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Sample records for wound infection

  1. Surgical wound infection - treatment

    MedlinePlus

    ... there is an infection and what kind of antibiotic medicine would work best Debride the wound by removing dead or infected tissue in the wound Rinse the wound with salt water (saline solution) Drain the pocket of pus (abscess), if present ...

  2. 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

  3. Surgical wound infection surveillance.

    PubMed

    Lee, J T

    2003-12-01

    Measuring the frequency of a defined outcome flaw for a series of patients undergoing operative procedures generates information for performance evaluation. Such data influence decisions to improve care if used responsibly. Wound infection (WI), bacterial invasion of the incision, is the most common infectious complication of surgical care and WI prevention has value because the complication affects economic, patient satisfaction, and patient functional status outcomes. WI frequency, one kind of surgical outcome flaw rate, is traditionally used to judge one aspect of surgical care quality. At the author's institution, global WI surveillance was conducted without interruption for 20 years. Results for 85,260 consecutive inpatient operations performed during the period showed that secular changes in infection rates occurred but were not necessarily caused by surgical care quality decrements. PMID:14750065

  4. Surgical wound infection - treatment

    MedlinePlus

    ... wounds heal, you may have a wound VAC (Vacuum Assisted Closure) dressing. It increases blood flow in ... helps with healing. This is a negative pressure (vacuum) dressing. There is a vacuum pump, a foam ...

  5. Animal models of external traumatic wound infections

    PubMed Central

    Dai, Tianhong; Kharkwal, Gitika B; Tanaka, Masamitsu; Huang, Ying-Ying; Bil de Arce, Vida J

    2011-01-01

    Background: Despite advances in traumatic wound care and management, infections remain a leading cause of mortality, morbidity and economic disruption in millions of wound patients around the world. Animal models have become standard tools for studying a wide array of external traumatic wound infections and testing new antimicrobial strategies. Results: Animal models of external traumatic wound infections reported by different investigators vary in animal species used, microorganism strains, the number of microorganisms applied, the size of the wounds and for burn infections, the length of time the heated object or liquid is in contact with the skin. Methods: This review covers experimental infections in animal models of surgical wounds, skin abrasions, burns, lacerations, excisional wounds and open fractures. Conclusions: As antibiotic resistance continues to increase, more new antimicrobial approaches are urgently needed. These should be tested using standard protocols for infections in external traumatic wounds in animal models. PMID:21701256

  6. Flavimonas oryzihabitans infection of a surgical wound.

    PubMed

    Munro, R; Buckland, G; Neville, S

    1990-10-01

    An unusual case of a post operative wound infection involving Flavimonas oryzihabitans is described. This organism is rarely isolated from human sources. It can cause infections in patients having continuous ambulatory peritoneal dialysis. Our patient developed a wound infection 2 months after femoro-popliteal bypass grafting. The source of the organism was unknown. PMID:2091006

  7. Topical antimicrobial toolkit for wound infection.

    PubMed

    Woo, Kevin Y; Alam, Tarik; Marin, Joseph

    2014-11-01

    Increased bacterial burden and formation of biofilm has been recognized as one of the key factors contributing to delayed wound healing. There is a toolbox of topical antimicrobial wound dressings that incorporate silver, iodine, polyhexamethylene biguanide, methylene blue/gentian violet, and honey. This article reviews a diverse range of evidence to discuss the advantages and disadvantage of topical antimicrobial dressings. Discussion will provide guidance on when and how to use topical antimicrobial dressings to achieve optimal outcomes and cost-effective wound care. Chronic wounds do not follow a predictable and expected healing trajectory, and they may persist for months or years due to underlying disease processes, recurrent injury, and comorbidities.1 With an aging population and increased prevalence of chronic diseases, the majority of wounds are refractory to healing, placing a significant burden on the health system and individual patients. Bacterial burden and biofilm have been recognized as key factors contributing to persistent inflammation, tissue destruction, delayed wound healing, and other serious complications (especially in individuals who are frail and immune-compromised).2 It has been demonstrated that when bacterial growth reaches a critical threshold of 105 bacteria per gram of tissue, bacterial toxins can cause tissue damage in the superficial wound compartment, delaying healing.2 In the literature, this phenomenon is referred to as critical colonization, increased bacterial burden, superficial infection, or localized infection. According to a recent review, over 50% of chronic wounds exhibit signs and symptoms that are consistent with localized infection.3. PMID:25433174

  8. Microbiology of animal bite wound infections.

    PubMed

    Abrahamian, Fredrick M; Goldstein, Ellie J C

    2011-04-01

    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

  9. 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

  10. Skin and wound infections: an overview.

    PubMed

    O'Dell, M L

    1998-05-15

    Skin infections are common and may be caused by bacteria, fungi or viruses. Breaks in the skin integrity, particularly those that inoculate pathogens into the dermis, frequently cause or exacerbate skin infections. Bacterial skin infections caused by corynebacteria include erythrasma, trichomycosis axillaris and pitted keratolysis. Staphylococci may cause impetigo, ecthyma and folliculitis. Streptococcal skin infections include impetigo and erysipelas. Human papillomavirus skin infections present as several different types of warts, depending on the surface infected and its relative moisture, and the patterns of pressure. The many dermatomycoses (skin infections caused by fungi or yeasts) include tinea capitis, tinea barbae, tinea cruris, tinea manus, tinea pedis and tinea unguium (onychomycosis). Candidal infections occur in moist areas, such as the vulva, mouth, penis, skinfolds and diaper area. Wounds caused by wood splinters or thorns may result in sporotrichosis. Animal bites may result in complex, serious infections, requiring tetanus and, possibly, rabies prophylaxis in addition to appropriate antibiotic therapy. PMID:9614412

  11. Enhanced susceptibility to infections in a diabetic wound healing model

    PubMed Central

    Hirsch, Tobias; Spielmann, Malte; Zuhaili, Baraa; Koehler, Till; Fossum, Magdalena; Steinau, Hans-Ulrich; Yao, Feng; Steinstraesser, Lars; Onderdonk, Andrew B; Eriksson, Elof

    2008-01-01

    Background Wound infection is a common complication in diabetic patients. The progressive spread of infections and development of drug-resistant strains underline the need for further insights into bacterial behavior in the host in order to develop new therapeutic strategies. The aim of our study was to develop a large animal model suitable for monitoring the development and effect of bacterial infections in diabetic wounds. Methods Fourteen excisional wounds were created on the dorsum of diabetic and non-diabetic Yorkshire pigs and sealed with polyurethane chambers. Wounds were either inoculated with 2 × 108 Colony-Forming Units (CFU) of Staphylococcus aureus or injected with 0.9% sterile saline. Blood glucose was monitored daily, and wound fluid was collected for bacterial quantification and measurement of glucose concentration. Tissue biopsies for microbiological and histological analysis were performed at days 4, 8, and 12. Wounds were assessed for reepithelialization and wound contraction. Results Diabetic wounds showed a sustained significant infection (>105 CFU/g tissue) compared to non-diabetic wounds (p < 0.05) over the whole time course of the experiment. S. aureus-inoculated diabetic wounds showed tissue infection with up to 8 × 107 CFU/g wound tissue. Non-diabetic wounds showed high bacterial counts at day 4 followed by a decrease and no apparent infection at day 12. Epidermal healing in S. aureus-inoculated diabetic wounds showed a significant delay compared with non-inoculated diabetic wounds (59% versus 84%; p < 0.05) and were highly significant compared with healing in non-diabetic wounds (97%; p < 0.001). Conclusion Diabetic wounds developed significantly more sustained infection than non-diabetic wounds. S. aureus inoculation leads to invasive infection and significant wound healing delay and promotes invasive co-infection with endogenous bacteria. This novel wound healing model provides the opportunity to closely assess infections during

  12. Ghee and honey dressing for infected wounds.

    PubMed

    Udwadia, Tehemton E

    2011-08-01

    Ghee and honey has been advocated and used as dressing for infected wounds by Sushruta (600BC) and since 1991 in four Mumbai Hospitals. The gratifying results observed with the dressing have prompted this study which aims to establish its efficacy in five recalcitrant subset of chronic infected wounds over a three year period 2006-2009. A standardized ghee and honey dressing was used to treat: a) Eight cases of fungating malignant lesions. b) Thirteen chronic venous ulcers. c) Twenty nine diabetic foot ulcers. d) Eleven of infected ventral hernia mesh hernioplasty. e) Eleven patient with post-cesarean wound dehiscence. The dressing markedly reduced the foul odour and discharge, significantly improving the quality of life in malignant lesions. The results were equivocal in cases of venous ulcers. The results were uniformly good in the last three groups. In view of our results, as also result of innumerable Randomized Control Trials (RCTs) reported on honey dressing for infected wounds, there is substantial evidence that ghee and honey dressing has at least comparable results to other modes of treatment. The easy availability and low cost of this treatment makes it significant in developing countries. Further trials seem warranted. PMID:22851841

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

    ClinicalTrials.gov

    2015-04-20

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

  14. Combat-Related Invasive Fungal Wound Infections

    PubMed Central

    Rodriguez, Carlos J.

    2014-01-01

    Combat-related invasive fungal (mold) wound infections (IFIs) have emerged as an important and morbid complication following explosive blast injuries among military personnel. Similar to trauma-associated IFI cases among civilian populations, as in agricultural accidents and natural disasters, these infections occur in the setting of penetrating wounds contaminated by environmental debris. Specific risk factors for combat-related IFI include dismounted (patrolling on foot) blast injuries occurring mostly in southern Afghanistan, resulting in above knee amputations requiring resuscitation with large-volume blood transfusions. Diagnosis of IFI is based upon early identification of a recurrently necrotic wound following serial debridement and tissue-based histopathology examination with special stains to detect invasive disease. Fungal culture of affected tissue also provides supportive information. Aggressive surgical debridement of affected tissue is the primary therapy. Empiric antifungal therapy should be considered when there is a strong suspicion for IFI. Both liposomal amphotericin B and voriconazole should be considered initially for treatment since many of the cases involve not only Mucorales species but also Aspergillus or Fusarium spp., with narrowing of regimen based upon clinical mycology findings. PMID:25530825

  15. 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.

  16. A deep sternal wound infection caused by Ureaplasma urealyticum.

    PubMed

    Lucke, Katja; Kuster, Stefan P; Bertea, Mihai; Ruef, Christian; Bloemberg, Guido V

    2010-10-01

    Ureaplasma species are usually associated with infection of the urogenital tract. An unusual case of a sternal wound infection caused by Ureaplasma urealyticum in a 41-year-old male after aortic valve replacement is described. PMID:20616189

  17. UVC Light Prophylaxis for Cutaneous Wound Infections in Mice

    PubMed Central

    Dai, Tianhong; Garcia, Barbara; Murray, Clinton K.; Vrahas, Mark S.

