healing possibilities. It is concluded that MEBO is a suitable and efficacious alternative to conventional silver-based topical therapies for treating partial-thickness burn wounds. PMID:21991159

  8. Noninfectious Wound Complications in Clean Surgery: Epidemiology, Risk Factors, and Association with Antibiotic Use

    Microsoft Academic Search

    Ilker UckayAmerico; Americo Agostinho; Wilson Belaieff; Laurence Toutous-Trellu; Saja Scherer-Pietramaggiori; Axel Andres; Louis Bernard; Hubert Vuagnat; Pierre Hoffmeyer; Blaise Wyssa

    2011-01-01

    Background  Noninfectious wound complications are frequent and often are confused with and treated as infection.\\u000a \\u000a \\u000a \\u000a Methods  We assessed the epidemiology, impact, risk factors, and associations with antibiotic use of noninfectious wound complications\\u000a in clean orthopedic and trauma surgery. We report a single-center, prospective, observational study in an orthopedic department.\\u000a \\u000a \\u000a \\u000a \\u000a Results  Among 1,073 adult patients, 630 (59%) revealed clinically relevant postoperative noninfectious wound complications,

  9. A rare case of mucormycosis of median sternotomy wound caused by Rhizopus arrhizus.

    PubMed

    Chawla, R; Sehgal, S; Kumar, S Ravindra; Mishra, B

    2007-10-01

    We describe a case of mucormycosis of median sternotomy wound caused by Rhizopus arrhizus . The patient, a known diabetic and a case of coronary artery disease underwent coronary artery bypass surgery. In the postoperative period, patient developed infection of the median sternotomy wound, from which R. arrhizus was isolated on culture. Patient succumbed in spite of being treated with surgical debridement and amphotericin B. To the best of our knowledge, this is the first reported case of mucormycosis of median sternotomy wound from India. PMID:18087101

  10. Successful Treatment of a Patient With Complicated Diabetic Foot Wound: A Case Report.

    PubMed

    Zheng, Yurong; Wang, Xingang; Zhang, Liping; You, Chuangang; Feng, Zhanzeng; Han, Chunmao

    2014-04-16

    Foot ulceration is one of the most serious complications of diabetes mellitus and may lead to amputation of the lower extremity. Timely prophylaxis and treatment of diabetic foot ulceration are important to maintain a good quality of life. This article reports a complicated diabetic patient with severe limb-threatening necrotizing infection. We successfully applied endovascular stent insertion, digit amputation, negative pressure wound therapy, and advanced dressings in different wound phases to achieve definitive wound healing after 12 months of treatment. Based on this case report, we would like to emphasize the importance of combined multiple therapies and patient compliance for severe diabetic foot ulcers. PMID:24743750

  11. Antimicrobial, Antioxidant, and Wound Healing Properties of Kigelia africana (Lam.) Beneth. and Strophanthus hispidus DC.

    PubMed Central

    Agyare, Christian; Dwobeng, Anita Serwaa; Agyepong, Nicholas; Boakye, Yaw Duah; Mensah, Kwesi Boadu; Ayande, Patrick George; Adarkwa-Yiadom, Martin

    2013-01-01

    Microbial infections of various types of wounds are a challenge to the treatment of wounds and wound healing. The study was to investigate antimicrobial and antioxidant properties of methanol leaf and stem bark extracts of Kigelia africana and methanol leaf and root extracts of Strophanthus hispidus and also to determine wound healing properties of the extracts. The antimicrobial activities of the methanol extracts were determined against two Gram-positive and two Gram-negative bacteria and a fungus using agar diffusion and micro-dilution methods. The antioxidant activity was determined using 1,1-diphenyl-2-picryl–hydrazyl (DPPH) method. The influence of the extracts on rate of wound closure was investigated using the excision wound model and histopathological investigation of treated and untreated wound tissues performed. The MICs of leaf extract of K. africana against test organisms were 2.5–7.5?mg/mL and stem bark extract were 2.25–7.5?mg/mL. The leaf extract of S. hispidus had MIC range of 2.5–7.5?mg/mL and 2.5–10?mg/mL for root extract. The IC50 of leaf and stem bark extracts of K. africana were 56.9 and 13.7??g/mL, respectively and leaf and root of S. hispidus were 49.8 and 45.1??g/mL, respectively. K. africana extracts (7.5% w/w) showed significant (P < 0.05) wound contraction at day 7 with 72% of wound closure whiles significant (P < 0.05) wound contractions were observed on day 11 for stem bark of K. africana, leaf and root extracts of S. hispidus. Wound tissues treated with the extracts showed improved collagenation, re-epitheliazition and rapid granulation formation compared with untreated wound tissues. The extracts were found to contain alkaloids, saponins, tannins, flavonoids, carbohydrates, and sapogenetic glycosides. The HPLC finger-printing of the extracts were developed. The leaf, stem bark and root extracts of K. africana and S. hispidus exhibited antimicrobial, antioxidant, and enhanced wound healing properties and these may justify the medicinal uses of the plants for treatment of microbial infections and wounds. PMID:23662099

  12. PLGA nanoparticles loaded with host defense peptide LL37 promote wound healing.

    PubMed

    Chereddy, Kiran Kumar; Her, Charles-Henry; Comune, Michela; Moia, Claudia; Lopes, Alessandra; Porporato, Paolo E; Vanacker, Julie; Lam, Martin C; Steinstraesser, Lars; Sonveaux, Pierre; Zhu, Huijun; Ferreira, Lino S; Vandermeulen, Gaëlle; Préat, Véronique

    2014-11-28

    Wound treatment remains one of the most prevalent and economically burdensome healthcare issues in the world. Poly (lactic-co-glycolic acid) (PLGA) supplies lactate that accelerates neovascularization and promotes wound healing. LL37 is an endogenous human host defense peptide that modulates wound healing and angiogenesis and fights infection. Hence, we hypothesized that the administration of LL37 encapsulated in PLGA nanoparticles (PLGA-LL37 NP) promotes wound closure due to the sustained release of both LL37 and lactate. In full thickness excisional wounds, the treatment with PLGA-LL37 NP significantly accelerated wound healing compared to PLGA or LL37 administration alone. PLGA-LL37 NP-treated wounds displayed advanced granulation tissue formation by significant higher collagen deposition, re-epithelialized and neovascularized composition. PLGA-LL37 NP improved angiogenesis, significantly up-regulated IL-6 and VEGFa expression, and modulated the inflammatory wound response. In vitro, PLGA-LL37 NP induced enhanced cell migration but had no effect on the metabolism and proliferation of keratinocytes. It displayed antimicrobial activity on Escherichia coli. In conclusion, we developed a biodegradable drug delivery system that accelerated healing processes due to the combined effects of lactate and LL37 released from the nanoparticles. PMID:25173841

  13. The chemistry and engineering of polymeric hydrogel adhesives for wound closure: a tutorial.

    PubMed

    Ghobril, C; Grinstaff, M W

    2015-04-01

    The closure and repair of wounds after traumatic or surgical injury is of significant clinical and research importance. While sutures remain the common wound closure technique, they have many disadvantages. Consequently, polymeric hydrogel adhesives have emerged as essential materials for wound management and repair because of their tunable chemical and physical properties, which enable them to adhere or stick to tissues, possess sufficient mechanical strength to stay intact and be subsequently removed, provide complete wound occlusion, and act as a barrier to bacterial infection. Moreover, these materials absorb wound exudates and keep the wound moist for faster healing. This tutorial review summarizes the key chemical features that enabled the development and use of polymeric hydrogels as wound adhesives, sealants, and hemostats, their design requirements, synthetic routes, determination of properties, and the tests needed to evaluate their performances. This tutorial review is a reference and a starting point for scientists and clinicians working or interested in the field of wound management and, importantly, for the general audience who is interested in polymers for medical applications. PMID:25649260

  14. Comparison between topical honey and mafenide acetate in treatment of burn wounds

    PubMed Central

    Maghsoudi, H.; Salehi, F.; Khosrowshahi, M.K.; Baghaei, M.; Nasirzadeh, M.; Shams, R.

    2011-01-01

    Summary Histological and clinical studies of wound healing were performed in comparable cases of fresh partial-thickness burns treated with honey dressing or mafenide acetate in two groups of 50 randomly allocated patients. Of the patients with honey-treated wounds, 84% showed satisfactory epithelialization by day 7 and 100% by day 21. In wounds treated with mafenide acetate, epithelialization occurred by day 7 in 72% of cases and in 84% by day 21. Histological evidence of reparative activity was observed in 80% of wounds treated with honey dressing by day 7 with minimal inflammation. Fifty-two per cent of the mafenide acetate treated wounds showed reparative activity with inflammatory changes by day 7. Reparative activity reached 100% by day 21 with the honey dressing and 84% with mafenide acetate. Thus, in honey-dressed wounds, early subsidence of acute inflammatory changes, better control of infection, and quicker wound healing were observed, while in mafenide acetate treated wounds a sustained inflammatory reaction was noted even on epithelialization. PMID:22396671

  15. Repeated leaf wounding alters the colonization of Medicago truncatula roots by beneficial and pathogenic microorganisms.

    PubMed

    Landgraf, Ramona; Schaarschmidt, Sara; Hause, Bettina

    2012-07-01

    In nature, plants are subject to various stresses that are often accompanied by wounding of the aboveground tissues. As wounding affects plants locally and systemically, we investigated the impact of leaf wounding on interactions of Medicago truncatula with root-colonizing microorganisms, such as the arbuscular mycorrhizal (AM) fungus Glomus intraradices, the pathogenic oomycete Aphanomyces euteiches and the nitrogen-fixing bacterium Sinorhizobium meliloti. To obtain a long-lasting wound response, repeated wounding was performed and resulted in locally and systemically increased jasmonic acid (JA) levels accompanied by the expression of jasmonate-induced genes, among them the genes encoding allene oxide cyclase 1 (MtAOC1) and a putative cell wall-bound invertase (cwINV). After repeated wounding, colonization with the AM fungus was increased, suggesting a role of jasmonates as positive regulators of mycorrhization, whereas the interaction with the rhizobacterium was not affected. In contrast, wounded plants appeared to be less susceptible to pathogens which might be caused by JA-induced defence mechanisms. The effects of wounding on mycorrhization and pathogen infection could be partially mimicked by foliar application of JA. In addition to JA itself, the positive effect on mycorrhization might be mediated by systemically induced cwINV, which was previously shown to exhibit a regulatory function on interaction with AM fungi. PMID:22329418

  16. Electrical Stimulation Technologies for Wound Healing

    PubMed Central

    Kloth, Luther C.

    2014-01-01

    Objective: To discuss the physiological bases for using exogenously applied electric field (EF) energy to enhance wound healing with conductive electrical stimulation (ES) devices. Approach: To describe the types of electrical currents that have been reported to enhance chronic wound-healing rate and closure. Results: Commercial ES devices that generate direct current (DC), and mono and biphasic pulsed current waveforms represent the principal ES technologies which are reported to enhance wound healing. Innovation: Wafer-thin, disposable ES technologies (wound dressings) that utilize mini or micro-batteries to deliver low-level DC for wound healing and antibacterial wound-treatment purposes are commercially available. Microfluidic wound-healing chips are currently being used with greater accuracy to investigate the EF effects on cellular electrotaxis. Conclusion: Numerous clinical trials described in subsequent sections of this issue have demonstrated that ES used adjunctively with standard wound care (SWC), enhances wound healing rate faster than SWC alone. PMID:24761348

  17. The Verge Videometer wound measurement package.

    PubMed

    Williams, C

    Wound measurement can be made as simple or as complex as time allows, but there is no doubt that wound measurement is required in some degree as part of the patient documentation process. To help assess the progress of wound healing, BES Rehab Ltd is distributing the Verge Videometer (VeV), a wound tracking system which can be used for precise wound measurement, tracking and documentation. The VeV is suitable for use in hospitals, outpatient clinics and in the community as well as being useful for those conducting research into wound progression. PMID:11033643

  18. Acceleration Of Wound Healing Ny Photodynamic Therapy

    DOEpatents

    Hasan, Tayyaba (Arlington, MA); Hamblin, Michael R. (Revere, MA); Trauner, Kenneth (Sacramento, CA)

    2000-08-22

    Disclosed is a method for accelerating wound healing in a mammal. The method includes identifying an unhealed wound site or partially-healed wound site in a mammal; administering a photosensitizer to the mammal; waiting for a time period wherein the photosensitizer reaches an effective tissue concentration at the wound site; and photoactivating the photosensitizer at the wound site. The dose of photodynamic therapy is selected to stimulate the production of one or more growth factor by cells at the wound site, without causing tissue destruction.

  19. Impact of a novel, antimicrobial dressing on in vivo, Pseudomonas aeruginosa wound biofilm: quantitative comparative analysis using a rabbit ear model.

    PubMed

    Seth, Akhil K; Zhong, Aimei; Nguyen, Khang T; Hong, Seok J; Leung, Kai P; Galiano, Robert D; Mustoe, Thomas A

    2014-01-01

    The importance of bacterial biofilms to chronic wound pathogenesis is well established. Different treatment modalities, including topical dressings, have yet to show consistent efficacy against wound biofilm. This study evaluates the impact of a novel, antimicrobial Test Dressing on Pseudomonas aeruginosa biofilm-infected wounds. Six-mm dermal punch wounds in rabbit ears were inoculated with 10(6) colony-forming units of P.?aeruginosa. Biofilm was established in vivo using our published model. Dressing changes were performed every other day with either Active Control or Test Dressings. Treated and untreated wounds were harvested for several quantitative endpoints. Confirmatory studies were performed to measure treatment impact on in vitro P.?aeruginosa and in vivo polybacterial wounds containing P.?aeruginosa and Staphylococcus aureus. The Test Dressing consistently decreased P.?aeruginosa bacterial counts, and improved wound healing relative to Inactive Vehicle and Active Control wounds (p?wound healing were also achieved in polybacterial wounds (p?wound biofilm. The development of clinically applicable therapies against biofilm such as this is critical to improving chronic wound care. PMID:25230854

  20. Necrotizing Soft Tissue Infections

    Microsoft Academic Search

    Daniel Mathieu; Raphaël Favory; Jean-François Cesari; Francis Wattel

    Anaerobic soft tissue infections are still life-threatening infections. Even if uncommon nowadays, they remain severe conditions\\u000a because often associated with major systemic effects leading to patient death if not promptly recognized and aggressively\\u000a treated. Their origins are often traumatic or surgical but they can also develop from an ulcer or a small wound in patients\\u000a at risk (i.e. diabetics, patients

  1. Wound Dressings and Comparative Effectiveness Data

    PubMed Central

    Sood, Aditya; Granick, Mark S.; Tomaselli, Nancy L.