    2012-01-01

    UVC light has long been known to be highly germicidal but has not been much developed as a therapy for infections. This study investigated the potential of UVC light for the prophylaxis of infections developing in highly contaminated superficial cutaneous wounds. In vitro studies demonstrated that the pathogenic bacteria Pseudomonas aeruginosa and Staphylococcus aureus were inactivated at UVC light exposures much lower than those needed for a similar effect on mammalian keratinocytes. Mouse models of partial-thickness skin abrasions infected with bioluminescent P. aeruginosa and S. aureus were developed. Approximately 107 bacterial cells were inoculated onto wounds measuring 1.2 by1.2 cm on the dorsal surfaces of mice. UVC light was delivered at 30 min after bacterial inoculation. It was found that for both bacterial infections, UVC light at a single radiant exposure of 2.59 J/cm2 reduced the bacterial burden in the infected mouse wounds by approximately 10-fold in comparison to those in untreated mouse wounds (P < 0.00001). Furthermore, UVC light increased the survival rate of mice infected with P. aeruginosa by 58.3% (P = 0.0023) and increased the wound healing rate in mice infected with S. aureus by 31.2% (P < 0.00001). DNA lesions were observed in the UVC light-treated mouse wounds; however, the lesions were extensively repaired by 48 h after UVC light exposure. These results suggested that UVC light may be used for the prophylaxis of cutaneous wound infections. PMID:22564833

  18. Wound infection: a knowledge deficit that needs addressing.

    PubMed

    Hughes, Maria A

    2016-03-01

    A survey was undertaken at a recent large wound-care exhibition, aimed at generalist nurses, podiatrists and other allied health professionals, to ascertain delegates' understanding of wound infection and its treatment options. The sample comprised 116 delegates, although not all of them answered every question. Results showed good knowledge in some areas, with most (90%) correctly identifying the symptoms of localised wound infection and the characteristics of an infected wound (97%). However, the results did reveal some alarming gaps in knowledge, with 64% unable to identify that it is the inability of the host to mount a robust immune response that can tip the balance between colonisation and infection. Similarly, over a third (38%) incorrectly considered that wounds should always be cleansed, regardless of the wound characteristics, while 5% stated that antimicrobial dressings should be used continuously until epithelialisation occurs. The results suggest that there is still a worrying trend for ritualistic wound care and that more ongoing education is needed on the core aspects of wound management. PMID:27019185

  19. Incidence of postoperative wound infections after open tendo Achilles repairs

    PubMed Central

    Marican, Mohd Mizan; Fook-Chong, Stephanie Man Chung; Rikhraj, Inderjeet Singh

    2015-01-01

    INTRODUCTION Tendo Achilles (TA), which is the confluence of the gastrocnemius and soleus muscles, is one of the most commonly injured tendons. The surgical repair of TA ruptures is associated with a significant risk of infection. This study examined several factors (i.e. gender, age, body mass index, history of diabetes mellitus, steroid use, acute or chronic TA injuries, type of surgical incision and type of sutures used) that may be associated with postoperative wound infection after open TA repair. METHODS This was a retrospective study involving 60 patients who underwent open TA repair over an 18-month period. Patients who had prior TA surgery or open TA injuries, or who needed soft tissues flaps were excluded. RESULTS Among the patients, 7 (11.7%) developed superficial wound infections that were successfully treated with oral antibiotics, while 3 (5.0%) developed deep wound infections that required at least one debridement procedure. No significant association was found between the risk of postoperative wound infection and gender, age, the presence of diabetes mellitus, acute or chronic ruptures, site of surgical incision and type of deep or superficial sutures used. CONCLUSION While diabetes mellitus and age did not appear to be associated with postoperative wound infections after open TA repair, obese patients were found to be two times more likely to develop a wound infection than normal-weight patients. The incidence of superficial wound infections in this study was similar to previously published results (11.7% vs. 8.2%–14.6%), but the incidence of deep infections was higher (5% vs. 1%–2%). PMID:26512146

  20. Development of biofilm-targeted antimicrobial wound dressing for the treatment of chronic wound infections.

    PubMed

    Ng, Shiow-Fern; Leow, Hon-Lunn

    2015-01-01

    It has been established that microbial biofilms are largely responsible for the recalcitrance of many wound infections to conventional antibiotics. It was proposed that the efficacy of antibiotics could be optimized via the inhibition of bacterial biofilm growth in wounds. The combination of antibiofilm agent and antibiotics into a wound dressing may be a plausible strategy in wound infection management. Xylitol is an antibiofilm agent that has been shown to inhibit the biofilm formation. The purpose of this study was to develop an alginate film containing xylitol and gentamicin for the treatment of wound infection. Three films, i.e. blank alginate film (SA), alginate film with xylitol (F5) and alginate film with xylitol and gentamicin (AG), were prepared. The films were studied for their physical properties, swelling ratio, moisture absorption, moisture vapor transmission rate (MVTR), mechanical and rheology properties, drug content uniformity as well as in vitro drug release properties. Antimicrobial and antibiofilm in vitro studies on Staphylococcus aureus and Pseudomonas aeruginosa were also performed. The results showed that AG demonstrates superior mechanical properties, rheological properties and a higher MVTR compared with SA and F5. The drug flux of AG was higher than that of commercial gentamicin cream. Furthermore, antimicrobial studies showed that AG is effective against both S. aureus and P. aeruginosa, and the antibiofilm assays demonstrated that the combination was effective against biofilm bacteria. In summary, alginate films containing xylitol and gentamicin may potentially be used as new dressings for the treatment of wound infection. PMID:25758412

  1. Ultraviolet C light for Acinetobacter baumannii wound infections in mice: Potential use for battlefield wound decontamination?

    PubMed Central

    Dai, Tianhong; Murray, Clinton K.; Vrahas, Mark S.; Baer, David G.; Tegos, George P.; Hamblin, Michael R.

    2012-01-01

    BACKGROUND Since the beginning of the conflicts in the Middle East, US Army physicians have noted a high rate of multidrug-resistant Acinetobacter baumannii infections among US soldiers wounded and initially treated in Iraq. In this study, we investigated the use of ultraviolet C (UVC) light for prevention of multidrug-resistant A. baumannii wound infections using mouse models. METHODS Partial-thickness skin abrasions and full-thickness burns in mice were infected with a multidrug-resistant A. baumannii isolate recovered from a wounded US soldier deployed to Iraq. The luxCDABE operon, which was contained in plasmid pMF 385, was cloned into the A. baumannii strain. This allowed real-time monitoring of the extent of infection in mice using bioluminescence imaging. UVC light was delivered to the mouse wounds at 30 minutes after the inoculation of A. baumannii. Groups of infected mouse wounds without being exposed to UVC served as the controls. RESULTS In vitro studies demonstrated that A. baumannii cells were inactivated at UVC exposures much lower than those needed for a similar effect on mammalian cells. It was observed in animal studies that UVC (3.24 J/cm2 for abrasions and 2.59 J/cm2 for burns) significantly reduced the bacterial burdens in UVC-treated wounds by approximately 10-fold compared with nontreated controls (p = 0.004 for abrasions, p = 0.019 for burns). DNA lesions were observed by immunofluorescence in mouse skin abrasions immediately after a UVC exposure of 3.24 J/cm2; however, the lesions were extensively repaired within 72 hours. CONCLUSION These results suggested that UVC may be useful in preventing combat-related wound infections. PMID:22929495

  2. 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

  3. Treatment of Sternal Wound Infection Using a Free Myocutaneous Flap.

    PubMed

    Chiang, I-han; Chen, Shyi-Gen; Wang, Chih-Hsin

    2015-11-01

    Deep sternal wound infections are potentially life-threatening complications after cardiac operations because they can spread into the mediastinum and cause postoperative morbidity and mortality. We present a 65-year-old man with a history of coronary artery bypass grafting. A large sternal defect was left after debridement. After brief vacuum-assisted closure (VAC), a free myocutaneous flap of the anterolateral thigh (ALT) was used to fill the dead space. At the 9-month follow-up, the wound had healed completely without tissue loss or complications, and the patient returned to normal life. This was a successful treatment of a deep sternal wound with free flap coverage. PMID:26522542

  4. Application of VitaVallis dressing for infected wounds

    NASA Astrophysics Data System (ADS)

    Kirilova, N. V.; Fomenko, A. N.; Korovin, M. S.

    2015-11-01

    Today there is a growing demand for safe and efficient antimicrobial dressings for infected wound treatment. The antimicrobial sorption material for VitaVallis dressings was produced by one-stage oxidation of aluminum nanopowder in water in the presence of fibrous acetylcellulose matrix. Scanning electron microscopy revealed that the material is made up of fibers of diameter 1.5-3.0 µm with adhered agglomerated alumina nanosheets. An antimicrobial study revealed a high inhibitory effect of VitaVallis against the growth of gram-negative (E.coli, P. aeruginosa) and gram-positive (S. aureus) strains. The antimicrobial activity of the dressing against microbial pathogens on the wound surface was demonstrated in in vivo experiments on male rats. The dressing was also tested on volunteer patients. The testing showed reduction of the wound healing period, accelerated cleaning of the infected wound and enhanced tissue regeneration in the wound. The results demonstrate that the VitaVallis dressing can be used for the treatment of deep infected wounds.

  5. Application of VitaVallis dressing for infected wounds

    SciTech Connect

    Kirilova, N. V. Fomenko, A. N. Korovin, M. S.

    2015-11-17

    Today there is a growing demand for safe and efficient antimicrobial dressings for infected wound treatment. The antimicrobial sorption material for VitaVallis dressings was produced by one-stage oxidation of aluminum nanopowder in water in the presence of fibrous acetylcellulose matrix. Scanning electron microscopy revealed that the material is made up of fibers of diameter 1.5–3.0 µm with adhered agglomerated alumina nanosheets. An antimicrobial study revealed a high inhibitory effect of VitaVallis against the growth of gram-negative (E.coli, P. aeruginosa) and gram-positive (S. aureus) strains. The antimicrobial activity of the dressing against microbial pathogens on the wound surface was demonstrated in in vivo experiments on male rats. The dressing was also tested on volunteer patients. The testing showed reduction of the wound healing period, accelerated cleaning of the infected wound and enhanced tissue regeneration in the wound. The results demonstrate that the VitaVallis dressing can be used for the treatment of deep infected wounds.

  6. Platelet-rich plasma inside the sternotomy wound reduces the incidence of sternal wound infections.

    PubMed

    Serraino, Giuseppe F; Dominijanni, Andrea; Jiritano, Federica; Rossi, Michele; Cuda, Aldo; Caroleo, Santo; Brescia, Adalgisa; Renzulli, Attilio

    2015-06-01

    Despite the large choice of wide-spectrum antibiotic therapy, deep sternal wound infection (DSWI) following cardiac surgery is a life-threatening complication worldwide. This study evaluated that the use of platelet-rich plasma (PRP) applied inside the sternotomy wound would reduce the effect of sternal wound infections, both superficial and deep. Between January 2007 and January 2012, 1093 consecutive patients underwent cardiac surgery through median sternotomy. Patients were divided into two groups. Group B, the study group, included those who received the PRP applied inside the sternotomy wound before closure. Group A, the control group, included patients who received a median sternotomy but without the application of PRP. Antibiotic prophylaxis remained unchanged across the study and between the two groups. Occurrence of DSWI was significantly higher in group A than in group B [10 of 671 (1·5%) versus 1 of 422 (0·20%), P = 0·043]. Also, superficial sternal wound infections (SSWIs) were significantly higher in group A than in group B [19 of 671 (2·8%) versus 2 of 422 (0·5%), P = 0·006]. The use of PRP can significantly reduce the occurrence of DSWI and SSWI in cardiac surgery. PMID:23692143

  7. Development of a diagnostic aid for bacterial infection in wounds

    NASA Astrophysics Data System (ADS)

    Pisanelli, A. M.; Persaud, K. C.; Bailey, A.; Stuczen, M.; Duncan, R.; Dunn, K.

    2009-05-01

    Infection of wounds during hospitalisation often induces morbidity and sometimes mortality. The delay in patient recovery and subsequent increased length of hospital stay also has economic consequences. Standard techniques for microbiological detection are surface swabbing and wound biopsy culture. Surface swabbing is the most commonly used technique mainly because is quite inexpensive and is not invasive but can give only a representation of surface infection and analysis is also time consuming. Infected wounds are often characterised by an offensive odour that can be used as a diagnostic parameter. We report the results obtained by examining swabs and dressings taken from patients using a gas sensor array instrument developed as part of an EU funded project WOUNDMONITOR.

  8. Photodynamic therapy for Staphylococcus aureus infected burn wounds in mice.

    PubMed

    Lambrechts, Saskia A G; Demidova, Tatiana N; Aalders, Maurice C G; Hasan, Tayyaba; Hamblin, Michael R

    2005-07-01

    The rise of multiply antibiotic resistant bacteria has led to searches for novel antimicrobial therapies to treat infections. Photodynamic therapy (PDT) is a potential candidate; it uses the combination of a photosensitizer with visible light to produce reactive oxygen species that lead to cell death. We used PDT mediated by meso-mono-phenyl-tri(N-methyl-4-pyridyl)-porphyrin (PTMPP) to treat burn wounds in mice with established Staphylococcus aureus infections The third degree burn wounds were infected with bioluminescent S. aureus. PDT was applied after one day of bacterial growth by adding a 25% DMSO/500 microM PTMPP solution to the wound followed by illumination with red light and periodic imaging of the mice using a sensitive camera to detect the bioluminescence. More than 98% of the bacteria were eradicated after a light dose of 210 J cm(-2) in the presence of PTMPP. However, bacterial re-growth was observed. Light alone or PDT both delayed the wound healing. These data suggest that PDT has the potential to rapidly reduce the bacterial load in infected burns. The treatment needs to be optimized to reduce wound damage and prevent recurrence. PMID:15986057

  9. Deep wound infection after proximal femoral fracture: consequences and costs.

    PubMed

    Pollard, T C B; Newman, J E; Barlow, N J; Price, J D; Willett, K M

    2006-06-01

    The purpose of this study was to assess the impact of deep wound infection after surgery for proximal femoral fracture (PFF) on the patient in terms of mortality and social consequences, and on the National Health Service in terms of financial burden. Sixty-one cases of PFF over a six-year period were complicated with deep surgical wound infection. These cases were compared with a matched control group of 122 patients without infection. Infected cases had greatly increased hospital stay (P<0.001), were 4.5 times less likely to survive to discharge (P=0.002), and if they survived, were three times less likely to return to their original residence (P=0.05). The total cost of treatment per infected case was 24,410 pound sterling compared with 7210 pound sterling for controls (P<0.001). Meticillin-resistant Staphylococcus aureus (MRSA) infection increased admission length and cost compared with non-MRSA infection (P=0.02). Deep wound infection after PFF is a devastating and costly complication for both the patient and the healthcare services. The cost consequences should be considered when allocating resources to trauma services to ensure adequate provision to minimize infection risks and to accommodate treatment costs in this vulnerable group. PMID:16621145

  10. Imaging modalities in wounds and superficial skin infections.

    PubMed

    Blankenship, Robert B; Baker, Todd

    2007-02-01

    Open wounds and lacerations are the most commonly encountered problems in emergency medicine. Detection and removal of a foreign body is essential to avoid the many complications of a retained foreign body, which may include infection, inflammation, allergic reaction, and disability. Currently, there are several imaging modalities that the emergency medicine provider may use to aid in foreign body detection and wound management. Techniques and appropriate use of these imaging modalities for foreign bodies and soft tissue infections are discussed in this article. PMID:17400083

  11. Wound infections on board ship--prevention, pathogens, and treatment.

    PubMed

    Dahl, Eilif

    2011-01-01

    Wounds are common in seafarers and they can easily become infected in the marine environment. Pre-sea tetanus immunization is essential. Without diagnostic facilities and only a limited range of antibiotics onboard, injury prevention and early treatment to reduce the likelihood of infection are important measures. Suturing clean cuts reduces healing time and risk of infection. Fresh, clean cuts, especially on the face or head, can be closed by adhesive tape or sutures, but if infection arises, then one or more sutures should be removed to enable drainage. Most wounds must be considered contaminated and should not be closed, just covered with sterile dressing after cleaning. Antibiotic treatment should be started immediately in seafarers with hand and puncture wounds. The primary treatment for a simple abscess is incision and drainage. Antibiotic treatment is recommended for abscesses if the infection spreads to the surrounding tissue (associated cellulitis), if there is lack of response to incision and drainage alone, or if the abscess is in an area difficult or dangerous to drain (e.g. face, palm, genitalia). Recommended therapy for cellulitis is 5-10 days of dicloxacillin, cephalexin, clindamycin, or erythromycin, but if there is no improvement after 2-3 days, methicillin-resistant Staphylococcus aureus (MRSA) should be suspected. Bites and burn wounds require special attention. Since wound infections can deteriorate rapidly, a telemedicine advice service (TMAS) should be consulted during the early stages, and serial digital photographs of the affected area, transmitted by e-mail to TMAS, are often useful during treatment at sea. PMID:22258845

  12. Case 7: highly infected post-surgical wound.

    PubMed

    von Hallern, Bernd

    2016-03-01

    Following treatment with antibiotics and surgical incision, which resulted in the release of putrid exudate, the wound was rinsed thoroughly with octenisept and covered with an antimicrobial dressing. This regimen successfully eradicated the infection, with full healing occurring in 6 weeks. PMID:26949851

  13. Negative-pressure wound therapy and laparoscopic omentoplasty for deep sternal wound infections after median sternotomy.

    PubMed

    De Brabandere, Kristof; Jacobs-Tulleneers-Thevissen, Daniel; Czapla, Jens; La Meir, Mark; Delvaux, Georges; Wellens, Francis

    2012-01-01

    Deep sternal wound infection remains one of the most serious complications in patients who undergo median sternotomy for coronary artery bypass surgery.We describe our experience in treating 6 consecutive patients with our treatment protocol that combines aggressive débridement, broad-spectrum antibiotics, negative-pressure wound therapy, omentoplasty with laparoscopically harvested omentum, and the use of bilateral pectoral muscle advancement flaps.The number of débridements needed in order to attain clinically clean wounds and negative cultures varied between 1 and 10, with a median of 5. The length of stay after omentoplasty and bilateral pectoral muscle advancement flap placement varied between 11 and 22 days. One of the 6 patients developed a small wound dehiscence that was treated conservatively. No bleeding related to vacuum-assisted closure therapy was identified. Three patients had pneumonia. Two of the 3 patients had an episode of acute renal failure. The 30-day mortality rate was zero, although 1 patient died in the hospital 43 days after the reconstructive surgery, of multiple-organ failure due to pneumonia that was induced by end-stage pulmonary fibrosis. No patient died between hospital discharge and the most recent follow-up date (4-12 mo). Late local follow-up results, both functional and aesthetic, were good.We conclude that negative-pressure wound therapy-in combination with omentoplasty using laparoscopically harvested omentum and with the use of bilateral pectoral advancement flaps-is a valuable technique in the treatment of deep sternal wound infection because it produces good functional and aesthetic results. PMID:22719146

  14. Negative-Pressure Wound Therapy and Laparoscopic Omentoplasty for Deep Sternal Wound Infections after Median Sternotomy

    PubMed Central

    De Brabandere, Kristof; Jacobs-Tulleneers-Thevissen, Daniel; Czapla, Jens; La Meir, Mark; Delvaux, Georges; Wellens, Francis

    2012-01-01

    Deep sternal wound infection remains one of the most serious complications in patients who undergo median sternotomy for coronary artery bypass surgery. We describe our experience in treating 6 consecutive patients with our treatment protocol that combines aggressive débridement, broad-spectrum antibiotics, negative-pressure wound therapy, omentoplasty with laparoscopically harvested omentum, and the use of bilateral pectoral muscle advancement flaps. The number of débridements needed in order to attain clinically clean wounds and negative cultures varied between 1 and 10, with a median of 5. The length of stay after omentoplasty and bilateral pectoral muscle advancement flap placement varied between 11 and 22 days. One of the 6 patients developed a small wound dehiscence that was treated conservatively. No bleeding related to vacuum-assisted closure therapy was identified. Three patients had pneumonia. Two of the 3 patients had an episode of acute renal failure. The 30-day mortality rate was zero, although 1 patient died in the hospital 43 days after the reconstructive surgery, of multiple-organ failure due to pneumonia that was induced by end-stage pulmonary fibrosis. No patient died between hospital discharge and the most recent follow-up date (4–12 mo). Late local follow-up results, both functional and aesthetic, were good. We conclude that negative-pressure wound therapy—in combination with omentoplasty using laparoscopically harvested omentum and with the use of bilateral pectoral advancement flaps—is a valuable technique in the treatment of deep sternal wound infection because it produces good functional and aesthetic results. PMID:22719146

  15. Prevention of orthopaedic wound infections: a quality improvement project.

    PubMed

    Douglas, P; Asimus, M; Swan, J; Spigelman, A

    2001-12-01

    Using clinical practice improvement methodology, a project was undertaken to reduce the incidence of surgical wound infections following elective hip and knee replacement surgery. A team was established, key measures for improvement were identified, strategies for change were developed and an action plan was implemented. Outcomes for this project included a reduction in the rate of clean surgical wound infection for joint replacement surgery from 28% to zero. Average length of stay for total hip replacement surgery was reduced from 13.9 to 9.3 days and from 14.6 to 10.4 days for total knee replacement surgery. Guidelines for patient selection were developed along with a protocol for the management of preparation to prevent urinary tract infections. Post-discharge surveillance and a preoperative rehabilitation and exercise programme have been implemented. There is potential for wider uptake and implementation of the quality principles described herein. PMID:11856413

  16. Topical antimicrobials for burn wound infections.

    PubMed

    Dai, T; Huang, Y Y; Sharma, S K; Hashmi, J T; Kurup, D B; Hamblin, M R

    2010-06-01

    Throughout most of history, serious burns occupying a large percentage of body surface area were an almost certain death sentence because of subsequent infection. A number of factors such as disruption of the skin barrier, ready availability of bacterial nutrients in the burn milieu, destruction of the vascular supply to the burned skin, and systemic disturbances lead to immunosuppression combined together to make burns particularly susceptible to infection. In the 20th century the introduction of antibiotic and antifungal drugs, the use of topical antimicrobials that could be applied to burns, and widespread adoption of early excision and grafting all helped to dramatically increase survival. However the relentless increase in microbial resistance to antibiotics and other antimicrobials has led to a renewed search for alternative approaches to prevent and combat burn infections. This review will cover patented strategies that have been issued or filed with regard to new topical agents, preparations, and methods of combating burn infections. Animal models that are used in preclinical studies are discussed. Various silver preparations (nanocrystalline and slow release) are the mainstay of many approaches but antimicrobial peptides, topical photodynamic therapy, chitosan preparations, new iodine delivery formulations, phage therapy and natural products such as honey and essential oils have all been tested. This active area of research will continue to provide new topical antimicrobials for burns that will battle against growing multidrug resistance. PMID:20429870

  17. Topical Antimicrobials for Burn Wound Infections

    PubMed Central

    Dai, Tianhong; Huang, Ying-Ying; Sharma, Sulbha K.; Hashmi, Javad T.; Kurup, Divya B.; Hamblin, Michael R.

    2010-01-01

    Throughout most of history, serious burns occupying a large percentage of body surface area were an almost certain death sentence because of subsequent infection. A number of factors such as disruption of the skin barrier, ready availability of bacterial nutrients in the burn milieu, destruction of the vascular supply to the burned skin, and systemic disturbances lead to immunosuppression combined together to make burns particularly susceptible to infection. In the 20th century the introduction of antibiotic and antifungal drugs, the use of topical antimicrobials that could be applied to burns, and widespread adoption of early excision and grafting all helped to dramatically increase survival. However the relentless increase in microbial resistance to antibiotics and other antimicrobials has led to a renewed search for alternative approaches to prevent and combat burn infections. This review will cover patented strategies that have been issued or filed with regard to new topical agents, preparations, and methods of combating burn infections. Animal models that are used in preclinical studies are discussed. Various silver preparations (nanocrystalline and slow release) are the mainstay of many approaches but antimicrobial peptides, topical photodynamic therapy, chitosan preparations, new iodine delivery formulations, phage therapy and natural products such as honey and essential oils have all been tested. This active area of research will continue to provide new topical antimicrobials for burns that will battle against growing multi-drug resistance. PMID:20429870

  18. Impact of Mucorales and Other Invasive Molds on Clinical Outcomes of Polymicrobial Traumatic Wound Infections.

    PubMed

    Warkentien, Tyler E; Shaikh, Faraz; Weintrob, Amy C; Rodriguez, Carlos J; Murray, Clinton K; Lloyd, Bradley A; Ganesan, Anuradha; Aggarwal, Deepak; Carson, M Leigh; Tribble, David R