    2014-01-01

    Significance: Injury to the skin provides a unique challenge, as wound healing is a complex and intricate process. Acute wounds have the potential to move from the acute wound to chronic wounds, requiring the physician to have a thorough understanding of outside interventions to bring these wounds back into the healing cascade. Recent Advances: The development of new and effective interventions in wound care remains an area of intense research. Negative pressure wound therapy has undoubtedly changed wound care from this point forward and has proven beneficial for a variety of wounds. Hydroconductive dressings are another category that is emerging with studies underway. Other modalities such as hyperbaric oxygen, growth factors, biologic dressings, skin substitutes, and regenerative materials have also proven efficacious in advancing the wound-healing process through a variety of mechanisms. Critical Issues: There is an overwhelming amount of wound dressings available in the market. This implies the lack of full understanding of wound care and management. The point of using advanced dressings is to improve upon specific wound characteristics to bring it as close to “ideal” as possible. It is only after properly assessing the wound characteristics and obtaining knowledge about available products that the “ideal” dressing may be chosen. Future Directions: The future of wound healing at this point remains unknown. Few high-quality, randomized controlled trials evaluating wound dressings exist and do not clearly demonstrate superiority of many materials or categories. Comparative effectiveness research can be used as a tool to evaluate topical therapy for wound care moving into the future. Until further data emerge, education on the available products and logical clinical thought must prevail. PMID:25126472

  2. [Water-filtered infrared-A (wIRA) promotes wound healing].

    PubMed

    Winkel, R; Hoffmann, G; Hoffmann, R

    2014-11-01

    Water-filtered infrared-A (wIRA) is a special form of heat radiation with high tissue penetration and low thermal load to the skin surface which promotes the healing of acute and chronic wounds both by thermal and thermic as well as by non-thermal and non-thermic effects. Water-filtered infrared-A increases tissue temperature (+ 2.7 °C at a tissue depth of 2 cm), tissue oxygen partial pressure (+ 32 % at a tissue depth of 2 cm) and tissue perfusion. These three factors are decisive for a sufficient supply of tissue with energy and oxygen and consequently also for wound healing and infection defense. Water-filtered infrared-A promotes normal as well as disturbed wound healing by diminishing inflammation and exudation, by promotion of infection defense and regeneration, and by alleviation of pain. These effects have been proven in a total of seven prospective studies (of these six randomized controlled studies) with most of the effects having an evidence level of Ia or Ib. The additional cases of complicated courses of wound healing presented in this article illustrate the proven effects of wIRA. Not only in the 6 presented cases wIRA turned the complicated courses of wound healing for the better and facilitated the healing of the wounds after varying total times of irradiation (in the 6 cases 51-550 h) and after variable times of wound care and mostly after transplantation of split skin grafts. In complicated courses of wound healing wIRA does not replace consultation and, when indicated, treatment by an experienced plastic surgeon and by a surgeon specialized in septic surgery. With these limitations wIRA can be recommended as a valuable complement for the treatment of acute as well as of chronic wounds. PMID:25385134

  3. Multifunctional activities of KSLW synthetic antimicrobial decapeptide: Implications for wound healing

    NASA Astrophysics Data System (ADS)

    Williams, Richard Leroy

    Wound healing is a complex process leading to the maintenance of skin integrity. Stress is known to increase susceptibility to bacterial infection, alter proinflammatory cytokine expression, and delay wound closure. Recently, antimicrobial peptides have generated interest due to their prokaryotic selectivity, decreased microbial resistance and multifunctional roles in wound healing, including fibroblast stimulation, keratinocyte migration and leukocyte migration. The objective of this dissertation project was to evaluate the effect of a synthetic antimicrobial decapeptide (KSLW) on bacterial clearance inflammation, and wound closure during stress-impaired healing. SKH-1 mice were randomly assigned to either control or restraint-stressed (RST) groups. Punch biopsy wounds (3.5 mm in diameter) were created bilaterally on the dorsal skin. Wounds were injected with 50 microL of empty carriers or KSLW prepared in Pluronic-F68, phospholipid micelles, or saline. Bacterial assays of harvested wounds were conducted on BHI agar. Wound closure was determined by photoplanimetry. Cytokine and growth factor mRNA expression was assessed with real-time RT-PCR. Human neutrophil migration assays and checkerboard analyses were performed using Transweli plates, and counting on hemacytometer. Oxidative burst activity was measured by spectrophotometric analysis of 2,7-dichlorofluorescein oxidation. KSLW-treatment resulted in significant reductions in bacterial load among RST mice, with no difference from control after 24h. The effect was sustained 5 days post-wounding, in RST mice treated with KSLW-F68. Temporal analysis of gene induction revealed reversals of stress-induced altered expression of growth factors, proinflammatory cytokines, and chemokines essential for favorable wound healing, at various time points. KSLW-treatment in RST mice demonstrated faster wound closure throughout the stress period. KSLW, at micromolar concentrations, demonstrated a significant effect on neutrophil migration and oxidative burst. These data suggest KSLW enhances bacterial clearance and promotes proinflammatory activity during early wound healing in stressed mice. Peptide delivery in Pluronic-F68 demonstrated increased substantivity, with faster wound closure, compared to other delivery systems. In addition to its antimicrobial activity, KSLW was shown to enhance neutrophil chemotaxis and sustain cell viability by inhibition of oxidative burst responses. Taken together, the cationic peptide may be implicated in the management of infection in different systems demonstrating impaired healing, including diabetes, age, hormone-imbalance, and bum models.

  4. Synergistic interactions of Pseudomonas aeruginosa and Staphylococcus aureus in an in vitro wound model.

    PubMed

    DeLeon, Stephanie; Clinton, Allie; Fowler, Haley; Everett, Jake; Horswill, Alexander R; Rumbaugh, Kendra P

    2014-11-01

    In individuals with polymicrobial infections, microbes often display synergistic interactions that can enhance their colonization, virulence, or persistence. One of the most prevalent types of polymicrobial infection occurs in chronic wounds, where Pseudomonas aeruginosa and Staphylococcus aureus are the two most common causes. Although they are the most commonly associated microbial species in wound infections, very little is known about their interspecies relationship. Evidence suggests that P. aeruginosa-S. aureus coinfections are more virulent than monoculture infection with either species; however, difficulties in growing these two pathogens together in vitro have hampered attempts to uncover the mechanisms involved. Here we describe a simple and clinically relevant in vitro wound model that supported concomitant growth of P. aeruginosa and S. aureus. We observed that the ability of P. aeruginosa and S. aureus to survive antibiotic treatment increased when they were grown together in planktonic cocultures and that antibiotic tolerance was further enhanced when they were grown together in the wound model. We attributed this enhanced tolerance to both the "host-derived" and "bacterium-derived" matrix components. Taken together, our data indicate that P. aeruginosa and S. aureus may benefit each other by coinfecting wounds and that the host-derived matrix may serve as important a role as the bacterium-derived matrix in protecting bacteria from some antibiotics. PMID:25156721

  5. Gingival wound healing: an essential response disturbed by aging?

    PubMed

    Smith, P C; Cáceres, M; Martínez, C; Oyarzún, A; Martínez, J

    2015-03-01

    Gingival wound healing comprises a series of sequential responses that allow the closure of breaches in the masticatory mucosa. This process is of critical importance to prevent the invasion of microbes or other agents into tissues, avoiding the establishment of a chronic infection. Wound healing may also play an important role during cell and tissue reaction to long-term injury, as it may occur during inflammatory responses and cancer. Recent experimental data have shown that gingival wound healing is severely affected by the aging process. These defects may alter distinct phases of the wound-healing process, including epithelial migration, granulation tissue formation, and tissue remodeling. The cellular and molecular defects that may explain these deficiencies include several biological responses such as an increased inflammatory response, altered integrin signaling, reduced growth factor activity, decreased cell proliferation, diminished angiogenesis, reduced collagen synthesis, augmented collagen remodeling, and deterioration of the proliferative and differentiation potential of stem cells. In this review, we explore the cellular and molecular basis of these defects and their possible clinical implications. PMID:25527254

  6. Graphite filament wound pressure vessels

    NASA Technical Reports Server (NTRS)

    Feldman, A.; Damico, J. J.

    1972-01-01

    Filament wound NOL rings, 4-inch and 8-inch diameter closed-end vessels involving three epoxy resin systems and three graphite fibers were tested to develop property data and fabrication technology for filament wound graphite/epoxy pressure vessels. Vessels were subjected to single-cycle burst tests at room temperature. Manufacturing parameters were established for tooling, winding, and curing that resulted in the development of a pressure/vessel performance factor (pressure x volume/weight) or more than 900,000 in. for an oblate spheroid specimen.

  7. Effect of blockade of the EGF system on wound healing in patients vaccinated with CIMAvax® EGF

    PubMed Central

    2013-01-01

    Background The epidermal growth factor receptor (EGFR) signaling system is frequently unbalanced in human malignancies due to increased ligand production, receptor overexpression, receptor mutations, and/or cross-talk with other receptor systems. For this reason, the EGFR is an attractive target for anticancer therapy. The epidermal growth factor also plays an important role in regulating multiple facets of cutaneous wound healing, including inflammation, wound contraction, proliferation, migration, and angiogenesis. In the Center of Molecular Immunology, a cancer vaccine is produced (CIMAvax® EGF) that blocks the binding of EGF to its receptor. This blockade causes a significant inverse association between the anti-EGF antibody titers and EGF concentration. Around 1,500 patients with non-small cell lung cancer have been treated, showing that this vaccine is safe, immunogenic, increases survival and improves quality of life. Taking into account the therapeutic benefits of CIMAvax® EGF vaccination and the role of EGF-EGFR system in the wound healing process, we decided to conduct a retrospective research with the aim of determining the effect to the CIMAvax® EGF vaccine on the wound healing process in patients undergoing surgical treatment. Methods Medical records of 452 vaccinated patients were reviewed and only six patients receiving surgical treatment were identified. Further information about these six patients was obtained from source documents, including medical records and operative reports using an observational list that included different variables. Post-surgical wound healing complications were identified using the National Cancer Institute Common Toxicity Criteria for Adverse Events (NCI-CTC) version 3.0. Results None of the six patients operated on presented adverse events related to the wound healing, that is to say, no wound dehiscence, wound infection, delayed wound healing, fistula formation, abscess formation or hemorrhage/bleeding associated with surgery during treatment with CIMAvax® EGF occurred. Conclusions These results suggest that the use of CIMAvax® EGF does not produce a deleterious effect in the wound healing process. PMID:24127898

  8. Sutures versus staples for wound closure in orthopaedic surgery: a pilot randomized controlled trial

    PubMed Central

    2013-01-01

    Background In the spectrum of surgical decision-making, wound closure material is often an afterthought. However, the findings of a recent meta-analysis suggest that the rate of surgical site infections (SSIs) is increased by using staples to close surgical wounds. Less clear is the effect of closure material on the incidence of non-infectious wound complications. The aim of this study was to compare sutures and staples in terms of: incidence of wound complications to determine the sample size for a definitive trial comparing wound closure methods. Methods Eligible adult orthopaedic patients were randomized to have wounds closed with sutures or staples. Time for skin closure was recorded. Wounds were assessed for complications for six weeks. The incidence of complications was compared using Fisher’s exact test. Time to close and pain with removal of closure material were compared using a Student’s t-test. Results The total number of patients reporting a wound complication was 59 of 148 patients completing six-week followup (41%), with no differennce between sutures and staples (RR = 0.77, CI = 0.52–1.14). The time to close wounds was shorter in the staple group (mean=4.8 min, CI = 2.6–7.1) than the suture group (mean=12 min, CI = 7.9–16). Patients in the staple group (mean=3.7, CI =2.8–4.6) reported more pain with removal than suture group (mean=2.5, CI =1.6–3.4). Conclusions This study suggests that 42% of patients report a wound complication with no difference between sutures and staples. It was demonstrated that suturing skin requires more time and staples are more painful to remove. Trial registration Clinicaltrials.gov identifier NCT01146236 (registered June 14, 2010) PMID:23394586

  9. Sutures versus staples for wound closure in orthopaedic surgery: a randomized controlled trial

    PubMed Central

    2012-01-01

    Background A recently published meta-analysis comparing metallic staples to sutures in orthopaedic procedures revealed three fold increase in risk for infection in stapled wounds. The studies included in the meta-analysis are at risk of bias due to experimental design limitations. A large randomized controlled trial is proposed to direct orthopaedic surgeons in their choice of wound closure material. Methods/Design A parallel group randomized controlled trial with institutional review board approval will be conducted. Patients will be randomized intraoperatively to have skin wounds closed with sutures or staples. Dressings will be used to maintain blinding outcome assessors. The primary outcome measure will be a composite all-cause wound complication outcome measure composed of: infection, wound drainage, wound necrosis, blistering, dehiscence, suture abscess and material sensitivity reaction. An independent review board blinded to treatment assignment will adjudicate suspected complications based on clinical data. All deceased patients will also be reviewed. An interim analysis of complications will take place after half of the patients have been recruited. All data will be analyzed by a blinded statistician. Dichotomous primary and secondary outcome measures will be analyzed using the Chi-squared statistic. Continuous outcome measures will be analyzed using Student's?t-test. Subgroup analysis will compare infection rates using sutures versus staples in each anatomic area (upper extremity, pelvis/acetabulum, hip/femur, knee, ankle). A further subgroup analysis will be conducted comparing trauma patients to elective surgery patients. Non-infected revision surgery will also be compared to primary surgery. Discussion Wound closure material is an afterthought for many orthopaedic surgeons. The combined results of several comparative trials suggests that the choice of wound closure materials may have an impact on the rate of surgical site infections. However, the strength of the evidence is poor given the heterogeneity of the methods employed in previous studies. The following study protocol aims to guide surgeons in their choice of wound closure material by determining if there is a difference in complication rates in sutured and stapled wounds. Trial Registration This trial was registered at ClinicalTrials.gov under the identifier NCT01146236 (registered June 14, 2010) PMID:22672186

  10. A Retrospective Analysis of Acoustic Pressure Wound Therapy: Effects on the Healing Progression of Chronic Wounds

    Microsoft Academic Search

    Jaimee Haan; Sharon Lucich

    2009-01-01

    BackgroundSmall clinical studies suggest adjunctive use of acoustic pressure wound therapy (APWT) may enhance wound healing, even in challenging patients. This noncontact low-frequency, nonthermal ultrasound therapy for assisting with the debridement of necrotic tissue from challenging wounds is generally better tolerated by patients for whom treatment-related wound pain, anticoagulation, or medical instability precludes sharp, surgical, or mechanical debridement.