    2015-07-01

    Combat trauma wounds with invasive fungal infections (IFIs) are often polymicrobial with fungal and bacterial growth, but the impact of the wound microbiology on clinical outcomes is uncertain. Our objectives were to compare the microbiological features between IFI and non-IFI wounds and evaluate whether clinical outcomes differed among IFI wounds based upon mold type. Data from U.S. military personnel injured in Afghanistan with IFI wounds were examined. Controls were matched by the pattern/severity of injury, including blood transfusion requirements. Wound closure timing was compared between IFI and non-IFI control wounds (with/without bacterial infections). IFI wound closure was also assessed according to mold species isolation. Eighty-two IFI wounds and 136 non-IFI wounds (63 with skin and soft tissue infections [SSTIs] and 73 without) were examined. The time to wound closure was longer for the IFI wounds (median, 16 days) than for the non-IFI controls with/without SSTIs (medians, 12 and 9 days, respectively; P < 0.001). The growth of multidrug-resistant Gram-negative rods was reported among 35% and 41% of the IFI and non-IFI wounds with SSTIs, respectively. Among the IFI wounds, times to wound closure were significantly longer for wounds with Mucorales growth than for wounds with non-Mucorales growth (median, 17 days versus 13 days; P < 0.01). When wounds with Mucorales and Aspergillus spp. growth were compared, there was no significant difference in wound closure timing. Trauma wounds with SSTIs were often polymicrobial, yet the presence of invasive molds (predominant types: order Mucorales, Aspergillus spp., and Fusarium spp.) significantly prolonged the time to wound closure. Overall, the times to wound closure were longest for the IFI wounds with Mucorales growth. PMID:25972413

  19. Postoperative wound infections after a proctectomy—Patient experiences

    PubMed Central

    Andersson, Kristin; Koinberg, Inga-Lill; Wennström, Berith

    2016-01-01

    Poor perineal wound healing and infections after proctectomy surgery cause a significant proportion of physical and psychological morbidities, such as pain, leakage, and abscesses. In the long run, some of these symptoms will lead to extended periods of hospitalization. These kinds of postoperative complications are also associated with delays in possible chemotherapy treatment. The aim of this study was to describe patient experiences of perineal wound infections following proctectomy due to rectal cancer, and the importance of the communication with and the self-care support from the nurse for these patients. Five women and five men (61–87 years, median age 71 years) were included and interviewed. A qualitative content analysis of the interviews was carried out and the following main categories emerged: “Managing postoperative complications,” “Being independent,” “Feeling safe,” and “Accepting the situation.” A perineal wound infection after a proctectomy is devastating for the individual patient. The limitations and changes to the patients’ lives turn into new daily routines, which force them to find new ways to live and to accept the situation. For many of them, the infections remained for several months and, sometimes, for years. The ability to lead an independent life is drastically reduced, but through continuity in care it is possible to create a feeling of safety. Information, communication, and self-care support are all important and valuable factors for recovery. Specialized care containing an action plan is therefore needed in clinical practice to reduce the number of perineal wound infections postoperatively and should be initiated when the patient is discharged from the ward and continue until recovery. PMID:26900139

  20. Postoperative wound infections after a proctectomy--Patient experiences.

    PubMed

    Hassel, Karin; Andersson, Kristin; Koinberg, Inga-Lill; Wennström, Berith

    2016-01-01

    Poor perineal wound healing and infections after proctectomy surgery cause a significant proportion of physical and psychological morbidities, such as pain, leakage, and abscesses. In the long run, some of these symptoms will lead to extended periods of hospitalization. These kinds of postoperative complications are also associated with delays in possible chemotherapy treatment. The aim of this study was to describe patient experiences of perineal wound infections following proctectomy due to rectal cancer, and the importance of the communication with and the self-care support from the nurse for these patients. Five women and five men (61-87 years, median age 71 years) were included and interviewed. A qualitative content analysis of the interviews was carried out and the following main categories emerged: "Managing postoperative complications," "Being independent," "Feeling safe," and "Accepting the situation." A perineal wound infection after a proctectomy is devastating for the individual patient. The limitations and changes to the patients' lives turn into new daily routines, which force them to find new ways to live and to accept the situation. For many of them, the infections remained for several months and, sometimes, for years. The ability to lead an independent life is drastically reduced, but through continuity in care it is possible to create a feeling of safety. Information, communication, and self-care support are all important and valuable factors for recovery. Specialized care containing an action plan is therefore needed in clinical practice to reduce the number of perineal wound infections postoperatively and should be initiated when the patient is discharged from the ward and continue until recovery. PMID:26900139

  1. Delayed aortic rupture resulting from postoperative superficial sternal wound infection

    PubMed Central

    Kim, Su Wan; Chang, Jee Won

    2016-01-01

    While deep sternal wound infection (DSWI) after cardiac surgery is a significant contributor to patient morbidity and mortality, superficial sternal wound infection (SSWI) mostly has a benign course. We report a mortality case of aortic rupture resulting from SSWI after cardiac surgery. A 50-year-old male underwent an aortic valve replacement (AVR). Three months after the valve operation, he presented with severe dyspnea, which had never before been observed, and chest computed tomography revealed an ascending aortic rupture with large hematoma compressing the main pulmonary artery. We performed an emergent operation for aortic rupture that possibly originated from the SSWI. Postoperatively, the patient died of hypovolemic shock due to recurrent aortic rupture despite efforts to resuscitate him. PMID:27499988

  2. G-CSF enhances resolution of Staphylococcus aureus wound infection in an age-dependent manner.

    PubMed

    Brubaker, Aleah L; Kovacs, Elizabeth J

    2013-10-01

    This study tested the hypothesis that heightened bacterial colonization and delayed wound closure in aged mice could be attenuated by granulocyte colony-stimulating factor (G-CSF) treatment. Previously, we reported that aged mice had elevated bacterial levels, protracted wound closure, and reduced wound neutrophil accumulation after Staphylococcus aureus wound infection relative to young mice. In aseptic wound models, G-CSF treatment improved wound closure in aged mice to rates observed in young mice. Given these data, our objective was to determine if G-CSF could restore age-associated differences in wound bacterial burden and closure by increasing wound neutrophil recruitment. Young (3- to 4-month) and aged (18- to 20-month) BALB/c mice received three dorsal subcutaneous injections of G-CSF (250 ng/50 μL per injection) or saline control (50 μL per injection) 30 min after wound infection. Mice were killed at days 3 and 7 after wound infection, and bacterial colonization, wound size, wound leukocyte accumulation, and peripheral blood were evaluated. At days 3 and 7 after wound infection, bacterial colonization was significantly reduced in G-CSF-treated aged mice to levels observed in saline-treated young animals. Wound size was reduced in G-CSF-treated aged animals, with no effect on wound size in G-CSF-treated young mice. Local G-CSF treatment significantly enhanced neutrophil wound accumulation in aged mice, whereas there was no G-CSF-induced change in young mice. These data demonstrate that G-CSF enhances bacterial clearance and wound closure in an age-dependent manner. Moreover, G-CSF may be of therapeutic potential in the setting of postoperative wound infection or chronic nonhealing wounds in elderly patients. PMID:23856924

  3. 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

  4. Staphylococcal scalded skin syndrome due to burn wound infection

    PubMed Central

    Farroha, A.; Frew, Q.; Jabir, S.; Dziewulski, P.

    2012-01-01

    Summary Introduction. The staphylococcal scalded skin syndrome is an acute exfoliation of the skin caused by exfoliative toxins A and B. Although Staphylococcus aureus is a common cause of burn wound infection, SSSS following burn wound infection is rare. Method. A retrospective review of all SSSS cases admitted to a regional burns service between January 2008 and January 2012 was undertaken. Results. Two cases of SSSS were reported during this time period as occurring following burns injury. The first case was a 17-month-old boy who had been hospitalized for a conservative treatment of 6% total body surface area (TBSA) mixed depth scald burns. On day four he developed exfoliation of 85% TBSA. The second case was a ten-month-old boy who sustained a 1% TBSA scald burn and was managed conservatively in the community by his general practitioner. On day five, he developed exfoliation of 80% TBSA. Staphylococcus aureus was isolated from the burn wounds in both cases. Conclusion: These two cases show that it is vital for burns surgeons and intensive care specialists to be aware of the possibility of SSSS occurring in patients with burn injuries with its potential devastating effects. PMID:23467312

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

    PubMed

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

    1988-09-01

    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

  6. Antiseptics for treating infected wounds: Efficacy on biofilms and effect of pH.

    PubMed

    Percival, Steven L; Finnegan, Simon; Donelli, Gianfranco; Vuotto, Claudia; Rimmer, Steve; Lipsky, Benjamin A

    2016-01-01

    Biofilm recalcitrance is a persistent problem when managing difficult to heal and infected chronic wounds. The wound biofilm is a fundamental factor in the re-occurrence and delayed healing commonly observed in non-healing and infected chronic wounds. However, there is presently no single antimicrobial agent that is completely efficacious against both the planktonic and sessile polymicrobial communities evident in at risk or infected wounds. We will review currently available antimicrobials, with particular emphasis on silver and iodine, employed to help suppress biofilms in wounds. In addition, we will also review the effect of pH on antimicrobial efficacy. Available evidence suggests that it is best to take a multifactorial approach towards controlling biofilm in chronic, "at risk" and infected wounds. This highlights the growing importance of avoiding indiscriminate or inappropriate use of antimicrobials in the treatment of chronic wounds. PMID:25159044

  7. Staphylococcus albus in Wound Infection and in Septicemia

    PubMed Central

    Wilson, T. S.; Stuart, R. D.

    1965-01-01

    Coagulase-negative Staphylococcus albus was considered to be the causal agent in 53 (4.4%) of 1200 wound infections investigated in a large general hospital over the eight-year period 1957-1964. There was clinical evidence of morbidity in these patients, with fever, but the infection cleared spontaneously, usually in a week or two, and antibiotics were unnecessary. Of much greater importance was the finding of this organism in blood cultures on repeated occasions, with associated clinical septicemia. Twelve patients were so affected, of whom six died, a mortality rate of 50%. Such data emphasize the tragic mistake of dismissing the report of Staph. albus in a blood culture as “only a contaminant”, and of failure to recognize that the organism can cause serious disease. This is particularly true in poor-risk patients, and in those who have undergone cardiac surgery. PMID:14308909

  8. Deep sternal wound infection after cardiac surgery: Evidences and controversies

    PubMed Central

    Cotogni, Paolo; Barbero, Cristina; Rinaldi, Mauro

    2015-01-01

    Despite many advances in prevention and perioperative care, deep sternal wound infection (DSWI) remains a pressing concern in cardiac surgery, with a still relevant incidence and with a considerable impact on in-hospital mortality and also on mid- and long-term survival. The permanent high impact of this complication is partially related to the increasing proportion of patients at high-risk for infection, as well as to the many patient and surgical risk factors involved in the pathogenesis of DSWI. The prophylactic antibiotic therapy is one of the most important tools in the prevention of DSWI. However, the choice of antibiotic, the dose, the duration, the adequate levels in serum and tissue, and the timing of antimicrobial prophylaxis are still controversial. The treatment of DSWI ranges from surgical revision with primary closure to surgical revision with open dressings or closed irrigation, from reconstruction with soft tissue flaps to negative pressure wound therapy (NPWT). However, to date, there have been no accepted recommendations regarding the best management of DSWI. Emerging evidence in the literature has validated the efficacy and safety of NPWT either as a single-line therapy, or as a “bridge” prior to final surgical closure. In conclusion, the careful control of patient and surgical risk factors - when possible, the proper antimicrobial prophylaxis, and the choice of validated techniques of treatment could contribute to keep DSWIs at a minimal rate. PMID:26557476

  9. Deep sternal wound infection after cardiac surgery: Evidences and controversies.

    PubMed

    Cotogni, Paolo; Barbero, Cristina; Rinaldi, Mauro

    2015-11-01

    Despite many advances in prevention and perioperative care, deep sternal wound infection (DSWI) remains a pressing concern in cardiac surgery, with a still relevant incidence and with a considerable impact on in-hospital mortality and also on mid- and long-term survival. The permanent high impact of this complication is partially related to the increasing proportion of patients at high-risk for infection, as well as to the many patient and surgical risk factors involved in the pathogenesis of DSWI. The prophylactic antibiotic therapy is one of the most important tools in the prevention of DSWI. However, the choice of antibiotic, the dose, the duration, the adequate levels in serum and tissue, and the timing of antimicrobial prophylaxis are still controversial. The treatment of DSWI ranges from surgical revision with primary closure to surgical revision with open dressings or closed irrigation, from reconstruction with soft tissue flaps to negative pressure wound therapy (NPWT). However, to date, there have been no accepted recommendations regarding the best management of DSWI. Emerging evidence in the literature has validated the efficacy and safety of NPWT either as a single-line therapy, or as a "bridge" prior to final surgical closure. In conclusion, the careful control of patient and surgical risk factors - when possible, the proper antimicrobial prophylaxis, and the choice of validated techniques of treatment could contribute to keep DSWIs at a minimal rate. PMID:26557476

  10. Diagnosis and rehabilitation of deep wound infection and internal fixation rejection in elbow: A case report.

    PubMed

    Lu, Huiping; Song, Lin; Lin, Ying

    2016-06-01

    This study aims at diagnosis and rehabilitation of a rare case of deep wound infection and internal fixation rejection in elbow. The patient sustained a distal fracture in the humerus 1 year ago, which was internal fixed. The wound always effused and the elbow had pain and swelling; joint motion was limited. Blood sedimentation rate and C reactive protein level increased, bacterial culture suggested deep wound infection, and ultrasound indicated inflammation. The main diagnoses were deep wound infection and internal fixation rejection. Therapeutics interventions were antibiotic agents, physical therapy, operative debridement, incision, drainage, and exercise and physical therapy. One year later, the internal fixation was taken out. His elbow was fully mobilized and the fracture healed. He got back to his former job. When encountered deep wound infection again and again after internal fixation, rejection should be considered. Except for anti-infection treatment, rehabilitation cannot be neglected, or the healing process may be delayed. PMID:27281079

  11. Diagnosis and rehabilitation of deep wound infection and internal fixation rejection in elbow

    PubMed Central

    Lu, Huiping; Song, Lin; Lin, Ying

    2016-01-01

    Abstract This study aims at diagnosis and rehabilitation of a rare case of deep wound infection and internal fixation rejection in elbow. The patient sustained a distal fracture in the humerus 1 year ago, which was internal fixed. The wound always effused and the elbow had pain and swelling; joint motion was limited. Blood sedimentation rate and C reactive protein level increased, bacterial culture suggested deep wound infection, and ultrasound indicated inflammation. The main diagnoses were deep wound infection and internal fixation rejection. Therapeutics interventions were antibiotic agents, physical therapy, operative debridement, incision, drainage, and exercise and physical therapy. One year later, the internal fixation was taken out. His elbow was fully mobilized and the fracture healed. He got back to his former job. When encountered deep wound infection again and again after internal fixation, rejection should be considered. Except for anti-infection treatment, rehabilitation cannot be neglected, or the healing process may be delayed. PMID:27281079

  12. Long-term prognosis of patients with surgical wound infections.

    PubMed

    Poulsen, K B; Gottschau, A

    1997-10-01

    This study examined if surgical wound infections (SWI) result in a severe prognosis regarding general health and increase the consumption of social resources. A group of 1301 patients were interviewed by self-administered questionnaires during 1993-1994, while operated during hospitalization in seven Danish hospitals. These patients were followed up at least once by similar questionnaires at a median time of 5.5 and 10.0 months postoperatively. The consequences of surgically diagnosed SWI were analyzed in a hospital cohort of 58 infected patients and 648 controls. Postdischarge infections were analyzed in a patient cohort of 263 cases and 767 controls. Changes in health was measured by the General Health Questionnaire, Activities of Daily Living index, and self-assessed health. Consumption of resources were estimated by reliance on assistance from family and friends, use of home services, and contacts to doctors. It was found that the long-term prognosis of general health was unaffected by SWIs. However significantly increased social dependence was found for patients with SWIs compared to uninfected patients. Almost one-fourth of the operations were complicated by an SWI. Most of the infections were recognized only after discharge and were thought to be of minor importance, which may explain why no chronic impairment of the health was found for patients with an SWI. A bias toward no-effect may have been introduced if patients with severe SWIs abstained from participation. The societal cost of care for patients with minor infections seems to be large. The causal relation between outcome and SWI needs to be further investigated. PMID:9327669

  13. Tilapia Piscidin 4 (TP4) Stimulates Cell Proliferation and Wound Closure in MRSA-Infected Wounds in Mice.

    PubMed

    Huang, Hang-Ning; Chan, Yi-Lin; Wu, Chang-Jer; Chen, Jyh-Yih

    2015-05-01

    Antimicrobial peptides (AMPs) are endogenous antibiotics that directly affect microorganisms, and also have a variety of receptor-mediated functions. One such AMP, Tilapia piscidin 4 (TP4), was isolated from Nile tilapia (Oreochromis niloticus); TP4 has antibacterial effects and regulates the innate immune system. The aim of the present study was to characterize the role of TP4 in the regulation of wound closure in mice and proliferation of a keratinocyte cell line (HaCaT) and fibroblast cell line (Hs-68). In vitro, TP4 stimulated cell proliferation and activated collagen I, collagen III, and keratinocyte growth factor (KGF) gene expression in Hs-68 cells, which induces keratin production by HaCaT cells. This effect was detectable at TP4 concentrations of 6.25 µg/mL in both cell lines. In vivo, TP4 was found to be highly effective at combating peritonitis and wound infection caused by MRSA in mouse models, without inducing adverse behavioral effects or liver or kidney toxicity. Taken together, our results indicate that TP4 enhances the survival rate of mice infected with the bacterial pathogen MRSA through both antimicrobial and wound closure activities mediated by epidermal growth factor (EGF), transforming growth factor (TGF), and vascular endothelial growth factor (VEGF). The peptide is likely involved in antibacterial processes and regulation of tissue homeostasis in infected wounds in mice. Overall, these results suggest that TP4 may be suitable for development as a novel topical agent for wound dressing. PMID:25955756

  14. Tilapia Piscidin 4 (TP4) Stimulates Cell Proliferation and Wound Closure in MRSA-Infected Wounds in Mice

    PubMed Central

    Huang, Hang-Ning; Chan, Yi-Lin; Wu, Chang-Jer; Chen, Jyh-Yih

    2015-01-01

    Antimicrobial peptides (AMPs) are endogenous antibiotics that directly affect microorganisms, and also have a variety of receptor-mediated functions. One such AMP, Tilapia piscidin 4 (TP4), was isolated from Nile tilapia (Oreochromis niloticus); TP4 has antibacterial effects and regulates the innate immune system. The aim of the present study was to characterize the role of TP4 in the regulation of wound closure in mice and proliferation of a keratinocyte cell line (HaCaT) and fibroblast cell line (Hs-68). In vitro, TP4 stimulated cell proliferation and activated collagen I, collagen III, and keratinocyte growth factor (KGF) gene expression in Hs-68 cells, which induces keratin production by HaCaT cells. This effect was detectable at TP4 concentrations of 6.25 µg/mL in both cell lines. In vivo, TP4 was found to be highly effective at combating peritonitis and wound infection caused by MRSA in mouse models, without inducing adverse behavioral effects or liver or kidney toxicity. Taken together, our results indicate that TP4 enhances the survival rate of mice infected with the bacterial pathogen MRSA through both antimicrobial and wound closure activities mediated by epidermal growth factor (EGF), transforming growth factor (TGF), and vascular endothelial growth factor (VEGF). The peptide is likely involved in antibacterial processes and regulation of tissue homeostasis in infected wounds in mice. Overall, these results suggest that TP4 may be suitable for development as a novel topical agent for wound dressing. PMID:25955756

  15. Gram Negative Wound Infection in Hospitalised Adult Burn Patients-Systematic Review and Metanalysis-

    PubMed Central

    Azzopardi, Ernest A.; Azzopardi, Elayne; Camilleri, Liberato; Villapalos, Jorge; Boyce, Dean E.; Dziewulski, Peter; Dickson, William A.; Whitaker, Iain S.

    2014-01-01

    Background Gram negative infection is a major determinant of morbidity and survival. Traditional teaching suggests that burn wound infections in different centres are caused by differing sets of causative organisms. This study established whether Gram-negative burn wound isolates associated to clinical wound infection differ between burn centres. Methods Studies investigating adult hospitalised patients (2000–2010) were critically appraised and qualified to a levels of evidence hierarchy. The contribution of bacterial pathogen type, and burn centre to the variance in standardised incidence of Gram-negative burn wound infection was analysed using two-way analysis of variance. Primary Findings Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumanni, Enterobacter spp., Proteus spp. and Escherichia coli emerged as the commonest Gram-negative burn wound pathogens. Individual pathogens’ incidence did not differ significantly between burn centres (F (4, 20) = 1.1, p = 0.3797; r2 = 9.84). Interpretation Gram-negative infections predominate in burn surgery. This study is the first to establish that burn wound infections do not differ significantly between burn centres. It is the first study to report the pathogens responsible for the majority of Gram-negative infections in these patients. Whilst burn wound infection is not exclusive to these bacteria, it is hoped that reporting the presence of this group of common Gram-negative “target organisms” facilitate clinical practice and target research towards a defined clinical demand. PMID:24751699

  16. Wound infection rate and irrigation pressure of two potential new wound irrigation devices: the port and the cap.

    PubMed

    Morse, J W; Babson, T; Camasso, C; Bush, A C; Blythe, P A

    1998-01-01

    The objectives of this study were to determine the speed of irrigation and the infection rate of two new irrigation devices. In the clinical portion of this two-part study, 208 patients with traumatic wounds were randomized to one of two new irrigation device groups, the cap/bottle or the port/bag, to determine irrigation times and infection/complication rates. Wounds were irrigated in less than 4 minutes in 97% of patients using a mean of 786 mL. The combined infection/complication rates were: port group, 1 of 99 (1%); cap group, 4 of 108 (4%), P = .356. In part II, 9 male and 8 female medical volunteers were timed in the delivery of 250 mL of saline into a graduated cylinder, using four different irrigation set-ups. Mean time for 250 mL and calculated stream pressures (psi) were: (1) cap/bottle, 12.9 seconds, 1.5 psi; (2) port/bag, 11.2 seconds, 2.0 psi; (3) syringe/catheter, 113.2 seconds, 8.2 psi; and (4) syringe/needle, 175.4 seconds, 7.3 psi (time and psi: P < .05 for all pairwise comparisons except cap versus port). Rapid irrigation and infection rates comparable with standard devices used in wound irrigation suggest that the new devices may prove to be valuable tools in emergent wound care. PMID:9451311

  17. Delayed primary closure of deep sternal wound infections.

    PubMed Central

    Zacharias, A; Habib, R H

    1996-01-01

    Deep infections of the sternum and mediastinum, with prevalence of osteomyelitis and tissue necrosis, were documented in 38 of 8,056 patients (0.47%) who underwent open-heart surgery (1975 through 1994) in our service. The incidences of insulin-dependent diabetes, obesity, and emergency surgery in these patients were relatively high at 39%, 47%, and 18%, respectively. Treatment with antibiotics, débridement, open packing, and delayed closure was administered to 33 patients (87%), with 100% healing. There were no deaths in this group. Flap reconstruction was indicated in 5 gravely ill patients (13%) in whom excessively large wound defects did not allow reapproximation. There were 2 deaths in this group, and 4 reoperations were necessary in the surviving patients because of sequelae arising from flap reconstruction. The overall mortality was 5.3% and the median period of hospitalization was 29 days. The length of stay decreased substantially over the period of this study (median = 21 days, year > or = 1987). Accordingly, we believe that treatment of deep sternal infections with delayed primary closure is safe and effective. Also, given the increased potential for complications and long-term sequelae, we believe that flap reconstruction should be used selectively and should be limited to patients with large defects, uncontrolled mediastinal bleeding, or both. PMID:8885104

  18. Polymeric Membrane Dressings for Topical Wound Management of Patients With Infected Wounds in a Challenging Environment: A Protocol With 3 Case Examples.