  11. Dressings and Products in Pediatric Wound Care.

    PubMed

    King, Alice; Stellar, Judith J; Blevins, Anne; Shah, Kara Noelle

    2014-04-01

    Significance: The increasing complexity of medical and surgical care provided to pediatric patients has resulted in a population at significant risk for complications such as pressure ulcers, nonhealing surgical wounds, and moisture-associated skin damage. Wound care practices for neonatal and pediatric patients, including the choice of specific dressings or other wound care products, are currently based on a combination of provider experience and preference and a small number of published clinical guidelines based on expert opinion; rigorous evidence-based clinical guidelines for wound management in these populations is lacking. Recent Advances: Advances in the understanding of the pathophysiology of wound healing have contributed to an ever-increasing number of specialized wound care products, most of which are predominantly marketed to adult patients and that have not been evaluated for safety and efficacy in the neonatal and pediatric populations. This review aims to discuss the available data on the use of both more traditional wound care products and newer wound care technologies in these populations, including medical-grade honey, nanocrystalline silver, and soft silicone-based adhesive technology. Critical Issues: Evidence-based wound care practices and demonstration of the safety, efficacy, and appropriate utilization of available wound care dressings and products in the neonatal and pediatric populations should be established to address specific concerns regarding wound management in these populations. Future Directions: The creation and implementation of evidence-based guidelines for the treatment of common wounds in the neonatal and pediatric populations is essential. In addition to an evaluation of currently marketed wound care dressings and products used in the adult population, newer wound care technologies should also be evaluated for use in neonates and children. In addition, further investigation of the specific pathophysiology of wound healing in neonates and children is indicated to promote the development of wound care dressings and products with specific applications in these populations. PMID:24761363

  12. Dressings and Products in Pediatric Wound Care

    PubMed Central

    King, Alice; Stellar, Judith J.; Blevins, Anne; Shah, Kara Noelle

    2014-01-01

    Significance: The increasing complexity of medical and surgical care provided to pediatric patients has resulted in a population at significant risk for complications such as pressure ulcers, nonhealing surgical wounds, and moisture-associated skin damage. Wound care practices for neonatal and pediatric patients, including the choice of specific dressings or other wound care products, are currently based on a combination of provider experience and preference and a small number of published clinical guidelines based on expert opinion; rigorous evidence-based clinical guidelines for wound management in these populations is lacking. Recent Advances: Advances in the understanding of the pathophysiology of wound healing have contributed to an ever-increasing number of specialized wound care products, most of which are predominantly marketed to adult patients and that have not been evaluated for safety and efficacy in the neonatal and pediatric populations. This review aims to discuss the available data on the use of both more traditional wound care products and newer wound care technologies in these populations, including medical-grade honey, nanocrystalline silver, and soft silicone-based adhesive technology. Critical Issues: Evidence-based wound care practices and demonstration of the safety, efficacy, and appropriate utilization of available wound care dressings and products in the neonatal and pediatric populations should be established to address specific concerns regarding wound management in these populations. Future Directions: The creation and implementation of evidence-based guidelines for the treatment of common wounds in the neonatal and pediatric populations is essential. In addition to an evaluation of currently marketed wound care dressings and products used in the adult population, newer wound care technologies should also be evaluated for use in neonates and children. In addition, further investigation of the specific pathophysiology of wound healing in neonates and children is indicated to promote the development of wound care dressings and products with specific applications in these populations. PMID:24761363

  13. A Global Perspective on Wound Care

    PubMed Central

    Serena, Thomas E.

    2014-01-01

    The development of an interprofessional team approach to the care of acute and chronic wounds is a worldwide challenge. This global unmet need has recently been recognized by the World Health Organization (WHO) and addressed by the Association for the Advancement of Wound Care (AAWC) Global Volunteers program. This article provides an overview of the escalating international wound problem. Current programs established to deal with wounds in resource-poor countries are presented as well as information on volunteering. PMID:25126476

  14. Cutaneous wound healing: Current concepts and advances in wound care

    PubMed Central

    Klein, Kenneth C; Guha, Somes Chandra

    2014-01-01

    A non-healing wound is defined as showing no measurable signs of healing for at least 30 consecutive treatments with standard wound care.[1] It is a snapshot of a patient's total health as well as the ongoing battle between noxious factors and the restoration of optimal macro and micro circulation, oxygenation and nutrition. In practice, standard therapies for non-healing cutaneous wounds include application of appropriate dressings, periodic debridement and eliminating causative factors.[2] The vast majority of wounds would heal by such approach with variable degrees of residual morbidity, disability and even mortality. Globally, beyond the above therapies, newer tools of healing are selectively accessible to caregivers, for various logistical or financial reasons. Our review will focus on the use of hyperbaric oxygen therapy (HBOT), as used at our institution (CAMC), and some other modalities that are relatively accessible to patients. HBOT is a relatively safe and technologically simpler way to deliver care worldwide. However, the expense for including HBOT as standard of care for recognized indications per UHMS(Undersea and Hyperbaric Medical Society) may vary widely from country to country and payment system.[3] In the USA, CMS (Centers for Medicare and Medicaid Services) approved indications for HBOT vary from that of the UHMS for logistical reasons.[1] We shall also briefly look into other newer therapies per current clinical usage and general acceptance by the medical community. Admittedly, there would be other novel tools with variable success in wound healing worldwide, but it would be difficult to include all in this treatise. PMID:25593414

  15. Cutaneous wound healing: Current concepts and advances in wound care.

    PubMed

    Klein, Kenneth C; Guha, Somes Chandra

    2014-01-01

    A non-healing wound is defined as showing no measurable signs of healing for at least 30 consecutive treatments with standard wound care.[1] It is a snapshot of a patient's total health as well as the ongoing battle between noxious factors and the restoration of optimal macro and micro circulation, oxygenation and nutrition. In practice, standard therapies for non-healing cutaneous wounds include application of appropriate dressings, periodic debridement and eliminating causative factors.[2] The vast majority of wounds would heal by such approach with variable degrees of residual morbidity, disability and even mortality. Globally, beyond the above therapies, newer tools of healing are selectively accessible to caregivers, for various logistical or financial reasons. Our review will focus on the use of hyperbaric oxygen therapy (HBOT), as used at our institution (CAMC), and some other modalities that are relatively accessible to patients. HBOT is a relatively safe and technologically simpler way to deliver care worldwide. However, the expense for including HBOT as standard of care for recognized indications per UHMS(Undersea and Hyperbaric Medical Society) may vary widely from country to country and payment system.[3] In the USA, CMS (Centers for Medicare and Medicaid Services) approved indications for HBOT vary from that of the UHMS for logistical reasons.[1] We shall also briefly look into other newer therapies per current clinical usage and general acceptance by the medical community. Admittedly, there would be other novel tools with variable success in wound healing worldwide, but it would be difficult to include all in this treatise. PMID:25593414

  16. Swellability of Silver (I) Antimicrobial Wound Dressings

    Technology Transfer Automated Retrieval System (TEKTRAN)

    An important characteristic of moist wound dressings is their ability to swell and absorb exudates from the wound, while maintaining a moist atmosphere at the wound site. At the Southern Regional Research Center, we have developed antimicrobial silver- CM-cotton print cloth from CM-Printcloth with l...

  17. Transmission of Therapeutic Ultrasound by Wound Dressings

    Microsoft Academic Search

    Leon Poltawski; Tim Watson

    Ultrasound has been used for the treatment of a variety of cutaneous wounds, particularly venous ulcers. Many of the published studies involved application of ultrasound to the surrounding tissue rather than directly over the wound. Insonating the wound itself may enhance the healing process, but the lack of data regarding the trans- mission characteristics of dressings has limited the use

  18. TU Delft researchers have invented a wound

    E-print Network

    Langendoen, Koen

    TU Delft researchers have invented a wound characterisation method that improves the accuracy and efficiency of wound diagnostics. A portable device using this method is capable of defining all important (single or multi- layered) wound characteristics simultaneously and in real time outside a diagnostic

  19. Honey in wound care: antibacterial properties

    PubMed Central

    Cooper, Rose

    2007-01-01

    Honey is an ancient wound treatment that was re-introduced into modern medical practice in Australasia and Europe following the development of regulated wound care products. Its therapeutic properties are attributed to its antimicrobial activity and its ability to stimulate rapid wound healing. This review will briefly describe the evidence that demonstrates its antimicrobial activity in vitro and in vivo. PMID:20204083

  20. Acceleration of cutaneous wound healing by brassinosteroids.

    PubMed

    Esposito, Debora; Rathinasabapathy, Thirumurugan; Schmidt, Barbara; Shakarjian, Michael P; Komarnytsky, Slavko; Raskin, Ilya

    2013-01-01

    Brassinosteroids are plant growth hormones involved in cell growth, division, and differentiation. Their effects in animals are largely unknown, although recent studies showed that the anabolic properties of brassinosteroids are possibly mediated through the phosphoinositide 3-kinase/protein kinase B signaling pathway. Here, we examined biological activity of homobrassinolide (HB) and its synthetic analogues in in vitro proliferation and migration assays in murine fibroblast and primary keratinocyte cell culture. HB stimulated fibroblast proliferation and migration and weakly induced keratinocyte proliferation in vitro. The effects of topical HB administration on progression of wound closure were further tested in the mouse model of cutaneous wound healing. C57BL/6J mice were given a full-thickness dermal wound, and the rate of wound closure was assessed daily for 10 days, with adenosine receptor agonist CGS-21680 as a positive control. Topical application of brassinosteroid significantly reduced wound size and accelerated wound healing in treated animals. mRNA levels of transforming growth factor beta and intercellular adhesion molecule 1 were significantly lower, while tumor necrosis factor alpha was nearly suppressed in the wounds from treated mice. Our data suggest that topical application of brassinosteroids accelerates wound healing by positively modulating inflammatory and reepithelialization phases of the wound repair process, in part by enhancing Akt signaling in the skin at the edges of the wound and enhancing migration of fibroblasts in the wounded area. Targeting this signaling pathway with brassinosteroids may represent a promising approach to the therapy of delayed wound healing. PMID:23937635

  1. BURN WOUND HEALING ACTIVITY OF Euphorbia hirta

    PubMed Central

    Jaiprakash, B.; Chandramohan; Reddy, D. Narishma

    2006-01-01

    The Ethanolic extract of whole plant of Euphorbia hirta was screened for burn wound healing activity in rats as 2% W/W cream. The study was carried out based on the assessment of percentage reduction in original wound. It showed significant burn wound healing activity. PMID:22557201

  2. BURN WOUND HEALING ACTIVITY OF Euphorbia hirta.

    PubMed

    Jaiprakash, B; Chandramohan; Reddy, D Narishma

    2006-01-01

    The Ethanolic extract of whole plant of Euphorbia hirta was screened for burn wound healing activity in rats as 2% W/W cream. The study was carried out based on the assessment of percentage reduction in original wound. It showed significant burn wound healing activity. PMID:22557201

  3. Fungal infections in burns: a comprehensive review

    PubMed Central

    Struck, M.F.; Gille, J.

    2013-01-01

    Summary Burn wound infections remain the most important factor limiting survival in burn intensive care units. Large wound surface, impaired immune systems, and broad-spectrum antibiotic therapy contribute to the growth of opportunistic fungal species. Faced with challenging fluid resuscitation, wound excision and cardiopulmonary stabilization, mycosis in burns are likely to be underestimated. Diagnostic performance can sometimes be delayed because clinical signs are unspecific and differentiation between colonization and infection is difficult. Therapeutic measures range from infection prophylaxis over treatment with antifungal agents towards radical amputation of infected limbs. New methods of early and reliable detection of fungal organisms, as well as the use of novel antifungal substances, are promising but require wider establishment to confirm the beneficial effects in burn patients. This review aims to highlight the main important aspects of fungal infections in burns including incidence, infection control, diagnostic and therapeutic approaches, prognosis and outcomes. PMID:24563641

  4. The influence of steroid injections on the incidence of infection following total knee arthroplasty

    Microsoft Academic Search

    Geoffrey Horne; Peter Devane; Andrew Davidson; Kathryn Adams; Gordon Purdie

    Aim To investigate whether a relationship exists between preoperative intra-articular steroid injections and postoperative wound healing in total knee arthroplasty (TKA). Similar research studies on total hip arthroplasty (THA) have found higher rates of post surgical problems in hips that have been injected with steroids. Methods Thirty-eight patients with TKA postoperative wound infection, and 352 TKA patients without postoperative wound

  5. Studies on Corneal Wound Healing

    Microsoft Academic Search

    N. Isnard; F. Bourles-Dagonet; L. Robert; G. Renard

    2005-01-01

    Corneal wound healing often leads to the development of scar tissue with loss of transparency. Reconstitution of transparent corneal stroma depends on the regulation of the biosynthetic activities of postlesional keratocytes and also to a large extent on the limitation of matrix degradation, attributed essentially to the upregulation of matrix metalloproteases and especially MMP-9. Using a standardized method for the

  6. Management of chronic osteomyelitis of the tibia with life-threatening complications under negative pressure wound therapy and isolation of Helcococcus kunzii.

    PubMed

    Stanger, Katrin M; Albert, Frauke; Kneser, Ulrich; Bogdan, Christian; Horch, Raymund

    2013-07-16

    We report the case of an 86-year-old man with severe wound infection originating from a chronic crural ulcer of the lower limb, which under negative pressure wound therapy led to excessive tissue necrosis and perforation of the anterior tibial artery. A swab taken 10 and 7?days preoperatively was positive for Helcococcus kunzii. H. kunzii has been described as a potentially pathogenic organism. The questions whether the negative pressure wound therapy itself caused the bleeding or the negative pressure wound therapy, which generates an anaerobic atmosphere, has triggered the growth and invasion of the facultative anaerobic bacterium H. kunzii and owing to the infection the artery perforated or whether the bacteria has no influence at all remain currently unanswered. After surgical debridement the signs of infection were completely eliminated, and a free musculocutaneous flap led to rapid healing of the wound. Following which H. kunzii was no longer detectable. PMID:23855685

  7. Recent Developments in Topical Wound Therapy: Impact of Antimicrobiological Changes and Rebalancing the Wound Milieu

    PubMed Central

    Erfurt-Berge, Cornelia; Renner, Regina

    2014-01-01

    Wound therapy improves every year by developing new wound treatment options or by advancing already existing wound materials, for example, adding self-releasing analgesic drugs or growth factors to wound dressings, or by binding and inactivating excessive proteases. Also new dressing materials based on silk fibers and enhanced methods to reduce bacterial burden, for example, cold argon plasma, might help to fasten wound healing. PMID:24829919

  8. Determining the effect of an oak bark formulation on methicillin-resistant staphylococcus aureus and wound healing in porcine wound models.