    PubMed

    Benskin, Linda L

    2016-06-01

    Patients with acute wounds often delay seeking medical assistance until an incapacitating infection has developed. When such patients come for help at a remote Christian clinic in northern Ghana, West Africa, the goals of care are to resolve and prevent a return of infection, decrease pain, enable an immediate return to normal activities, and facilitate healing. Because the local protocol of care, Edinburgh University Solution of Lime (EUSOL)-soaked gauze, did not meet these goals, the author tried using a variety of donated wound dressing regimens. Ultimately, polymeric membrane dressings (PMDs) were observed to meet patient care needs while also reducing clinic staff time and resources, and a PMD protocol of care was developed. Three (3) representative patients who presented with acute wounds and infection are described: a 20-year-old man with a hand abscess, a 16-year-old boy with a malleolus wound, and an approximately 20-year-old woman with an injection abscess, all otherwise relatively healthy, albeit undernourished. All 3 patients re- ceived oral antibiotics, their wounds were initially cleansed and debrided, and an appropriate configuration of either regular or silver-containing PMDs was applied to all exposed wound surfaces. Dressing changes were scheduled based upon the personalized plan of care. In all 3 patients, the pain-relieving properties of PMDs allowed resumption of activi- ties within 1 day of initiating treatment, the dressings' continuous wound cleansing system kept the wounds clean and free of infection despite the challenging environment, and the wounds healed steadily. Managing infected acute wounds with PMDs through complete wound closure was time efficient for clinic staff and met all 4 major patient goals of care. Randomized, controlled studies to compare wound and quality of life outcomes in patients whose infected wounds are managed with PMDs compared with those whose wounds are managed with other advanced dressings are warranted. PMID

  19. Gentamicin-impregnated collagen sponge for preventing sternal wound infection after cardiac surgery

    PubMed Central

    Targońska, Sylwia; Stążka, Janusz; Kozioł-Montewka, Maria

    2014-01-01

    The frequency of sternal wound infection (SWI) after cardiac surgery ranges from 0.5% to 8% and is associated with significant morbidity, mortality, and treatment cost. Perioperative antibiotic prophylaxis is not sufficient to fully prevent the contamination of the surgical access site. One of the most effective methods for the prevention of wound infection seems to be the use of gentamicin-impregnated collagen sponge, which is successfully used in abdominal and orthopedic surgery. Surgically implantable topical antibiotics can reduce wound infection in cardiac patients as well, but the efficacy of SWI prevention in cardiac surgery still raises many questions. PMID:26336388

  20. Management of Large Sternal Wound Infections With the Superior Epigastric Artery Perforator Flap.

    PubMed

    Eburdery, H; Grolleau, J L; Berthier, C; Bertheuil, N; Chaput, B

    2016-01-01

    The management of sternal wound infections often requires pedicled flaps. In recent years, the emergence of perforator flaps has changed our management of wounds involving tissue loss. For sternal wounds, the superior epigastric artery perforator (SEAP) flap can be used with the propeller procedure with minimal donor site morbidity. In our practice, this flap has replaced the traditional latissimus dorsi and pectoralis major flaps in the treatment of many sternal wounds. We report our experience with 4 patients with large sternal wound infection after cardiothoracic operations. The SEAP flap appears a safe alternative for low-morbidity coverage of sternal infections. Moreover, muscle flaps remain available in case the SEAP flap fails. PMID:26694288

  1. Prevention of post-operative infections after surgical treatment of bite wounds

    PubMed Central

    Kramer, Axel; Assadian, Ojan; Frank, Matthias; Bender, Claudia; Hinz, Peter

    2010-01-01

    After reviewing the literature about the microbial spectrum, the risk factors of post-operative infections, and the results of surgical interventions, the following recommendation can be made for the management of bite wounds: fresh, open wounds: surgical debridement, if appropriate, then an antiseptic lavage with a fluid consisting of povidone iodine and ethanol (e.g., Betaseptic®), no antibiotics, primary wound closure nearly closed fresh wounds (e.g., cat bites): surgical debridement, if appropriate, dressing with an antiseptic-soaked compress for ~60 minutes with repeated soaking (e.g., Betaseptic®), no antibiotics older wounds after ~4 hours: surgical debridement, if appropriate, dressing with an antiseptic-soaked compress or bandage for ~60 minutes with repeated soaking (e.g., Betaseptic®), at the same time intravenous or dose-adapted oral antibiotics (Amoxicillin and/or clavulanic acid) older wounds after ~24 hours: surgical debridement, then antiseptic lavage (Betaseptic®), in case of clinically apparent infection or inflammation surgical revision with opening of wound and treatment with antibiotics according to resistogram (empirical start with Amoxicillin and/or clavulanic acid). For each kind of bite wound, the patient’s tetanus immunization status as well as the risk of exposure to rabies have to be assessed. Similarly, the possibility of other infections, such as lues (Syphilis), hepatitis B (HBV), hepatitis C (HBC), hepatitis D (HDV) and HIV, in the rare case of a human bite wound, has to be taken into account. PMID:20941334

  2. 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

  3. Postoperative wound infection associated with Vibrio parahaemolyticus in a patient without exposure to seawater.

    PubMed Central

    Ahsan, N; Conter, R L; Appelbaum, P C

    1988-01-01

    This report describes a case of wound infection associated with Vibrio parahaemolyticus. The patient had ingested steamed crabs 7 days before admission for surgical treatment of intestinal obstruction due to colon carcinoma. The Vibrio sp. was isolated from postoperative wound drainage as well as from stool. Recovery was uneventful. PMID:3384932

  4. Pseudomonas aeruginosa wound infection involves activation of its iron acquisition system in response to fascial contact

    PubMed Central

    Kim, M.; Christley, S.; Khodarev, N. N.; Fleming, I.; Huang, Y.; Chang, E.; Zaborina, O.; Alverdy, J.

    2015-01-01

    Background Wound infections are traditionally thought to occur when microbial burden exceeds the innate clearance capacity of host immune system. Here we introduce the idea that the wound environment itself plays a significant contributory role to wound infection. Methods We developed a clinically relevant murine model of soft tissue infection to explore the role of activation of microbial virulence in response to tissue factors as a mechanism by which pathogenic bacteria cause wound infections. Mice underwent abdominal skin incision and light muscle injury with a crushing forceps versus skin incision alone followed by topical inoculation of P. aeruginosa. Mice were sacrificed on postoperative day 6 and abdominal tissues analyzed for clinical signs of wound infection. To determine if specific wound tissues components induce bacterial virulence, P. aeruginosa was exposed to skin, fascia, and muscle. Results Gross wound infection due to P. aeruginosa was observed to be significantly increased in injured tissues vs non-injured (80% vs 10%) tissues (n=20/group, p<0.0001). Exposure of P. aeruginosa to individual tissue components demonstrated that fascia significantly induced bacterial virulence as judged by the production of pyocyanin, a redox-active phenazine compound known to kill immune cells. Whole genome transcriptional profiling of P. aeruginosa exposed to fascia demonstrated activation of multiple genes responsible for the synthesis of the iron scavenging molecule pyochelin. Conclusion We conclude that wound elements, in particular fascia, may play a significant role in enhancing the virulence of P. aeruginosa and may contribute to the pathogenesis of clinical wound infection. PMID:25807409

  5. 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

  6. Maggot therapy for repairing serious infective wound in a severely burned patient.

    PubMed

    Wu, Jun-Cheng; Lu, Ren-Rong; Huo, Ran; Fu, Hong-Bin

    2012-01-01

    The larvae of musca domestica were put in use to discard the dead tissue of a case of severe burn. A total of 50 000 aseptic maggots were put onto the infective wound surface, and aseptic dressings overlaid the surface. Three days later, another 20 000 maggots were put onto the wound for the second therapy. After twice maggot debridement, most necrotic muscle tissues of the wound were cleaned up, and eventually fresh granulation tissue grew and later the wound was covered and healed by 3 times of skin grafting. The result demonstrates that maggot therapy is safe and effective with no adverse complications except pain. PMID:22480679

  7. 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

  8. Wound infection during the Yom Kippur war: observations concerning antibiotic prophylaxis and therapy.

    PubMed Central

    Klein, R S; Berger, S A; Yekutiel, P

    1975-01-01

    Eighty-eight episodes of wound associated infection were identified among 624 consecutively admitted battlefield casualties. Ninety-one per cent of infections occurred during the administration of antibiotic therapy or prophylaxis and 65% were associated with the use of multiple antibacterial agents. Gram negative bacillary and mixed microbial infection predominated and were found to increase in relative incidence after the second day of hospitalization. Appropriate therapy, based on disc sensitivity testing, was administered in only 33% of infectious episodes. The practice of antibiotic wound prophylaxis may contribute to the incidence and nature of infection in battlefield wounds. Problems unique to the handling of battlefield wounded are discussed in comparing the present data with those of other war associated and civilian studies. PMID:167666

  9. Interactions of Methicillin Resistant Staphylococcus aureus USA300 and Pseudomonas aeruginosa in Polymicrobial Wound Infection

    PubMed Central

    Pastar, Irena; Nusbaum, Aron G.; Gil, Joel; Patel, Shailee B.; Chen, Juan; Valdes, Jose; Stojadinovic, Olivera; Plano, Lisa R.; Tomic-Canic, Marjana; Davis, Stephen C.

    2013-01-01

    Understanding the pathology resulting from Staphylococcus aureus and Pseudomonas aeruginosa polymicrobial wound infections is of great importance due to their ubiquitous nature, increasing prevalence, growing resistance to antimicrobial agents, and ability to delay healing. Methicillin-resistant S. aureus USA300 is the leading cause of community-associated bacterial infections resulting in increased morbidity and mortality. We utilized a well-established porcine partial thickness wound healing model to study the synergistic effects of USA300 and P. aeruginosa on wound healing. Wound re-epithelialization was significantly delayed by mixed-species biofilms through suppression of keratinocyte growth factor 1. Pseudomonas showed an inhibitory effect on USA300 growth in vitro while both species co-existed in cutaneous wounds in vivo. Polymicrobial wound infection in the presence of P. aeruginosa resulted in induced expression of USA300 virulence factors Panton-Valentine leukocidin and α-hemolysin. These results provide evidence for the interaction of bacterial species within mixed-species biofilms in vivo and for the first time, the contribution of virulence factors to the severity of polymicrobial wound infections. PMID:23451098

  10. Protective immunization against Staphylococcus aureus infection in a novel experimental wound model in mice.

    PubMed

    Schennings, Torgny; Farnebo, Filip; Szekely, Laszlo; Flock, Jan-Ingmar

    2012-10-01

    A novel murine experimental wound infection model was used to assess the efficacy of multi-component immunization against Staphylococcus aureus infection. Necrotic lesions were induced in mice with venom from Bothrops asper and infected with a low inoculum, 1 × 10(2) CFU. The wound infection model therefore more resembles a clinical case of S. aureus infection compared with conventional infection models where far more bacteria are required. Before infection, mice were immunized with four recombinant S.aureus proteins expressed from Escherichia coli: (i) domains 1-3 of Extracellular adherence protein (Eap), (ii) Efb - D (fusion protein combining Extracellular fibrinogen binding protein (Efb) and a fibronectin binding domain (D) of the fibronectin binding protein (FnBP) and (iii) clumping factor A (ClfA). In the immunized group, lower bacterial colonization, undisturbed crust formation and significantly faster wound healing were found compared with the unimmunized control group. Efb and Eap have previously been found to impair wound healing and neutralization of these proteins by antibodies restores a more natural wound healing process. This effect is further also enhanced by the proposed opsonic activity of antibodies against ClfA and FnBP. PMID:22958286

  11. 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

  12. The Wound Healing and Antibacterial Activity of Five Ethnomedical Calophyllum inophyllum Oils: An Alternative Therapeutic Strategy to Treat Infected Wounds

    PubMed Central

    Léguillier, Teddy; Lecsö-Bornet, Marylin; Lémus, Christelle; Rousseau-Ralliard, Delphine; Lebouvier, Nicolas; Hnawia, Edouard; Nour, Mohammed; Aalbersberg, William; Ghazi, Kamelia; Raharivelomanana, Phila; Rat, Patrice