    PubMed

    Davis, Stephen C; Mertz, Patricia M

    2008-10-01

    Control of wound infections, especially those associated with methicillin-resistant Staphylococcus aureus, is necessary for the wound healing process. Selection of topical agents should be based not only on their ability to eliminate pathogenic bacteria, but also on whether they may be detrimental to tissue repair. Two randomized, controlled in vivo studies using different porcine models were conducted to evaluate the effect of a topical oak bark ointment (treatment) on 1) methicillin-resistant Staphylococcus aureus in partial-thickness wounds, and 2) healing of second-degree burn wounds. Silver sulfadiazine, oak bark ointment vehicle control (polyethylene glycol), and no treatment (untreated wounds) were used as controls in both studies. In the first study, 108 partial-thickness wounds in three animals were inoculated with a methicillin-resistant S. aureus suspension (average 6.96+/-0.4 log CFU/mL) and covered for 24 hours with a polyurethane film. After polyurethane film removal, treatments were applied twice daily and nine wounds per day (three per animal) from each treatment group were cultured after 24, 48, and 72 hours. Methicillin-resistant S. aureus colonization was lowest in the active treatment group at all three assessment times and after 72 hours ranged from (5.01+/-1.1 CFU/mL) in the treatment to (6.20+/-0.8 CFU/mL) in the vehicle control treated wounds. In the second study, treatments were applied twice daily to second-degree burn wounds (n = 720) on eight animals. Daily epithelialization assessment (n = five wounds) was performed on day 7 through 10 after wounding. At every assessment time, the proportion of wounds healed was higher in the treatment than in the control treatment groups - days 8, 9, and 10 (active versus vehicle and untreated), P <0.01; days 9 and 10 (vehicle versus untreated), P <0.001. The oak bark formulation studied reduces methicillin-resistant S aureus contamination and facilitates healing in vivo. Research to ascertain the importance of these findings for clinical practice is needed. PMID:18927480

  9. Topical application of Katupila (Securinega leucopyrus) in Dushta Vrana (chronic wound) showing excellent healing effect: A case study

    PubMed Central

    Ajmeer, Ahamed Shahan; Dudhamal, Tukaram S.; Gupta, Sanjay Kumar; Mahanta, Vyasadeva

    2014-01-01

    Securinega leucopyrus (Willd.) Muell. is known as Humari in India, Katupila in Sri Lanka and Spinous fluggea in English. It is a desert climatic plant used topically in paste form for healing of chronic and non-healing wounds. Application of Katupila Kalka (paste) is used commonly in the management of acute as well as chronic wounds in Sri Lanka as a folklore medicine. The aim of this study is to evaluate the role of herbal paste of Katupila in the treatment of Dushta Vrana (chronic wound). It is a single observational innovative case study. A female aged 40 years presented with a non-healing infected wound on her right buttock with a history of 2 months. On examination, there was a rounded wound having black color necrosed tissue and slough with foul smelling, measuring about 3 inch × 3 inch × 1 inch in diameter caused by pyogenic local infection. The routine laboratory investigations were within normal limit except hemoglobin and the swab culture test of the wound bed was reported infection of Staphylococcus aureus. This case study showed effective wound healing by topical application of Katupila paste and sesame oil. PMID:25558163

  10. Topical application of Katupila (Securinega leucopyrus) in Dushta Vrana (chronic wound) showing excellent healing effect: A case study.

    PubMed

    Ajmeer, Ahamed Shahan; Dudhamal, Tukaram S; Gupta, Sanjay Kumar; Mahanta, Vyasadeva

    2014-04-01

    Securinega leucopyrus (Willd.) Muell. is known as Humari in India, Katupila in Sri Lanka and Spinous fluggea in English. It is a desert climatic plant used topically in paste form for healing of chronic and non-healing wounds. Application of Katupila Kalka (paste) is used commonly in the management of acute as well as chronic wounds in Sri Lanka as a folklore medicine. The aim of this study is to evaluate the role of herbal paste of Katupila in the treatment of Dushta Vrana (chronic wound). It is a single observational innovative case study. A female aged 40 years presented with a non-healing infected wound on her right buttock with a history of 2 months. On examination, there was a rounded wound having black color necrosed tissue and slough with foul smelling, measuring about 3 inch × 3 inch × 1 inch in diameter caused by pyogenic local infection. The routine laboratory investigations were within normal limit except hemoglobin and the swab culture test of the wound bed was reported infection of Staphylococcus aureus. This case study showed effective wound healing by topical application of Katupila paste and sesame oil. PMID:25558163

  11. Preparation and Evaluation of Transdermal Plasters Containing Norfloxacin: A Novel Treatment for Burn Wound Healing

    PubMed Central

    Dua, Kamal; Ramana, M. V.; Sara, U. V. S.; Agrawal, D. K.; Pabreja, Kavita; Chakravarthi, Srikumar

    2010-01-01

    Objective: In an attempt for better treatment of bacterial infections and burn wounds, plaster formulations containing different concentrations of norfloxacin were prepared using polymers like polyvinylpyrrolidone and polyvinyl alcohol and evaluated for physicochemical parameters, in vitro drug release, antimicrobial activity, and burn wound healing properties. The prepared formulations were compared with silver sulfadiazine cream 1%, USP. Methods: Plaster formulations containing different concentrations of norfloxacin were prepared by solvent casting method using combination of polymers like polyvinylpyrrolidone and polyvinyl alcohol. These plasters were characterized for drug content, thickness, percentage elongation, tensile strength, in vitro drug release properties, and antimicrobial activity against various strains of aerobic and anaerobic microorganisms. The wound healing property was evaluated by histopathological examination and by measuring the wound contraction. Results: The in vitro release and in vitro skin permeation followed the first-order kinetics followed by diffusion as dominant release mechanism. In spite of the significant antimicrobial and wound healing effects produced by plasters, the observed values were less than the values obtained with silver sulfadiazine 1% cream (P < .05). Various histopathological changes observed during the study period (days 1, 4, 8, and 12) also supported the wound healing process. Conclusion: Based on the observed in vitro performances along with antimicrobial and wound healing effects, the 5% norfloxacin transdermal plasters could be employed as an alternative to commercial silver sulfadiazine 1% cream. PMID:20596234

  12. Quantitative wound healing measurement and monitoring system based on an innovative 3D imaging system

    NASA Astrophysics Data System (ADS)

    Yi, Steven; Yang, Arthur; Yin, Gongjie; Wen, James

    2011-03-01

    In this paper, we report a novel three-dimensional (3D) wound imaging system (hardware and software) under development at Technest Inc. System design is aimed to perform accurate 3D measurement and modeling of a wound and track its healing status over time. Accurate measurement and tracking of wound healing enables physicians to assess, document, improve, and individualize the treatment plan given to each wound patient. In current wound care practices, physicians often visually inspect or roughly measure the wound to evaluate the healing status. This is not an optimal practice since human vision lacks precision and consistency. In addition, quantifying slow or subtle changes through perception is very difficult. As a result, an instrument that quantifies both skin color and geometric shape variations would be particularly useful in helping clinicians to assess healing status and judge the effect of hyperemia, hematoma, local inflammation, secondary infection, and tissue necrosis. Once fully developed, our 3D imaging system will have several unique advantages over traditional methods for monitoring wound care: (a) Non-contact measurement; (b) Fast and easy to use; (c) up to 50 micron measurement accuracy; (d) 2D/3D Quantitative measurements;(e) A handheld device; and (f) Reasonable cost (< $1,000).

  13. Control of burn wound sepsis in rats by methylene blue-mediated photodynamic treatment

    NASA Astrophysics Data System (ADS)

    Hasegawa, Hiroyuki; Sato, Shunichi; Kawauchi, Satoko; Saitoh, Daizoh; Shinomiya, Nariyoshi; Ashida, Hiroshi; Terakawa, Mitsuhiro

    2012-02-01

    Control of wound sepsis is an important challenge in traumatology. However, increase in the drug-resistant bacteria makes this challenge considerably difficult in recent years. In this study, we attempted to control burn wound sepsis in rats by photodynamic treatment, which has been reported to be effective against some drug-resistant bacteria. A 20% TBSA (total body surface area) full-thickness burn was made in rat dorsal skin, and five days after injury, a suspension of P. aeruginosa was applied to the wound surface. At 30 min after infection, a methylene blue (MB) solution was applied to the wound surface; 5 min afterwards, the wound was illuminated with a 665-nm light emitting diode (LED) array for 10 min. This treatment (application of MB and illumination) was repeated 3 times successively. The averaged light intensity on the wound surface was 3.3 mW/cm2, the corresponding total light dose being 5.9 J/cm2. One week after injury, the numbers of bacteria in the blood and liver were counted by colony forming assay. In the liver, the number of bacteria of the treated group was significantly lower than that of the sham control group without photodynamic treatment. In the blood, no bacteria were detected in the treated group, while a certain amount of bacteria was detected in the control group. These results demonstrate the efficacy of MB-mediated PDT with a red LED array to control burn wound sepsis.

  14. Autofluorescence imaging device for real-time detection and tracking of pathogenic bacteria in a mouse skin wound model: preclinical feasibility studies.

    PubMed

    Wu, Yichao Charlie; Kulbatski, Iris; Medeiros, Philip J; Maeda, Azusa; Bu, Jiachuan; Xu, Lizhen; Chen, Yonghong; DaCosta, Ralph S

    2014-08-01

    Bacterial infection significantly impedes wound healing. Clinical diagnosis of wound infections is subjective and suboptimal, in part because bacteria are invisible to the naked eye during clinical examination. Moreover, bacterial infection can be present in asymptomatic patients, leading to missed opportunities for diagnosis and treatment. We developed a prototype handheld autofluorescence (AF) imaging device (Portable Real-time Optical Detection, Identification and Guidance for Intervention - PRODIGI) to noninvasively visualize and measure bacterial load in wounds in real time. We conducted preclinical pilot studies in an established nude mouse skin wound model inoculated with bioluminescent Staphylococcus aureus bacteria. We tested the feasibility of longitudinal AF imaging for in vivo visualization of bacterial load in skin wounds, validated by bioluminescence imaging. We showed that bacteria (S. aureus), occult to standard examination, can be visualized in wounds using PRODIGI. We also detected quantitative changes in wound bacterial load over time based on the antibiotic treatment and the correlation of bacterial AF intensity with bacterial load. AF imaging of wounds offers a safe, noninvasive method for visualizing the presence, location, and extent of bacteria as well as measuring relative changes in bacterial load in wounds in real time. PMID:25089944

  15. Autofluorescence imaging device for real-time detection and tracking of pathogenic bacteria in a mouse skin wound model: preclinical feasibility studies

    NASA Astrophysics Data System (ADS)

    Wu, Yichao Charlie; Kulbatski, Iris; Medeiros, Philip J.; Maeda, Azusa; Bu, Jiachuan; Xu, Lizhen; Chen, Yonghong; DaCosta, Ralph S.

    2014-08-01

    Bacterial infection significantly impedes wound healing. Clinical diagnosis of wound infections is subjective and suboptimal, in part because bacteria are invisible to the naked eye during clinical examination. Moreover, bacterial infection can be present in asymptomatic patients, leading to missed opportunities for diagnosis and treatment. We developed a prototype handheld autofluorescence (AF) imaging device (Portable Real-time Optical Detection, Identification and Guidance for Intervention-PRODIGI) to noninvasively visualize and measure bacterial load in wounds in real time. We conducted preclinical pilot studies in an established nude mouse skin wound model inoculated with bioluminescent Staphylococcus aureus bacteria. We tested the feasibility of longitudinal AF imaging for in vivo visualization of bacterial load in skin wounds, validated by bioluminescence imaging. We showed that bacteria (S. aureus), occult to standard examination, can be visualized in wounds using PRODIGI. We also detected quantitative changes in wound bacterial load over time based on the antibiotic treatment and the correlation of bacterial AF intensity with bacterial load. AF imaging of wounds offers a safe, noninvasive method for visualizing the presence, location, and extent of bacteria as well as measuring relative changes in bacterial load in wounds in real time.

  16. [Chronic wounds as a public health problem].

    PubMed

    Situm, Mirna; Koli?, Maja; Redzepi, Gzim; Antoli?, Slavko

    2014-10-01

    Chronic wounds represent a significant burden to patients, health care professionals and the entire health care system. Regarding the healing process, wounds can be classified as acute or chronic wounds. A wound is considered chronic if healing does not occur within the expected period according to the wound etiology and localization. Chronic wounds can be classified as typical and atypical. The majority of wounds (95 percent) are typical ones, which include ischemic, neurotrophic and hypostatic ulcers and two separate entities: diabetic foot and decubital ulcers. Eighty percent of chronic wounds localized on lower leg are the result of chronic venous insufficiency, in 5-10 percent the cause is of arterial etiology, whereas the rest are mostly neuropathic ulcers. Chronic wounds significantly decrease the quality of life of patients by requiring continuous topical treatment, causing immobility and pain in a high percentage of patients. Chronic wounds affect elderly population. Chronic leg ulcers affect 0.6-3 percent of those aged over 60, increasing to over 5 percent of those aged over 80. Emergence of chronic wounds is a substantial socioeconomic problem as 1-2 percent of western population will suffer from it. This estimate is expected to rise due to the increasing proportion of elderly population along with the diabetic and obesity epidemic. It has been proved that chronic wounds account for the large proportion of costs in the health care system, even in rich societies. Socioeconomically, the management of chronic wounds reaches a total of 2-4 percent of the health budget in western countries. Treatment costs for some other diseases are not irrelevant, nor are the method and materials used for treating these wounds. Considering etiologic factors, a chronic wound demands a multidisciplinary approach with great efforts of health care professionals to treat it more efficiently, more simply and more painlessly for the patient, as well as more inexpensively for health care funds. PMID:25326983

  17. Wound dressings from a hygienic point of view using the example of sorbion sachet S

    PubMed Central

    Kramer, Axel; Maassen, Alexander

    2009-01-01

    Nosocomial infections present a growing challenge in wound care, especially in light of the rising distribution of multiresistant bacterial strains. Because wounds are an ideal breeding ground for pathogens, special care must be taken in choosing the right dressing. Following the traditional preventive approach, exposure of the nursing staff as well as the wounds to pathogens should be reduced. Dressings allowing a reduced frequency of dressing changes may help accomplish this. During dressing changes the dressing should allow for safe handling with a low risk of contamination. To protect the patient, the dressing should minimise exposure to pathogens during wear time as well as promote healing even if the dressing remains on the wound for a longer period of time. The dressing sorbion sachet S is used as an example to examine possible strategies. PMID:20204089

  18. Eradication of multidrug-resistant A. baumannii in burn wounds by antiseptic pulsed electric field

    PubMed Central

    Golberg, Alexander; Broelsch, G. Felix; Vecchio, Daniela; Khan, Saiqa; Hamblin, Michael R.; Austen, William G.; Sheridan, Robert L.; Yarmush, Martin L.

    2014-01-01

    Emerging bacterial resistance to multiple drugs is an increasing problem in burn wound management. New non-pharmacologic interventions are needed for burn wound disinfection. Here we report on a novel physical method for disinfection: antiseptic pulsed electric field (PEF) applied externally to the infected burns. In a mice model, we show that PEF can reduce the load of multidrug resistant Acinetobacter baumannii present in a full thickness burn wound by more than four orders of magnitude, as detected by bioluminescence imaging. Furthermore, using a finite element numerical model, we demonstrate that PEF provides non-thermal, homogeneous, full thickness treatment for the burn wound, thus, overcoming the limitation of treatment depth for many topical antimicrobials. These modeling tools and our in vivo results will be extremely useful for further translation of the PEF technology to the clinical setting, as they provide the essential elements for planning of electrode design and treatment protocol. PMID:25089285

  19. Multidrug-resistant Acinetobacter extremity infections in soldiers.

    PubMed

    Davis, Kepler A; Moran, Kimberly A; McAllister, C Kenneth; Gray, Paula J

    2005-08-01

    War wound infection and osteomyelitis caused by multidrug-resistant (MDR) Acinetobacter species have been prevalent during the 2003-2005 military operations in Iraq. Twenty-three soldiers wounded in Iraq and subsequently admitted to our facility from March 2003 to May 2004 had wound cultures positive for Acinetobacter calcoaceticus-baumannii complex. Eighteen had osteomyelitis, 2 burn infection, and 3 deep wound infection. Primary therapy for these infections was directed antimicrobial agents for an average of 6 weeks. All soldiers initially improved, regardless of the specific type of therapy. Patients were followed up to 23 months after completing therapy, and none had recurrent infection with Acinetobacter species. Despite the drug resistance that infecting organisms demonstrated in this series, a regimen of carefully selected extended antimicrobial-drug therapy appears effective for osteomyelitis caused by MDR Acinetobacter spp. PMID:16102310

  20. Multidrug-Resistant Acinetobacter Extremity Infections in Soldiers

    PubMed Central

    Moran, Kimberly A.; McAllister, C. Kenneth; Gray, Paula J.

    2005-01-01

    War wound infection and osteomyelitis caused by multidrug-resistant (MDR) Acinetobacter species have been prevalent during the 2003–2005 military operations in Iraq. Twenty-three soldiers wounded in Iraq and subsequently admitted to our facility from March 2003 to May 2004 had wound cultures positive for Acinetobacter calcoaceticus-baumannii complex. Eighteen had osteomyelitis, 2 burn infection, and 3 deep wound infection. Primary therapy for these infections was directed antimicrobial agents for an average of 6 weeks. All soldiers initially improved, regardless of the specific type of therapy. Patients were followed up to 23 months after completing therapy, and none had recurrent infection with Acinetobacter species. Despite the drug resistance that infecting organisms demonstrated in this series, a regimen of carefully selected extended antimicrobial-drug therapy appears effective for osteomyelitis caused by MDR Acinetobacter spp. PMID:16102310

  1. Electric Cautery Lowers the Contamination Threshold for Infection of Laparotomies 1 1 This work was supported by the Naval Medical Research and Development Command, work unit 61153N MR04120.001-1002. 2 2 The first two authors contributed equally to this work

    Microsoft Academic Search

    Peter W Soballe; Narayan V Nimbkar; Isaac Hayward; Thor B Nielsen; William R Drucker

    1998-01-01

    Background: Interplay between wound resistance factors and bacterial innoculum determines the risk of surgical infection. Since cautery causes more damage than the scalpel, our hypothesis is that lower numbers of bacteria are required to infect wounds made by electric cautery than to infect wounds made with a scalpel.Methods: Abdominal fascia was incised in 375 rats by cold knife, cutting current,

  2. Physics of Wound Healing I: Energy Considerations

    E-print Network

    Apell, S Peter; Papazoglou, Elisabeth S; Pizziconi, Vincent

    2012-01-01

    Wound healing is a complex process with many components and interrelated processes on a microscopic level. This paper addresses a macroscopic view on wound healing based on an energy conservation argument coupled with a general scaling of the metabolic rate with body mass M as M^{\\gamma} where 0 wound healing rate peaks at a value determined by {\\gamma} alone, suggesting a concept of wound acceleration to monitor the status of a wound. 2) We find that the time-scale for wound healing is a factor 1/(1 -{\\gamma}) longer than the average internal timescale for producing new material filling the wound cavity in corresondence with that it usually takes weeks rather than days to heal a wound. 3) The model gives a prediction for the maximum wound mass which can be generated in terms of measurable quantities related to wound status. We compare our model predictions to experimental results for a range of different wound conditions (healthy, lean, diabetic and obses...

  3. Placenta Growth Factor in Diabetic Wound Healing

    PubMed Central

    Cianfarani, Francesca; Zambruno, Giovanna; Brogelli, Laura; Sera, Francesco; Lacal, Pedro Miguel; Pesce, Maurizio; Capogrossi, Maurizio C.; Failla, Cristina Maria; Napolitano, Monica; Odorisio, Teresa

    2006-01-01

    Reduced microcirculation and diminished expression of growth factors contribute to wound healing impairment in diabetes. Placenta growth factor (PlGF), an angiogenic mediator promoting pathophysiological neovascularization, is expressed during cutaneous wound healing and improves wound closure by enhancing angiogenesis. By using streptozotocin-induced diabetic mice, we here demonstrate that PlGF induction is strongly reduced in diabetic wounds. Diabetic transgenic mice overexpressing PlGF in the skin displayed accelerated wound closure compared with diabetic wild-type littermates. Moreover, diabetic wound treatment with an adenovirus vector expressing the human PlGF gene (AdCMV.PlGF) significantly accelerated the healing process compared with wounds treated with a control vector. The analysis of treated wounds showed that PlGF gene transfer improved granulation tissue formation, maturation, and vascularization, as well as monocytes/macrophages local recruitment. Platelet-derived growth factor, fibroblast growth factor-2, and vascular endothelial growth factor mRNA levels were increased in AdCMV.PlGF-treated wounds, possibly enhancing PlGF-mediated effects. Finally, PlGF treatment stimulated cultured dermal fibroblast migration, pointing to a direct role of PlGF in accelerating granulation tissue maturation. In conclusion, our data indicate that reduced PlGF expression contributes to impaired wound healing in diabetes and that PlGF gene transfer to diabetic wounds exerts therapeutic activity by promoting different aspects of the repair process. PMID:17003476

  4. Postoperative infections in obstetrics and gynecology.

    PubMed

    Jaiyeoba, Oluwatosin

    2012-12-01

    Postoperative infection is the most commonly seen complication of surgery in obstetrics and gynecology. The use of antibiotic prophylaxis has greatly decreased though not completely eliminated this adverse outcome. Postoperative infections include wound cellulitis, wound abscess, endomyometritis, pelvic cellulitis, and pelvic abscess. Infections usually manifest as fever and greater than normal postoperative pain. Refractory fevers maybe because of septic pelvic vein thrombophlebitis or maybe noninfectious in origin. Broad-spectrum antibiotics should be initiated as soon as possible when diagnosis of postoperative infection is made; most patients will respond to treatment within 24 to 48 hours when appropriate antibiotics are selected. PMID:23090459

  5. Integrin Regulation of Epidermal Functions in Wounds

    PubMed Central

    Longmate, Whitney M.; DiPersio, C. Michael

    2014-01-01

    Significance: Integrins are bidirectional signaling receptors for extracellular matrix that regulate both inside-out signaling that controls keratinocyte-mediated changes to the wound microenvironment and outside-in signaling that controls keratinocyte responses to microenvironmental changes. As such, integrins represent attractive therapeutic targets for treatment of chronic wounds or general promotion of wound healing. Advances in wound management are particularly important as the elderly and diabetic populations within the United States continue to grow. Recent Advances: Although integrins are best known for mediating cell adhesion and migration, integrins in wound epidermis also control cell survival, proliferation, matrix remodeling, and paracrine crosstalk to other cellular compartments of the wound. Importantly, the concept of targeting integrins in the clinic has been established for treatment of certain cancers and other diseases, laying the groundwork for similar exploitation of integrins as targets to treat chronic wounds. Critical Issues: Despite their attractiveness as therapeutic targets, integrins have complex roles in wound healing that are impacted by both their own expression and a highly dynamic wound microenvironment that determines ligand availability. Therefore, identifying relevant integrin ligands in the wound and understanding both distinct and overlapping functions that different integrins play in the epidermis will be critical to determine their precise roles in wound healing. Future Directions: Future research should focus on gaining a thorough understanding of the highly coordinated functions of different integrins in wound epidermis, and on determining which of these functions go awry in pathological wounds. This focus should facilitate development of integrin-targeting therapeutics for treating chronic wounds. PMID:24669359

  6. Management of Traumatic Wounds and a Novel Approach to Delivering Wound Care in Children

    PubMed Central

    Bernabe, Kathryn Q.; Desmarais, Thomas J.; Keller, Martin S.

    2014-01-01

    Significance: The costs and morbidity of pediatric traumatic wounds are not well known. The literature lacks a comprehensive review of the volume, management, and outcomes of children sustaining soft tissue injury. We briefly review the existing literature for traumatic wounds such as open fractures and burns. Such injuries require dedicated wound care and we propose a novel approach for more efficient and more effective delivery of dedicated pediatric wound care. Recent Advances: New pediatric literature is emerging regarding the long-term effects of wound care pain in traumatic injuries—especially burns. A variety of wound dressings and alternative management techniques exist and are geared toward reducing wound care pain. Our institution utilizes a unique model to provide adequate sedation and pain control through a dedicated pediatric wound care unit. We believe that this model reduces the cost of wound care by decreasing emergency department and operating room visits as well as hospital length of stay. Critical Issues: First, medical costs related to pediatric traumatic wound care are not insignificant. The need for adequate pain control and sedation in children with complex wounds is traditionally managed with operating room intervention. Afterward, added costs can be from a hospital stay for ongoing acute wound management. Second, morbidities of complex traumatic wounds are shown to be related to the acute wound care received. Future Directions: Further guidelines are needed to determine the most effective and efficient care of complex traumatic soft tissue injuries in the pediatric population. PMID:24761364

  7. Polymeric Multilayers that Localize the Release of Chlorhexidine from Biologic Wound Dressings

    PubMed Central

    Agarwal, Ankit; Nelson, Tyler B.; Kierski, Patricia R.; Schurr, Michael J.; Murphy, Christopher J.; Czuprynski, Charles J.; McAnulty, Jonathan F.; Abbott, Nicholas L.

    2012-01-01

    Biologic wound dressings contain animal-derived components and are susceptible to high infection rates. To address this issue, we report an approach that permits incorporation of non-toxic levels of the small-molecule antiseptic ‘chlorhexidine’ into biologic dressings. The approach relies on the fabrication of polyelectrolyte multilayer (PEMs) films containing poly(allylaminehydrochloride) (PAH), poly(acrylicacid) (PAA), and chlorhexidine acetate (CX) on elastomeric poly(dimethylsiloxane) (PDMS) sheets. The PEMs (20-100 nm thick) are subsequently stamped onto the wound-contact surface of a synthetic biologic dressing, Biobrane, which contains collagen peptides. Chlorhexidine loading in the PEMs was tailored by tuning the number of (CX/PAA) bilayers deposited, providing burst release of up to 0.98±0.06 ?g/cm2 of CX over 24 h, followed by zero order release of 0.35±0.04 ?g/cm2/day for another week. Although the CX concentrations released were below the reported in vitro cytotoxicity limit (5 ?g/mL over 24 h) for human dermal fibroblasts, they killed 4 log10 counts of pathogenic bacteria Staphylococcus aureus in solution. The CX/PEMs could be stamped onto Biobrane with high efficiency to provide CX release kinetics and in-vitro antibacterial activity similar to that on PDMS stamps. In a full-thickness ‘splinted’ dermal wound-model in normal wild-type mice, the CX-functionalized Biobrane showed no decrease in either its adherence to the wound-bed or wound-closure rate over 14 days. The murine wounds topically inoculated with ~105 CFU/cm2 of S. aureus and treated with CX-functionalized Biobrane demonstrated a 3 log10 decrease in the wound's bacterial burden within 3 days, compared to persistent bacterial colonization found in wounds treated with unmodified Biobrane (n=10 mice, p<0.005). Overall, this study presents a promising approach to prevent bacterial colonization in wounds under biologic dressings. PMID:22784602

  8. Silver Sol Improves Hospital Associated Wound Care In Long Term, High Risk Hospital Patients Who Have Pressure Sores Including MRSA: A Review and Study of Wound Care Treatments in Long Stay, High Risk Hospitals. By

    Microsoft Academic Search

    Gordon Pedersen

    Silver Sol is a nutritional supplement that has anti-bacterial, antiviral and anti fungal properties (US Patent #7135195). Silver Sol has unique mechanisms of action that promote wound healing by preventing infection and promoting stem cell release and activation (Nexus, 2008). The purpose of this study is to review the results of nursing homes using Silver Sol for pressure sores infected

  9. Human placental extract mediated inhibition of proteinase K: implications of heparin and glycoproteins in wound physiology.