    2015-01-01

    Background Calophyllum inophyllum L. (Calophyllaceae) is an evergreen tree ethno-medically used along the seashores and islands of the Indian and Pacific Oceans, especially in Polynesia. Oil extracted from the seeds is traditionally used topically to treat a wide range of skin injuries from burn, scar and infected wounds to skin diseases such as dermatosis, urticaria and eczema. However, very few scientific studies reported and quantified the therapeutic properties of Calophyllum inophyllum oil (CIO). In this work, five CIO from Indonesia (CIO1), Tahiti (CIO2, 3), Fiji islands (CIO4) and New Caledonia (CIO5) were studied and their cytotoxic, wound healing, and antibacterial properties were presented in order to provide a scientific support to their traditional use and verify their safety. Methods The safety of the five CIO was ascertained using the Alamar blue assay on human keratinocyte cells. CIO wound healing properties were determined using the scratch test assay on human keratinocyte cells. CIO-stimulated antibacterial innate immune response was evaluated using ELISA by measuring β defensin-2 release in human derivative macrophage cells. CIO antibacterial activity was tested using oilogramme against twenty aerobic Gram- bacteria species, twenty aerobic Gram+ bacteria species, including a multi-drug resistant Staphylococcus aureus strain and two anaerobic Gram+ bacteria species e.g. Propionibacterium acnes and Propionibacterium granulosum. To detect polarity profile of the components responsible of the antibacterial activity, we performed bioautography against a Staphylococcus aureus strain. Results Based on Alamar Blue assay, we showed that CIO can be safely used on keratinocyte cells between 2.7% and 11.2% depending on CIO origin. Concerning the healing activity, all the CIO tested accelerated in vitro wound closure, the healing factor being 1.3 to 2.1 higher compared to control when keratinocytes were incubated after scratch with CIO at 0.1%. Furthermore

  13. Chitosan based substrates for wound infection detection based on increased lysozyme activity.

    PubMed

    Tegl, Gregor; Rollett, Alexandra; Dopplinger, Jasmin; Gamerith, Clemens; Guebitz, Georg M

    2016-10-20

    There is a strong need of point-of-care diagnostics for early detection of wound infection. In this study, substrates based on functionalized chitosan were developed for visual detection of elevated lysozyme activity, an infection biomarker in wound fluids. For efficient hydrolysis by lysozyme, N-acetyl chitosan with a final degree of acetylation of around 50% was synthesized. N-acetylated chitosan and a chitosan-starch composite were labeled with structurally different dyes resulting in lysozyme-responsive biomaterials. Incubation with lysozyme in buffer and artificial wound fluid lead to a release of colored hydrolysis products already after 2h incubation. Tests in human wound fluid from infected wounds indicated a clear visual color change after 2.5h compared to control samples. A higher degree of swelling of the chitosan/starch containing substrate led to faster hydrolysis by lysozyme. This study demonstrates the potential of the lysozyme-responsive materials for diagnosis of wound infection and provides different diagnostic substrates for potential incorporation in point-of-care devices. PMID:27474566

  14. 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

  15. Infected total knee arthroplasty due to postoperative wound contamination with Pasteurella multocida.

    PubMed

    Subramanian, Bala; Holloway, Edward; Townsend, Robert; Sutton, Paul

    2013-01-01

    Pasteurella multocida is a small Gram-negative bacterium comprising part of the normal gastrointestinal and nasopharyngeal flora of domestic pets, such as dogs and cats. It rarely causes infection in humans. Previous reports of P multocida causing prosthetic joint infection have described either haematogenous spread of infection from a distant site through a scratch or bite, or reactivation of infection from a previous injury. We report a case of acute total knee arthroplasty joint infection becoming acutely infected by P multocida. We postulate that the mechanism of infection was direct contamination of the wound as a consequence of the patient being licked by his pet dog. We discuss the potential role played by thromboprophylaxis as a factor contributing to prolonged wound leak. PMID:24108765

  16. 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

  17. 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

  18. 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

  19. Improved Surgical Site Infection (SSI) rate through accurately assessed surgical wounds

    PubMed Central

    John, Honeymol; Nimeri, Abdelrahman; ELLAHHAM, SAMER

    2015-01-01

    Sheikh Khalifa Medical City's (SKMC) Surgery Institute was identified as a high outlier in Surgical Site Infections (SSI) based on the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) - Semi-Annual Report (SAR) in January 2012. The aim of this project was to improve SSI rates through accurate wound classification. We identified SSI rate reduction as a performance improvement and safety priority at SKMC, a tertiary referral center. We used the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) best practice guidelines as a guide. ACS NSQIP is a clinical registry that provides risk-adjusted clinical outcome reports every six months. The rates of SSI are reported in an observed/expected ratio. The expected ratio is calculated based on the risk factors of the patients which include wound classification. We established a multidisciplinary SSI taskforce. The members of the SSI taskforce included the ACS NSQIP team members, quality, surgeons, nurses, infection control, IT, pharmacy, microbiology, and it was chaired by a colorectal surgeon. The taskforce focused on five areas: pre-op showering and hair removal, skin antisepsis, prophylactic antibiotics, peri-operative maintenance of glycaemia, and normothermia. We planned audits to evaluate our wound classification and our SSI rates based on the SAR. Our expected SSI rates in general surgery and the whole department were 2.52% and 1.70% respectively, while our observed SSI rates were 4.68% and 3.57% respectively, giving us a high outlier status with an odd's ratio of 1.72 and 2.03. Wound classifications were identified as an area of concern. For example, wound classifications were preoperatively selected based on the default wound classification of the booked procedure in the Electronic Medical Record (EMR) which led to under classifying wounds in many occasions. A total of 998 cases were reviewed, our rate of incorrect wound classification

  20. Implementing evidence-based practice findings to decrease postoperative sternal wound infections following open heart surgery.

    PubMed

    Haycock, Camille; Laser, Craig; Keuth, Jennifer; Montefour, Kerry; Wilson, Melissa; Austin, Kerry; Coulen, Charmaine; Boyle, Deborah

    2005-01-01

    Sternal wound infections following open heart surgery are an infrequent occurrence but can have significant impact on patient morbidity, length of stay, and cost of care. The objective of this project initiative was to decrease the incidence of sternal wound infections by examining and changing current practice in the preoperative and postoperative management of patients undergoing open heart surgery. Following a literature review of interdisciplinary best practices, process teams were formed to evaluate our own patient cohort with documented infection. Five key areas were addressed: (1) preoperative skin preparation, (2) antibiotic prophylaxis, (3) blood glucose control, (4) wound care management, and (5) hand hygiene. A retrospective chart review of patients with documented sternal wound infections status post-mediastinal open heart surgery revealed that the average postoperative glucose was 201 mg/dL. An inquiry of practice variations determined the absence of a common provider and causative organism. A change model guided project initiatives and sustainability of new behaviors and practice. Each element of the project initiative had defined outcome measures. Staff nurses participated in peer education and outcome data collection. Following the implementation of evidence based practice changes, a linear decrease in sternal wound infections was documented. Nurses play a critical role in identifying, orchestrating, and evaluating change efforts in clinical practice. Outcomes are enhanced when nurses collaborate with all stakeholders in the practice improvement initiative. PMID:16141774

  1. Offset layered closure reduces deep wound infection in early-onset scoliosis surgery.

    PubMed

    Grzywna, Alexandra M; Miller, Patricia E; Glotzbecker, Michael P; Emans, John B

    2016-07-01

    Deep wound infection is a common complication in early-onset scoliosis (EOS) surgery. Soft tissue technique has received less attention as a means to reduce infection. A retrospective review of 1170 EOS surgeries (single surgeon, institution) investigated the impact of offset layered closure (OLC) and soft tissue awareness. The introduction of OLC reduced deep infection from 3.0% in 99 surgeries to 0.37% in 1071. Logistic regression confirmed that OLC led to significantly lower odds of infection (P=0.007). This deep infection rate (0.37%) is more typical of elective surgery, providing a more optimistic view of infection in EOS surgery than generally reported. PMID:27196268

  2. Assessment and management of wound infection: the role of silver.

    PubMed

    Stephen-Haynes, Jackie; Toner, Louise

    2007-03-01

    The appropriate selection of anti-microbial dressings has become an increasing challenge within clinical practice with an increasing array of dressing availability. A major area of growth has been in dressings containing silver. This article will discuss the rationale for use of silver dressings in the context of wound bed preparation, and offers guidance on their selection and appropriate use. PMID:17505354

  3. 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

  4. 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 (λ680nm/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.

  5. A Case of Wound Infection with Providencia rettgeri and Coincident Gout in a Patient from Guam

    PubMed Central

    Barnhill, Jason; Griffin, Jaclyn M

    2015-01-01

    Providencia rettgeri (P. rettgeri) is a ubiquitous organism that is infrequently associated with human disease. Here we report the isolation of this organism from a polymicrobial wound infection resulting from ruptured tophi on a 54-year-old male patient from Guam. We describe the identification and confirmation of this organism, and propose metabolic synergy as a possible mechanism of pathogenesis. To our knowledge, this is the first published report of a wound infection colonized by P. rettgeri from Guam, and the first report to speculate upon the role of bacterial synergy in P. rettgeri pathogenesis. PMID:26568901

  6. A Case of Wound Infection with Providencia rettgeri and Coincident Gout in a Patient from Guam.

    PubMed

    Washington, Michael A; Barnhill, Jason; Griffin, Jaclyn M

    2015-11-01

    Providencia rettgeri (P. rettgeri) is a ubiquitous organism that is infrequently associated with human disease. Here we report the isolation of this organism from a polymicrobial wound infection resulting from ruptured tophi on a 54-year-old male patient from Guam. We describe the identification and confirmation of this organism, and propose metabolic synergy as a possible mechanism of pathogenesis. To our knowledge, this is the first published report of a wound infection colonized by P. rettgeri from Guam, and the first report to speculate upon the role of bacterial synergy in P. rettgeri pathogenesis. PMID:26568901

  7. Coronary artery bypass surgery in diabetic patients – risk factors for sternal wound infections

    PubMed Central

    Lenz, Kristina; Brandt, Michael; Fraund-Cremer, Sandra; Cremer, Jochen

    2016-01-01

    The incidence of sternal wound infections (SWI) after coronary artery bypass surgery (CABG) as reported worldwide is low. However, it is associated with significant increase of postoperative mortality and treatment costs. The major risk factors discussed are diabetes mellitus and bilateral IMA harvesting of the internal mammary artery. This study analyses data of 590 patients receiving CABG concerning the risk factors for SWI. Sternal wound infections occur significantly more often in diabetic patients, one crucial and significant additional risk factor is obesity. PMID:27547690

  8. Murine Model Imitating Chronic Wound Infections for Evaluation of Antimicrobial Photodynamic Therapy Efficacy.

    PubMed

    Fila, Grzegorz; Kasimova, Kamola; Arenas, Yaxal; Nakonieczna, Joanna; Grinholc, Mariusz; Bielawski, Krzysztof P; Lilge, Lothar

    2016-01-01

    It is generally acknowledged that the age of antibiotics could come to an end, due to their widespread, and inappropriate use. Particularly for chronic wounds alternatives are being thought. Antimicrobial Photodynamic Therapy (APDT) is a potential candidate, and while approved for some indications, such as periodontitis, chronic sinusitis and other niche indications, its use in chronic wounds is not established. To further facilitate the development of APDT in chronic wounds we present an easy to use animal model exhibiting the key hallmarks of chronic wounds, based on full-thickness skin wounds paired with an optically transparent cover. The moisture-retaining wound exhibited rapid expansion of pathogen colonies up to 8 days while not jeopardizing the host survival. Use of two bioluminescent pathogens; methicillin resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa permits real time monitoring of the pathogens. The murine model was employed to evaluate the performance of four different photosensitizers as mediators in Photodynamic Therapy. While all four photosensitizers, Rose Bengal, porphyrin TMPyP, New Methylene Blue, and TLD1411 demonstrated good to excellent antimicrobial efficacy in planktonic solutions at 1 to 50 μM concentrations, whereas in in vivo the growth delay was limited with 24-48 h delay in pathogen expansion for MRSA, and we noticed longer growth suppression of P. aeruginosa with TLD1411 mediated Photodynamic Therapy. The murine model will enable developing new strategies for enhancement of APDT for chronic wound infections. PMID:27555843

  9. Murine Model Imitating Chronic Wound Infections for Evaluation of Antimicrobial Photodynamic Therapy Efficacy

    PubMed Central

    Fila, Grzegorz; Kasimova, Kamola; Arenas, Yaxal; Nakonieczna, Joanna; Grinholc, Mariusz; Bielawski, Krzysztof P.; Lilge, Lothar

    2016-01-01

    It is generally acknowledged that the age of antibiotics could come to an end, due to their widespread, and inappropriate use. Particularly for chronic wounds alternatives are being thought. Antimicrobial Photodynamic Therapy (APDT) is a potential candidate, and while approved for some indications, such as periodontitis, chronic sinusitis and other niche indications, its use in chronic wounds is not established. To further facilitate the development of APDT in chronic wounds we present an easy to use animal model exhibiting the key hallmarks of chronic wounds, based on full-thickness skin wounds paired with an optically transparent cover. The moisture-retaining wound exhibited rapid expansion of pathogen colonies up to 8 days while not jeopardizing the host survival. Use of two bioluminescent pathogens; methicillin resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa permits real time monitoring of the pathogens. The murine model was employed to evaluate the performance of four different photosensitizers as mediators in Photodynamic Therapy. While all four photosensitizers, Rose Bengal, porphyrin TMPyP, New Methylene Blue, and TLD1411 demonstrated good to excellent antimicrobial efficacy in planktonic solutions at 1 to 50 μM concentrations, whereas in in vivo the growth delay was limited with 24–48 h delay in pathogen expansion for MRSA, and we noticed longer growth suppression of P. aeruginosa with TLD1411 mediated Photodynamic Therapy. The murine model will enable developing new strategies for enhancement of APDT for chronic wound infections. PMID:27555843

  10. 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

  11. Ciprofloxacin-Loaded Keratin Hydrogels Prevent Pseudomonas aeruginosa Infection and Support Healing in a Porcine Full-Thickness Excisional Wound

    PubMed Central

    Roy, Daniel C.; Tomblyn, Seth; Burmeister, David M.; Wrice, Nicole L.; Becerra, Sandra C.; Burnett, Luke R.; Saul, Justin M.; Christy, Robert J.