    PubMed

    Sharma, Kanika; Mukherjee, Chaitali; Roy, Siddhartha; De, Debashree; Bhattacharyya, Debasish

    2014-09-01

    Efficient debridement of the wound bed following the removal of microbial load prevents its progression into a chronic wound. Bacterial infection and excessive proteolysis characterize impaired healing and therefore, their inhibition might restore the disturbed equilibrium in the healing process. Human placental extract exhibits reversible, non-competitive inhibition towards Proteinase K, a microbial protease, by stabilizing it against auto-digestion. Scattering and fluorescence studies followed by biochemical analysis indicated the involvement of a glycan moiety. Surface plasmon resonance demonstrated specific interaction of heparin with Proteinase K having Kd in ?M range. Further, Proteinase K contains sequence motifs similar to other heparin-binding proteins. Molecular docking revealed presence of clefts suitable for binding of heparin-derived oligosaccharides. Comprehensive analysis of this inhibitory property of placental extract partly explains its efficacy in curing wounds with common bacterial infections. PMID:24435659

  10. COMPARISON OF EFFICACY OF HONEY VERSUS SILVER SULFADIAZINE AND ACETATE MAFENID IN THE TREATMENT OF CONTAMINATED BURN WOUNDS IN PIGGIES

    Microsoft Academic Search

    Hemmati H; Shahraki S

    Introduction: Heat injury, with creation of conclusive necrosis in skin layers, prepares an environ- ment suitable for bacterial infection as a result of low tissue perfusion and high protein content. Gram negative bacteries especially Pseudomonas Auroginosa have been recognized as the main cre- ative organisms of wound infection mortality. Mankind has been interested in remedial role of honey since long.

  11. Influencing dressing choice and supporting wound management using remote 'tele-wound care'.

    PubMed

    King, Brenda

    2014-06-01

    This article describes a local involvement in a project to evaluate a remote system of wound management, incorporating the use of digital and mobile technology. It outlines how this involvement influenced the current system of 'tele wound care' (remote wound management) in a large community organisation. The system allows remote wound assessment, management advice and ongoing monitoring of wounds to ensure that the dressing choice remains appropriate and that timely wound care support can be provided to community nurses, practice nurses and GPs. PMID:24912832

  12. Filament wound rocket motor chambers

    NASA Technical Reports Server (NTRS)

    1976-01-01

    The design, analysis, fabrication and testing of a Kevlar-49/HBRF-55A filament wound chamber is reported. The chamber was fabricated and successfully tested to 80% of the design burst pressure. Results of the data reduction and analysis from the hydrotest indicate that the chamber design and fabrication techniques used for the chamber were adequate and the chamber should perform adequately in a static test.

  13. Modified spiral wound retaining ring

    NASA Technical Reports Server (NTRS)

    Lawson, A. G. (inventor)

    1980-01-01

    A spiral wound retaining ring with angled ends is described. The ring is crimped at the same angle as the ring ends to maintain a constant thickness dimension. The angling of the ends of the ring and crimp allow the ends to be positioned closer together while maintaining enough clearance to enable insertion and removal of the ring. By reducing the separation distance between the ends a stronger ring results since the double layer area of the ring is maximized.

  14. Evaluation of Antimicrobial and Wound Healing Potential of Justicia flava and Lannea welwitschii.

    PubMed

    Agyare, Christian; Bempah, Solomon Boamah; Boakye, Yaw Duah; Ayande, Patrick George; Adarkwa-Yiadom, Martin; Mensah, Kwesi Boadu

    2013-01-01

    Microbial infections of various types of wounds are a challenge to the treatment of wounds and wound healing. The aim of the study is to determine the antimicrobial, antioxidant, and in vivo wound healing properties of methanol leaf extracts of Justicia flava and Lannea welwitschii. The antimicrobial activity was investigated using agar well diffusion and microdilution methods. The free radical scavenging activity of the methanol leaf extracts was performed using 1,1-diphenyl-2-picryl-hydrazyl (DPPH). The rate of wound contraction was determined using excision model. The test organisms used were Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 4853, Bacillus subtilis NTCC 10073, Staphylococcus aureus ATCC 25923, and clinical strains of Candida albicans. The MICs of methanol leaf extract of J. flava against test organisms were E. coli (7.5?mg/mL); P. aeruginosa (7.5?mg/mL); S. aureus (5?mg/mL); B. subtilis (7.5?mg/mL); and C. albicans (5?mg/mL). The MICs of methanol leaf extract of L. welwitschii against test organisms were E. coli (5?mg/mL); P. aeruginosa (10?mg/mL); S. aureus (5?mg/mL); B. subtilis (2.5?mg/mL); and C. albicans (2.5?mg/mL). The MBC/MFC of the extract was between 10 and 50?mg/mL. The IC50 of the reference antioxidant, ? -tocopherol, was 1.5? ? g/mL and the methanol leaf extracts of J. flava and L. welwitschii had IC50 of 65.3? ? g/mL and 81.8? ? g/mL, respectively. The methanol leaf extracts of J. flava and L. welwitschii gave a significant reduction in wound size as compared to the untreated. The rates of wound closure after the application of the extracts (7.5%?w/w) were compared to the untreated wounds. On the 9th day, J. flava extract had a percentage wound closure of 99% (P < 0.01) and that of L. welwitschii exhibited wound closure of 95% (P < 0.05) on the 13th day compared to the untreated wounds. The two extracts significantly (P < 0.01) increased the tensile strength of wounds compared to the untreated wounds. The extracts treated wound tissues showed improved angiogenesis, collagenation, and reepithelialization compared to the untreated wound tissues. The preliminary phytochemical screening of J. flava and L. welwitschii leaf extracts revealed the presence of tannins, alkaloids, flavonoids, and glycosides. The above results indicate that methanol leaf extracts of J. flava and L. welwitschii possess antimicrobial and wound healing properties which may justify the traditional uses of J. flava and L. welwitschii in the treatment of wounds and infections. PMID:24159350

  15. Evaluation of Antimicrobial and Wound Healing Potential of Justicia flava and Lannea welwitschii

    PubMed Central

    Bempah, Solomon Boamah; Boakye, Yaw Duah; Ayande, Patrick George; Adarkwa-Yiadom, Martin; Mensah, Kwesi Boadu

    2013-01-01

    Microbial infections of various types of wounds are a challenge to the treatment of wounds and wound healing. The aim of the study is to determine the antimicrobial, antioxidant, and in vivo wound healing properties of methanol leaf extracts of Justicia flava and Lannea welwitschii. The antimicrobial activity was investigated using agar well diffusion and microdilution methods. The free radical scavenging activity of the methanol leaf extracts was performed using 1,1-diphenyl-2-picryl-hydrazyl (DPPH). The rate of wound contraction was determined using excision model. The test organisms used were Escherichia coli ATCC 25922, Pseudomonas aeruginosa ATCC 4853, Bacillus subtilis NTCC 10073, Staphylococcus aureus ATCC 25923, and clinical strains of Candida albicans. The MICs of methanol leaf extract of J. flava against test organisms were E. coli (7.5?mg/mL); P. aeruginosa (7.5?mg/mL); S. aureus (5?mg/mL); B. subtilis (7.5?mg/mL); and C. albicans (5?mg/mL). The MICs of methanol leaf extract of L. welwitschii against test organisms were E. coli (5?mg/mL); P. aeruginosa (10?mg/mL); S. aureus (5?mg/mL); B. subtilis (2.5?mg/mL); and C. albicans (2.5?mg/mL). The MBC/MFC of the extract was between 10 and 50?mg/mL. The IC50 of the reference antioxidant, ?-tocopherol, was 1.5??g/mL and the methanol leaf extracts of J. flava and L. welwitschii had IC50 of 65.3??g/mL and 81.8??g/mL, respectively. The methanol leaf extracts of J. flava and L. welwitschii gave a significant reduction in wound size as compared to the untreated. The rates of wound closure after the application of the extracts (7.5%?w/w) were compared to the untreated wounds. On the 9th day, J. flava extract had a percentage wound closure of 99% (P < 0.01) and that of L. welwitschii exhibited wound closure of 95% (P < 0.05) on the 13th day compared to the untreated wounds. The two extracts significantly (P < 0.01) increased the tensile strength of wounds compared to the untreated wounds. The extracts treated wound tissues showed improved angiogenesis, collagenation, and reepithelialization compared to the untreated wound tissues. The preliminary phytochemical screening of J. flava and L. welwitschii leaf extracts revealed the presence of tannins, alkaloids, flavonoids, and glycosides. The above results indicate that methanol leaf extracts of J. flava and L. welwitschii possess antimicrobial and wound healing properties which may justify the traditional uses of J. flava and L. welwitschii in the treatment of wounds and infections. PMID:24159350

  16. Pulsed electric fields for burn wound disinfection in a murine model.

    PubMed

    Golberg, Alexander; Broelsch, G Felix; Vecchio, Daniela; Khan, Saiqa; Hamblin, Michael R; Austen, William G; Sheridan, Robert L; Yarmush, Martin L

    2015-01-01

    Emerging bacterial resistance renders many antibiotics ineffective, making alternative strategies of wound disinfection important. Here the authors report on a new, physical burn wound disinfection method: pulsed electric fields (PEFs). High voltage, short PEFs create nonthermal, permanent damage to cell membranes, possibly by irreversible electroporation. In medicine, PEF technology has recently been used for nonthermal ablation of solid tumors. The authors have expanded the spectrum of PEF applications in medicine to burn wound disinfection. A third-degree burn was induced on the dorsal skin of C57BL/6 mice. Immediately after the injury, the burn wound was infected with Acinetobacter baumannii expressing the luxCDABE operon. Thirty minutes after infection, the infected areas were treated with 80 pulses delivered at 500 V/mm, 70 ?s, 1 Hz. The authors used bioluminescence to quantify bacteria on skin. Three animals were used for each experimental condition. PEFs were effective in the disinfection of infected burned murine skin. The bacterial load reduction correlated with the number of delivered pulses. Forty pulses of 500 V/mm led to a 2.04 ± 0.29 Log10 reduction in bacterial load; 80 pulses led to the immediate 5.53 ± 0.30 Log10 reduction. Three hours after PEF, the bacterial reduction of the skin treated with 500 V/mm, 80 pulses was 4.91 ± 0.71 Log10. The authors introduce a new method of wound disinfection using high voltage, short PEFs. They believe that PEF technology may represent an important alternative to antibiotics in addressing bacterial contamination of wounds, particularly those contaminated with multidrug-resistant bacteria. PMID:25167374

  17. Sternotomy infections: sternal salvage and the importance of sternal stability

    PubMed Central

    Bray, Peter W.; Mahoney, James L.; Anastakis, Dimitri; Yao, James K.Y.

    1996-01-01

    Objective To review the management of sternal wound infections after cardiovascular surgery. Design Retrospective case study. Setting All management took place in a single tertiary-care university hospital. Patients Twenty-one consecutive patients seen over a 3-year period who had infected median sternotomy incisions after cardiovascular surgery. Interventions Surgical eradication of infection, including sternal débridement and rewiring or placement of vascularized muscle flaps, or both. Main Outcome Measures Resolution of infection and restoration of sternal stability. Results The development of sternal wound infection was found to be associated with sternal instability. In 12 of 17 patients treated initially with sternal débridement and rewiring the infection was cured. Vascularized muscle flap transfers were required to eradicate the infection in the remaining patients. Conclusions Sternal débridement and rewiring is an effective initial treatment for sternal wound infections in selected patients. Some patients may require placement of muscle flaps for definitive treatment. PMID:8697320

  18. Irradiation at 660 nm modulates different genes central to wound healing in wounded and diabetic wounded cell models

    NASA Astrophysics Data System (ADS)

    Houreld, Nicolette N.

    2014-02-01

    Wound healing is a highly orchestrated process and involves a wide variety of cellular components, chemokines and growth factors. Laser irradiation has influenced gene expression and release of various growth factors, cytokines and extracellular matrix proteins involved in wound healing. This study aimed to determine the expression profile of genes involved in wound healing in wounded and diabetic wounded fibroblast cells in response to irradiation at a wavelength of 660 nm. Human skin fibroblast cells (WS1) were irradiated with a diode laser (wavelength 660 nm; fluence 5 J/cm2; power output 100 mW; power density 11 mW/cm2; spot size 9.1 cm2; exposure duration 7 min 35 s). Total RNA was isolated and 1 ?g reverse transcribed into cDNA which was used as a template in real-time qualitative polymerase chain reaction (qPCR). Eighty four genes involved in wound healing (extracellular matrix and cell adhesion; inflammatory cytokines and chemokines; growth factors; and signal transduction) were evaluated in wounded and diabetic wounded cell models. Forty eight hours post-irradiation, 6 genes were significantly upregulated and 8 genes were down-regulated in irradiated wounded cells, whereas 1 gene was up-regulated and 33 genes down-regulated in irradiated diabetic wounded cells. Irradiation of stressed fibroblast cells to a wavelength of 660 nm and a fluence of 5 J/cm2 modulated the expression of different genes involved in wound healing in different cell models. Modulation of these genes leads to the effects of laser irradiation seen both in vivo and in vitro, and facilitates the wound healing process.

  19. C. elegans epidermal wounding induces a mitochondrial ROS burst that promotes wound repair.

    PubMed

    Xu, Suhong; Chisholm, Andrew D

    2014-10-13

    Reactive oxygen species (ROS) such as hydrogen peroxide are generated at wound sites and act as long-range signals in wound healing. The roles of other ROS in wound repair are little explored. Here, we reveal a cytoprotective role for mitochondrial ROS (mtROS) in Caenorhabditis elegans skin wound healing. We show that skin wounding causes local production of mtROS superoxide at the wound site. Inhibition of mtROS levels by mitochondrial superoxide-specific antioxidants blocks actin-based wound closure, whereas elevation of mtROS promotes wound closure and enhances survival of mutant animals defective in wound healing. mtROS act downstream of wound-triggered Ca(2+) influx. We find that the mitochondrial calcium uniporter MCU-1 is essential for rapid mitochondrial Ca(2+) uptake and mtROS production after wounding. mtROS can promote wound closure by local inhibition of Rho GTPase activity via a redox-sensitive motif. These findings delineate a pathway acting via mtROS that promotes cytoskeletal responses in wound healing. PMID:25313960

  20. Wound fixation for pressure ulcers: A new therapeutic concept based on the physical properties of wounds.

    PubMed

    Mizokami, Fumihiro; Takahashi, Yoshiko; Nemoto, Tetsuya; Nagai, Yayoi; Tanaka, Makiko; Utani, Atsushi; Furuta, Katsunori; Isogai, Zenzo

    2015-02-01

    A pressure ulcer is defined as damage to skin and other tissues over a bony prominence caused by excess pressure. Deep pressure ulcers that develop over specific bony prominences often exhibit wound deformity, defined as a change in the 3-dimensional shape of the wound. Subsequently, the wound deformity can result in undermining formation, which is a characteristic of deep pressure ulcers. However, to date, a concept with respect to alleviating wound deformity has yet to be defined and described. To clarify the issue, we propose a new concept called "wound fixation" based on the physical properties of deep pressure ulcers with wound deformity. Wound fixation is defined here as the alleviation of wound deformity by exogenous materials. The wound fixation methods are classified as traction, anchor, and insertion based on the relation between the wound and action point by the exogenous materials. A retrospective survey of a case series showed that wound fixation was preferentially used for deep pressure ulcers at specific locations such as the sacrum, coccyx, and greater trochanter. Moreover, the methods of wound fixation were dependent on the pressure ulcer location. In conclusion, our new concept of wound fixation will be useful for the practical treatment and care of pressure ulcers. Further discussion and validation by other experts will be required to establish this concept. PMID:25660756

  1. A double-edged sword: the role of VEGF in wound repair and chemoattraction of opportunist pathogens.

    PubMed

    Birkenhauer, Eric; Neethirajan, Suresh

    2015-01-01

    Wound healing is a complex process essential to repairing damaged tissues and preventing infection. Skin is the first line of defense, a chief physical barrier to microbe entry. Wound healing is a physical rebuilding process, but at the same time it is an inflammatory event. In turn, molecules for wound repair are secreted by fibroblasts and others present at the wound site. Vascular endothelial growth factor (VEGF) is a critical cytokine that exhibits chemoattractant properties, recruiting other immune cells to the site. Although generally beneficial, VEGF may also act as a chemoattractant for invading microorganisms, such as Pseudomonas aeruginosa. P. aeruginosa is problematic during wound infection due to its propensity to form biofilms and exhibit heightened antimicrobial resistance. Here, we explored the influence of VEGF gradients (in a microfluidic device wound model) on the motility and chemotactic properties of P. aeruginosa. At lower concentrations, VEGF had little effect on motility, but as the maximal concentration within the gradient increased, P. aeruginosa cells exhibited directed movement along the gradient. Our data provide evidence that while beneficial, VEGF, in excess, may aid colonization by P. aeruginosa. This highlights the necessity for the efficient resolution of inflammation. Understanding the dynamics of wound colonization may lead to new/enhanced therapeutics to hasten recovery. PMID:25830483

  2. Putative virulence factors of Botrytis cinerea acting as a wound pathogen

    Microsoft Academic Search

    R. C. Staples; A. M. Mayer

    1995-01-01

    The grey mold fungus, Botrytis cinerea, is a wound pathogen of worldwide distribution, and causes rots of almost all fruits and vegetables. The fungus can also penetrate directly from appressoria to cause severe losses to growers of flowers. B. cinerea secretes a number of inducible attack enzymes which can degrade host cell walls to widen the infection, including ?-glucosidase, pectin

  3. A systematic review of topical negative pressure therapy for acute and chronic wounds

    Microsoft Academic Search

    D. T. Ubbink; S. J. Westerbos; E. A. Nelson; H. Vermeulen

    2008-01-01

    device. Selection of trials for analysis, quality assessment, data abstraction and data synthesis were conducted by two authors independently. The primary endpoint was any measure of wound healing. Secondary endpoints were infection, pain, quality of life, oedema, microcirculation, bacterial load, adverse events, duration of hospital stay and cost. Results: The search identified 15 publications on 13 RCTs. These reported on

  4. Survey of bacterial diversity in chronic wounds using Pyrosequencing, DGGE, and full ribosome shotgun sequencing.

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Background: Chronic wound pathogenic biofilms are host-pathogen environments that colonize and exist as a cohabitation of many bacterial species that cooperate to promote their own survival and the chronic nature of the infection. Few studies have performed extensive surveys of the different populat...

  5. On the application of a photo plasma dynamic method for pussy wounds treatment

    Microsoft Academic Search

    V. V. Pedder; D. V. Belik; G. Z. Rot; I. V. Sourgutskova; Y. V. Shkuro; A. V. Pedder; I. A. Shnyptev

    2008-01-01

    We offer a new photo plasma dynamic method and ELECTRON -PULSAR complex of apparatuses for the implementation of the method. The method and the complex of the apparatuses ensure the treatment for pussy wounds by means of a gaseous mixture effecting on the infection nidus. The gaseous mixture includes the following highly- active components such as O*, O2* 1O2, O',

  6. Molecular and Culture-Based Assessment of the Microbial Diversity of Diabetic Chronic Foot Wounds and Contralateral Skin Sites

    PubMed Central

    Oates, Angela; Bowling, Frank L.; Boulton, Andrew J. M.

    2012-01-01

    Wound debridement samples and contralateral (healthy) skin swabs acquired from 26 patients attending a specialist foot clinic were analyzed by differential isolation and eubacterium-specific PCR-denaturing gradient gel electrophoresis (DGGE) in conjunction with DNA sequencing. Thirteen of 26 wounds harbored pathogens according to culture analyses, with Staphylococcus aureus being the most common (13/13). Candida (1/13), pseudomonas (1/13), and streptococcus (7/13) were less prevalent. Contralateral skin was associated with comparatively low densities of bacteria, and overt pathogens were not detected. According to DGGE analyses, all wounds contained significantly greater eubacterial diversity than contralateral skin (P < 0.05), although no significant difference in total eubacterial diversity was detected between wounds from which known pathogens had been isolated and those that were putatively uninfected. DGGE amplicons with homology to Staphylococcus sp. (8/13) and S. aureus (2/13) were detected in putatively infected wound samples, while Staphylococcus sp. amplicons were detected in 11/13 noninfected wounds; S. aureus was not detected in these samples. While a majority of skin-derived DGGE consortial fingerprints could be differentiated from wound profiles through principal component analysis (PCA), a large minority could not. Furthermore, wounds from which pathogens had been isolated could not be distinguished from putatively uninfected wounds on this basis. In conclusion, while chronic wounds generally harbored greater eubacterial diversity than healthy skin, the isolation of known pathogens was not associated with qualitatively distinct consortial profiles or otherwise altered diversity. The data generated support the utility of both culture and DGGE for the microbial characterization of chronic wounds. PMID:22553231

  7. Evaluation of Antimicrobial and Wound Healing Potentials of Ethanol Extract of Wedelia biflora Linn D.C. Leaves.

    PubMed

    Biswas, D; Yoganandam, G P; Dey, A; Deb, L

    2013-03-01

    To rationalize scientifically the traditional claim on use of Wedelia biflora (Linn.) D. C. for the treatment of wounds and infections, the present study was designed to evaluate the antimicrobial and wound healing activity of ethanol extract of leaves of W. biflora. In in vitro assays the test extract was subjected to antimicrobial activity by agar well-diffusion method and minimum inhibitory concentration method in different microbial strains. Wound healing activity of the test extract was studied by excision wound model and incision wound model in Wistar albino rats. In excision wound model, 97.90% wound healing was recorded in 10% w/w extract treated group on 16(th) days of postsurgery, whereas only 58.50% was observed in control group. In incision model, higher breaking strength, high hydroxyl proline content and histopathological study in extract treated groups revealed higher collagen redeposition than the control group. The agar well-diffusion evaluation and minimum inhibitory concentration established antimicrobial efficacy of ethanol extracts of W. biflora. These observations established the traditional claim and therapeutic activity of W. biflora and it could be a potent wound healing candidate for use in future. PMID:24019563

  8. A prospective randomised clinical and histological study of superficial burn wound healing with honey and silver sulfadiazine.

    PubMed

    Subrahmanyam, M

    1998-03-01

    Histological and clinical studies of wound healing have been made on comparable fresh partial thickness burns with honey dressing or silver sulfadiazine (SSD) in two groups of 25 randomly allocated patients. Of the wounds treated with honey 84 per cent showed satisfactory epithelialization by the 7th day, and in 100 per cent of the patients by the 21st day. In wounds treated with silver sulfadiazine, epithelialization occurred by the 7th day in 72 per cent of the patients and in 84 per cent of patients by 21 days. Histological evidence of reparative activity was seen in 80 per cent of wounds treated with the honey dressing by the 7th day with minimal inflammation. Fifty two per cent of the silver sulfadiazine treated wounds showed reparative activity with inflammatory changes by the 7th day. Reparative activity reached 100 per cent by 21 days with the honey dressing and 84 per cent with SSD. Thus in honey dressed wounds, early subsidence of acute inflammatory changes, better control of infection and quicker wound healing was observed while in the SSD treated wounds sustained inflammatory reaction was noted even on epithelialization. PMID:9625243

  9. Wound Care Nursing: Professional Issues and Opportunities

    PubMed Central

    Corbett, Lisa Q.

    2012-01-01

    As the field of wound care advances and seeks validity as a distinctive healthcare specialty, it becomes imperative to define practice competencies for all related professionals in the arena. As such, the myriad nurses practicing wound care in settings across the continuum should be understood for their unique contribution to the wound care team. Furthermore, the hierarchy of wound care nursing with varying levels of licensure, certification, and scope of practice can be clarified to delineate leadership and reimbursement issues to meet current health care challenges. A review of the role of nursing in wound care from a historical and evolutionary perspective helps to characterize the trend towards advanced practice nursing in the wound care specialty. PMID:24527304

  10. Multimodal imaging of cutaneous wound tissue

    NASA Astrophysics Data System (ADS)

    Zhang, Shiwu; Gnyawali, Surya; Huang, Jiwei; Ren, Wenqi; Gordillo, Gayle; Sen, Chandan K.; Xu, Ronald

    2015-01-01

    Quantitative assessment of wound tissue ischemia, perfusion, and inflammation provides critical information for appropriate detection, staging, and treatment of chronic wounds. However, few methods are available for simultaneous assessment of these tissue parameters in a noninvasive and quantitative fashion. We integrated hyperspectral, laser speckle, and thermographic imaging modalities in a single-experimental setup for multimodal assessment of tissue oxygenation, perfusion, and inflammation characteristics. Algorithms were developed for appropriate coregistration between wound images acquired by different imaging modalities at different times. The multimodal wound imaging system was validated in an occlusion experiment, where oxygenation and perfusion maps of a healthy subject's upper extremity were continuously monitored during a postocclusive reactive hyperemia procedure and compared with standard measurements. The system was also tested in a clinical trial where a wound of three millimeters in diameter was introduced on a healthy subject's lower extremity and the healing process was continuously monitored. Our in vivo experiments demonstrated the clinical feasibility of multimodal cutaneous wound imaging.

  11. Comparative Analysis of Single-Species and Polybacterial Wound Biofilms Using a Quantitative, In Vivo, Rabbit Ear Model

    PubMed Central

    Seth, Akhil K.; Geringer, Matthew R.; Hong, Seok J.; Leung, Kai P.; Galiano, Robert D.; Mustoe, Thomas A.

    2012-01-01

    Introduction The recent literature suggests that chronic wound biofilms often consist of multiple bacterial species. However, without appropriate in vivo, polybacterial biofilm models, our understanding of these complex infections remains limited. We evaluate and compare the effect of single- and mixed-species biofilm infections on host wound healing dynamics using a quantitative, in vivo, rabbit ear model. Methods Six-mm dermal punch wounds in New Zealand rabbit ears were inoculated with Staphylococcus aureus strain UAMS-1, Pseudomonas aeruginosa strain PAO1, or both, totaling 10?6 colony-forming units/wound. Bacterial proliferation and maintenance in vivo were done using procedures from our previously published model. Wounds were harvested for histological measurement of wound healing, viable bacterial counts using selective media, or inflammatory cytokine (IL-1?, TNF-?) expression via quantitative reverse-transcription PCR. Biofilm structure was studied using scanning electron microscopy (SEM). For comparison, biofilm deficient mutant UAMS-929 replaced strain UAMS-1 in some mixed-species infections. Results Bacterial counts verified the presence of both strains UAMS-1 and PAO1 in polybacterial wounds. Over time, strain PAO1 became predominant (p<0.001). SEM showed colocalization of both species within an extracellular matrix at multiple time-points. Compared to each monospecies infection, polybacterial biofilms impaired all wound healing parameters (p<0.01), and increased expression of IL-1? and TNF-? (p<0.05). In contrast, mixed-species infections using biofilm-deficient mutant UAMS-929 instead of wild-type strain UAMS-1 showed less wound impairment (p<0.01) with decreased host cytokine expression (p<0.01), despite a bacterial burden and distribution comparable to that of mixed-wild-type wounds. Conclusions This study reveals that mixed-species biofilms have a greater impact on wound healing dynamics than their monospecies counterparts. The increased virulence of polybacterial biofilm appears dependent on the combined pathogenicity of each species, verified using a mutant strain. These data suggest that individual bacterial species can interact synergistically within a single biofilm structure. PMID:22905182

  12. Advances in Wound Healing: A Review of Current Wound Healing Products

    PubMed Central

    Murphy, Patrick S.; Evans, Gregory R. D.

    2012-01-01

    Successful wound care involves optimizing patient local and systemic conditions in conjunction with an ideal wound healing environment. Many different products have been developed to influence this wound environment to provide a pathogen-free, protected, and moist area for healing to occur. Newer products are currently being used to replace or augment various substrates in the wound healing cascade. This review of the current state of the art in wound-healing products looks at the latest applications of silver in microbial prophylaxis and treatment, including issues involving resistance and side effects, the latest uses of negative pressure wound devices, advanced dressings and skin substitutes, biologic wound products including growth factor applications, and hyperbaric oxygen as an adjunct in wound healing. With the abundance of available products, the goal is to find the most appropriate modality or combination of modalities to optimize healing. PMID:22567251

  13. Symptoms Associated with Malignant Wounds: A Prospective Case Series

    Microsoft Academic Search

    Vincent Maida; Marguerite Ennis; Craig Kuziemsky; Linda Trozzolo

    2009-01-01

    A significant proportion of cancer patients develop malignant wounds. Malignant wounds are generally nonhealable and are managed with palliative methods. Palliative wound care encompasses the pain and symptom management of such wounds. Sixty-seven of 472 cancer patients from a prospective sequential case series of palliative medicine consultations demonstrated malignant wounds at the time of referral and were studied to determine

  14. Therapeutic Ultrasound in Lower Extremity Wound Management

    Microsoft Academic Search

    Christine Uhlemann; Birgit Heinig; Uwe Wollina

    2003-01-01

    In medical practice, ultrasound (US) is used for diagnosis and therapy. High-frequency (1-4 MHz) and low-frequency (20-120 KHz) therapeutic US are relevant to wound healing. The heating effects of high-frequency US are important, whereas the mechanical effects of low-frequency US must be considered. The physiological effects of low-frequency US include metabolic enhancement, perfusion, wound cleansing, and the acceleration of wound

  15. Results of vacuum assisted wound closure application.

    PubMed

    Atay, Tolga; Burc, Halil; Baykal, Yakup Barbaros; Kirdemir, Vecihi

    2013-08-01

    In recent past, various methods have been used for wound treatment purpose. In this study, we aimed to compare our results established from the vacuum-assisted wound closure method, which has gained popularity day by day, with the literature. A total of 48 patients, who received vacuum-assisted wound closure treatment in our clinic between 2007and 2010, were included in this study. Etiological distribution of the patients was as follows: 32 traumatic, 6 pressure sore, 9 diabetic, and 1 iliac disarticulation. All cases were evaluated in terms of age, gender, etiology, period of treatment, and size of the wound. In the patients studied, 42 were men (87.5 %) and 6 were women (12.5 %). Mean age of the patients was 39.6 years (11-61 years). All of our traumatic patients suffered from open fracture. After the vacuum-assisted wound closure application, wound size reduced by 28.8 %, while the mean area of the surface of the wound was 94.7 cm(2) (13.7-216.3 cm(2)) on average. After the wounds became ready for surgery, 15 of them were treated with split-thickness grafting, 9 of them were treated with secondary suture, 18 of them were treated with full-thickness grafting, and 6 of them were treated with flap. Average period of the application of vacuum-assisted wound closure was 11.6 days (7-15 days). Results of vacuum-assisted wound closure can be regarded as satisfactory when cases are selected properly. This system has three different effect mechanisms. Firstly, it increases local blood flow on the wound bed. Secondly, cell proliferation is triggered following the mechanic stress. Thirdly, vacuum removes the proteases from the environment which obstructs healing. Therefore, it is intended to prepare alive wound bed which is required for subsequent soft tissue reconstructions. PMID:24426458

  16. Inhibition of wound healing by topical steroids.

    PubMed

    Marks, J G; Cano, C; Leitzel, K; Lipton, A

    1983-10-01

    A new animal model was used to study the effect of topical agents on wound healing. A weak- (hydrocortisone cream 1%) and medium-strength (fluocinolone acetonide ointment 0.025%) steroid and their vehicles were applied to full-thickness skin wounds placed on the backs of female Syrian hamsters. Wound healing was significantly retarded by both steroids when compared to their vehicles. Fluocinolone had a greater inhibitory effect than hydrocortisone. PMID:6619384

  17. Ultraviolet light and hyperpigmentation in healing wounds

    SciTech Connect

    Wiemer, D.R.; Spira, M.

    1983-10-01

    The concept of permanent hyperpigmentation in wounds following ultraviolet light exposure during the postoperative period has found a place in plastic surgical literature but has not been documented. This study evaluates the effect of ultraviolet light on healing wounds in paraplegics. It failed to confirm permanent alteration in pigmentation response to ultraviolet exposure and suggests that other factors are of greater importance in the development of hyperpigmentation in the healing wound.

  18. Next-Generation Sequencing: A Review of Technologies and Tools for Wound Microbiome Research

    PubMed Central

    Hodkinson, Brendan P.; Grice, Elizabeth A.

    2015-01-01

    Significance: The colonization of wounds by specific microbes or communities of microbes may delay healing and/or lead to infection-related complication. Studies of wound-associated microbial communities (microbiomes) to date have primarily relied upon culture-based methods, which are known to have extreme biases and are not reliable for the characterization of microbiomes. Biofilms are very resistant to culture and are therefore especially difficult to study with techniques that remain standard in clinical settings. Recent Advances: Culture-independent approaches employing next-generation DNA sequencing have provided researchers and clinicians a window into wound-associated microbiomes that could not be achieved before and has begun to transform our view of wound-associated biodiversity. Within the past decade, many platforms have arisen for performing this type of sequencing, with various types of applications for microbiome research being possible on each. Critical Issues: Wound care incorporating knowledge of microbiomes gained from next-generation sequencing could guide clinical management and treatments. The purpose of this review is to outline the current platforms, their applications, and the steps necessary to undertake microbiome studies using next-generation sequencing. Future Directions: As DNA sequencing technology progresses, platforms will continue to produce longer reads and more reads per run at lower costs. A major future challenge is to implement these technologies in clinical settings for more precise and rapid identification of wound bioburden. PMID:25566414

  19. Aprotinin and classic wound drainage are unnecessary in total hip replacement a prospective randomized trial

    PubMed Central

    2011-01-01

    Background Classic wound drainage is still common in hip replacement but its benefit is doubtful. The role of systemic administration of proteinase inhibitors like aprotinin to avoid perioperative blood loss is still unclear. Patients and Methods In a prospective randomized trial, the perioperative blood loss in alloplastic hip replacement under the influence of proteinase inhibitor (aprotinin, Trasylol®) using wound drainage as well as compression treatment alone were compared. 80 patients were prospectively randomized in 4 arms. Patients received either aprotinin or placebo during surgery as well as drainage or targeted external wound compression. Results Observing the "drug therapy" aprotinin had no effect on the intraor postoperative blood loss (p > 0.05), a trend to lower postoperative hemoglobin decline was found, but without significance. thrombosis occurred in neither the aprotinin nor in the placebo group. Two patients had a severe allergic drug reaction and were excluded from the study. Under "non drug therapy" with compression therapy and wound drainage a significant difference in blood loss was found (p < 0.001). The blood loss was higher under the wound drainage. There was no influence on the infection rate. Yet we could observe increased bruising under the sole external compression treatment. Conclusion The administration of aprotinin did not achieve the desired reduction of perioperative blood loss. Hence, costs and two severe allergic drug reactions in our study represent arguments against its use in regular treatment. Furthermore, it seems that wound drainage is neglectable in hip replacement and can be substituted by a sole compression treatment. PMID:21345766

  20. Prospective, double-blinded, randomised controlled trial assessing the effect of an Octenidine-based hydrogel on bacterial colonisation and epithelialization of skin graft wounds in burn patients

    PubMed Central

    W, Eisenbeiß; F, Siemers; G, Amtsberg; P, Hinz; B, Hartmann; T, Kohlmann; A, Ekkernkamp; U, Albrecht; O, Assadian; A, Kramer

    2012-01-01

    Background: Moist wound treatment improves healing of skin graft donor site wounds. Microbial colonised wounds represent an increased risk of wound infection; while antimicrobially active, topical antiseptics may impair epithelialization. Objectives: The aim of this prospective randomised controlled clinical trial was to examine the influence of an Octenidine-dihydrochloride (OCT) hydrogel on bacterial colonisation and epithelialization of skin graft donor sites. Methods: The study was designed as a randomised, double-blinded, controlled clinical trial. Skin graft donor sites from a total of 61 patients were covered either with 0.05% OCT (n=31) or an OCT-free placebo wound hydrogel (n=30). Potential interaction with wound healing was assessed by measuring the time until 100% re-epithelialization. In addition, microbial wound colonisation was quantitatively determined in all skin graft donor sites. Results: There was no statistically significant difference in the time for complete epithelialization of skin graft donor sites in the OCT and the placebo group (7.3±0.2 vs. 6.9±0.2 days; p=0.236). Microbial wound colonisation was significantly lower in the OCT group than in the placebo group (p=0.014). Conclusions: The OCT-based hydrogel showed no delay in wound epithelialization and demonstrated a significantly lower bacterial colonisation of skin graft donor site wounds. PMID:23071904

  1. Multifunctional medicated lyophilised wafer dressing for effective chronic wound healing.

    PubMed

    Pawar, Harshavardhan V; Boateng, Joshua S; Ayensu, Isaac; Tetteh, John

    2014-06-01

    Wafers combining weight ratios of Polyox with carrageenan (75/25) or sodium alginate (50/50) containing streptomycin and diclofenac were prepared to improve chronic wound healing. Gels were freeze-dried using a lyophilisation cycle incorporating an annealing step. Wafers were characterised for morphology, mechanical and in vitro functional (swelling, adhesion, drug release in the presence of simulated wound fluid) characteristics. Both blank (BLK) and drug-loaded (DL) wafers were soft, flexible, elegant in appearance and non-brittle in nature. Annealing helped to improve porous nature of wafers but was affected by the addition of drugs. Mechanical characterisation demonstrated that the wafers were strong enough to withstand normal stresses but also flexible to prevent damage to newly formed skin tissue. Differences in swelling, adhesion and drug release characteristics could be attributed to differences in pore size and sodium sulphate formed because of the salt forms of the two drugs. BLK wafers showed relatively higher swelling and adhesion than DL wafers with the latter showing controlled release of streptomycin and diclofenac. The optimised dressing has the potential to reduce bacterial infection and can also help to reduce swelling and pain associated with injury due to the anti-inflammatory action of diclofenac and help to achieve more rapid wound healing. PMID:24700434

  2. Using Light to Treat Mucositis and Help Wounds Heal

    NASA Technical Reports Server (NTRS)

    Ignatius, Robert W.; Martin, Todd S.; Kirk, Charles

    2008-01-01

    A continuing program of research and development is focusing on the use of controlled illumination by light-emitting diodes (LEDs) to treat mucositis and to accelerate healing of wounds. The basic idea is to illuminate the affected area of a patient with light of an intensity, duration, and wavelength (or combination of wavelengths) chosen to produce a therapeutic effect while generating only a minimal amount of heat. This method of treatment was originally intended for treating the mucositis that is a common complication of chemotherapy and radiation therapy for cancer. It is now also under consideration as a means to accelerate the healing of wounds and possibly also to treat exposure to chemical and radioactive warfare agents. Radiation therapy and many chemotherapeutic drugs often damage the mucosal linings of the mouth and gastrointestinal tract, leading to mouth ulcers (oral mucositis), nausea, and diarrhea. Hyperbaric-oxygen therapy is currently the standard of care for ischemic, hypoxic, infected, and otherwise slowlyhealing problem wounds, including those of oral mucositis. Hyperbaric-oxygen therapy increases such cellular activities as collagen production and angiogenesis, leading to an increased rate of healing. Biostimulation by use of laser light has also been found to be effective in treating mucositis. For hyperbaricoxygen treatment, a patient must remain inside a hyperbaric chamber for an extended time. Laser treatment is limited by laser-wavelength capabilities and by narrowness of laser beams, and usually entails the generation of significant amounts of heat.

  3. An innovative bi-layered wound dressing made of silk and gelatin for accelerated wound healing.

    PubMed

    Kanokpanont, Sorada; Damrongsakkul, Siriporn; Ratanavaraporn, Juthamas; Aramwit, Pornanong

    2012-10-15

    In this study, the novel silk fibroin-based bi-layered wound dressing was developed. Wax-coated silk fibroin woven fabric was introduced as a non-adhesive layer while the sponge made of sericin and glutaraldehyde-crosslinked silk fibroin/gelatin was fabricated as a bioactive layer. Wax-coated silk fibroin fabrics showed improved mechanical properties compared with the non-coated fabrics, but less adhesive than the commercial wound dressing mesh. This confirmed by results of peel test on both the partial- and full-thickness wounds. The sericin-silk fibroin/gelatin spongy bioactive layers showed homogeneous porous structure and controllable biodegradation depending on the degree of crosslinking. The bi-layered wound dressings supported the attachment and proliferation of L929 mouse fibroblasts, particularly for the silk fibroin/gelatin ratio of 20/80 and 0.02% GA crosslinked. Furthermore, we proved that the bi-layered wound dressings promoted wound healing in full-thickness wounds, comparing with the clinically used wound dressing. The wounds treated with the bi-layered wound dressings showed the greater extent of wound size reduction, epithelialization, and collagen formation. The superior properties of the silk fibroin-based bi-layered wound dressings compared with those of the clinically used wound dressings were less adhesive and had improved biological functions to promote cell activities and wound healing. This novel bi-layered wound dressing should be a good candidate for the healing of full-thickness wounds. PMID:22771972

  4. Microwave Tissue Soldering for Immediate Wound Closure

    NASA Technical Reports Server (NTRS)

    Arndt, G. Dickey; Ngo, Phong H.; Plan, Chau T.; Byerly, Diane; Dusl, John; Sognier, Marguerite A.

    2011-01-01

    A novel approach for the immediate sealing of traumatic wounds is under development. A portable microwave generator and handheld antenna are used to seal wounds, binding the edges of the wound together using a biodegradable protein sealant or solder. This method could be used for repairing wounds in emergency settings, by restoring the wound surface to its original strength within minutes. This technique could also be utilized for surgical purposes involving solid visceral organs (i.e., liver, spleen, and kidney) that currently do not respond well to ordinary surgical procedures. A miniaturized microwave generator and a handheld antenna are used to deliver microwave energy to the protein solder, which is applied to the wound. The antenna can be of several alternative designs optimized for placement either in contact with or proximity to the protein solder covering the wound. In either case, optimization of the design includes the matching of impedances to maximize the energy delivered to the protein solder and wound at a chosen frequency. For certain applications, an antenna could be designed that would emit power only when it is in direct contact with the wound. The optimum frequency or frequencies for a specific application would depend on the required depth of penetration of the microwave energy. In fact, a computational simulation for each specific application could be performed, which would then match the characteristics of the antenna with the protein solder and tissue to best effect wound closure. An additional area of interest with potential benefit that remains to be validated is whether microwave energy can effectively kill bacteria in and around the wound. Thus, this may be an efficient method for simultaneously sterilizing and closing wounds. Using microwave energy to seal wounds has a number of advantages over lasers, which are currently in experimental use in some hospitals. Laser tissue welding is unsuitable for emergency use because its large, bulky equipment cannot be easily moved between operating rooms, let alone relocated to field sites where emergencies often occur. In addition, this approach is highly dependent on the uniformity and thickness of the protein solder as well as the surgeon s skills. In contrast, the use of microwave energy is highly tolerant of the thickness of the protein solder, level of fluids in and around the wound, and other parameters that can adversely affect the outcome of laser welding. However, controlling the depth of penetration of the microwave energy into the wound is critical for achieving effective wound sealing without damaging the adjacent tissue. In addition, microspheres that encapsulate metallic cores