    2015-01-01

    Objective: Cutaneous wound infection can lead to impaired healing, multiple surgical procedures, and increased hospitalization time. We tested the effectiveness of keratin-based hydrogels (termed “keratose”) loaded with ciprofloxacin to inhibit infection and support healing when topically administered to porcine excision wounds infected with Pseudomonas aeruginosa. Approach: Using a porcine excisional wound model, 10 mm full-thickness wounds were inoculated with 106 colony-forming units of P. aeruginosa and treated on days 1 and 3 postinoculation with ciprofloxacin-loaded keratose hydrogels. Bacteria enumeration and wound healing were assessed on days 3, 7, and 11 postinjury. Results: Ciprofloxacin-loaded keratose hydrogels reduced the amount of P. aeruginosa in the wound bed by 99.9% compared with untreated wounds on days 3, 7, and 11 postinjury. Ciprofloxacin-loaded keratose hydrogels displayed decreased wound contraction and reepithelialization at day 7 postinjury. By day 11, wounds treated with ciprofloxacin-keratose hydrogels contained collagen-rich granulation tissue and myofibroblasts. Wounds treated with ciprofloxacin-loaded keratose hydrogels exhibited a transient increase in macrophages in the wound bed at day 7 postinjury that subsided by day 11. Innovation: Current therapies for wound infection include systemic antibiotics, which could lead to antibiotic resistance, and topical antimicrobial treatments, which require multiple applications and can delay healing. Here, we show that ciprofloxacin-loaded keratose hydrogels inhibit cutaneous wound infection without interfering with key aspects of the healing process including granulation tissue deposition and remodeling. Conclusions: Ciprofloxacin-loaded keratose hydrogels have the potential to serve as a point-of-injury antibiotic therapy that prevents infection and supports healing following cutaneous injury. PMID:26244102

  12. Actinobacillus spp. and related bacteria in infected wounds of humans bitten by horses and sheep.

    PubMed Central

    Peel, M M; Hornidge, K A; Luppino, M; Stacpoole, A M; Weaver, R E

    1991-01-01

    We describe the isolation of Actinobacillus lignieresii and an A. equuli-like bacterium from an infected horse-bite wound in a 22-year-old stable foreman and A. suis from a bite injury in a 35-year-old man who had been attacked by a horse. A. lignieresii was also isolated in pure culture from an infected sheep-bite wound in a rural worker. These species of the genus Actinobacillus are primarily associated with animals and animal diseases and are rarely isolated from humans. The purpose of this report is to raise awareness of the possible occurrence of Actinobacillus spp. in bite wounds inflicted by farm animals and to discuss the difficulties encountered in the identification of species of Actinobacillus and related bacteria. PMID:1774260

  13. Neutropenia exacerbates infection by Acinetobacter baumannii clinical isolates in a murine wound model

    PubMed Central

    Grguric-Smith, Laryssa M.; Lee, Hiu H.; Gandhi, Jay A.; Brennan, Melissa B.; DeLeon-Rodriguez, Carlos M.; Coelho, Carolina; Han, George; Martinez, Luis R.

    2015-01-01

    The Gram negative coccobacillus Acinetobacter baumannii has become an increasingly prevalent cause of hospital-acquired infections in recent years. The majority of clinical A. baumannii isolates display high-level resistance to antimicrobials, which severely compromises our capacity to care for patients with A. baumannii disease. Neutrophils are of major importance in the host defense against microbial infections. However, the contribution of these cells of innate immunity in host resistance to cutaneous A. baumannii infection has not been directly investigated. Hence, we hypothesized that depletion of neutrophils increases severity of bacterial disease in an experimental A. baumannii murine wound model. In this study, the Ly-6G-specific monoclonal antibody (mAb), 1A8, was used to generate neutropenic mice and the pathogenesis of several A. baumannii clinical isolates on wounded cutaneous tissue was investigated. We demonstrated that neutrophil depletion enhances bacterial burden using colony forming unit determinations. Also, mAb 1A8 reduces global measurements of wound healing in A. baumannii-infected animals. Interestingly, histological analysis of cutaneous tissue excised from A. baumannii-infected animals treated with mAb 1A8 displays enhanced collagen deposition. Furthermore, neutropenia and A. baumannii infection alter pro-inflammatory cytokine release leading to severe microbial disease. Our findings provide a better understanding of the impact of these innate immune cells in controlling A. baumannii skin infections. PMID:26528277

  14. 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)-β1 expressions to Aquacel and silver sulfadiazine. PMID:22693632

  15. Review of Subcutaneous Wound Drainage in Reducing Surgical Site Infections after Laparotomy

    PubMed Central

    Manzoor, B.; Heywood, N.; Sharma, A.

    2015-01-01

    Purpose. Surgical site infections (SSIs) remain a significant problem after laparotomies. The aim of this review was to assess the evidence on the efficacy of subcutaneous wound drainage in reducing SSI. Methods. MEDLINE database was searched. Studies were identified and screened according to criteria to determine their eligibility for meta-analysis. Meta-analysis was performed using the Mantel-Haenszel method and a fixed effects model. Results. Eleven studies were included with two thousand eight hundred and sixty-four patients. One thousand four hundred and fifty patients were in the control group and one thousand four hundred and fourteen patients were in the drain group. Wound drainage in all patients shows no statistically significant benefit in reducing SSI incidence. Use of drainage in high risk patients, contaminated wound types, and obese patients appears beneficial. Conclusion. Using subcutaneous wound drainage after laparotomy in all patients is unnecessary as it does not reduce SSI risk. Similarly, there seems to be no benefit in using it in clean and clean contaminated wounds. However, there may be benefit in using drains in patients who are at high risk, including patients who are obese and/or have contaminated wound types. A well designed trial is needed which examines these factors. PMID:26783556

  16. Maggot Debridement Therapy of Infected Ulcers: Patient and Wound Factors Influencing Outcome – A Study on 101 Patients with 117 Wounds

    PubMed Central

    Steenvoorde, Pascal; Jacobi, Cathrien E; Van Doorn, Louk; Oskam, Jacques

    2007-01-01

    INTRODUCTION It has been known for centuries that maggots are potent debriding agents capable of removing necrotic tissue and slough. In January 2004, the US Food and Drug Administration decided to regulate maggot debridement therapy (MDT). As it is still not clear which wounds are likely or unlikely to benefit from MDT, we performed a prospective study to gain more insight in patient and wound characteristics influencing outcome. PATIENTS AND METHODS In the period between August 2002 and December 2005, patients with infected wounds with signs of gangrenous or necrotic tissue who seemed suited for MDT were enrolled in the present study. In total, 101 patients with 117 ulcers were treated. Most wounds were worst-case scenarios, in which maggot therapy was a treatment of last resort. RESULTS In total, 72 patients (71%) were classified as ASA III or IV. In total, 78 of 116 wounds (67%) had a successful outcome. These wounds healed completely (n = 60), healed almost completely (n = 12) or were clean at least (n = 6) at last follow-up. These results seem to be in line with those in the literature. All wounds with a traumatic origin (n = 24) healed completely. All wounds with septic arthritis (n = 13), however, failed to heal and led in half of these cases to a major amputation. According to a multivariate analysis, chronic limb ischaemia (odds ratio [OR], 7.5), the depth of the wound (OR, 14.0), and older age (≥ 60 years; OR, 7.3) negatively influenced outcome. Outcome was not influenced by gender, obesity, diabetes mellitus, smoking, ASAclassification, location of the wound, wound size or wound duration. CONCLUSIONS Some patient characteristics (i.e. gender, obesity, smoking behaviour, presence of diabetes mellitus and ASA-classification at presentation) and some wound characteristics (i.e. location of the wound, wound duration and size) do not seem to contra-indicate eligibility for MDT. However, older patients and patients with chronic limb ischaemia or deep wounds

  17. 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 μm 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.

  18. A Comparison of Tissue versus Swab Culturing of Infected Diabetic Foot Wounds.

    PubMed

    Huang, Ying; Cao, Ying; Zou, Mengchen; Luo, Xiangrong; Jiang, Ya; Xue, Yaoming; Gao, Fang

    2016-01-01

    Objective. To compare the efficacy of swabbing versus tissue biopsy for microbiological diagnosis of diabetic foot infection. Methods. This was a prospective trial. Fifty-six patients with diabetic foot infection were divided into the following 3 groups according to the PEDIS grading system: grade 2 (n = 10), grade 3 (n = 29), and grade 4 (n = 17). Two specimens were collected from each wound for microbial culturing after debridement, including a superficial swab and a deep tissue punch biopsy specimen. Results. Swab culturing identified all of the microorganisms isolated from the corresponding deep tissue specimens in 9/10 of grade 2 wounds (90.0%), and this proportion decreased to 12/29 (41.4%) and 7/17 (41.2%) for grades 3 and 4 wounds, respectively (p = 0.02). Moreover, the sensitivity for identifying Gram-negative bacteria, such as E. coli and Citrobacter, by swabbing was low (33.3%). In addition, some Gram-negative bacteria, such as Serratia and Ralstonia pickettii, were isolated from deep tissues but not from swabs. Conclusions. Swab culturing may be reliable for identification of pathogens in diabetic foot wounds classified as grade 2. However, it is advisable to culture deep tissue specimens for wounds of grade ≥3 because swab culturing is associated with a high risk of missing pathogens, especially Gram-negative bacteria. PMID:27123004

  19. A Comparison of Tissue versus Swab Culturing of Infected Diabetic Foot Wounds

    PubMed Central

    Huang, Ying; Cao, Ying; Zou, Mengchen; Luo, Xiangrong; Jiang, Ya; Xue, Yaoming; Gao, Fang

    2016-01-01

    Objective. To compare the efficacy of swabbing versus tissue biopsy for microbiological diagnosis of diabetic foot infection. Methods. This was a prospective trial. Fifty-six patients with diabetic foot infection were divided into the following 3 groups according to the PEDIS grading system: grade 2 (n = 10), grade 3 (n = 29), and grade 4 (n = 17). Two specimens were collected from each wound for microbial culturing after debridement, including a superficial swab and a deep tissue punch biopsy specimen. Results. Swab culturing identified all of the microorganisms isolated from the corresponding deep tissue specimens in 9/10 of grade 2 wounds (90.0%), and this proportion decreased to 12/29 (41.4%) and 7/17 (41.2%) for grades 3 and 4 wounds, respectively (p = 0.02). Moreover, the sensitivity for identifying Gram-negative bacteria, such as E. coli and Citrobacter, by swabbing was low (33.3%). In addition, some Gram-negative bacteria, such as Serratia and Ralstonia pickettii, were isolated from deep tissues but not from swabs. Conclusions. Swab culturing may be reliable for identification of pathogens in diabetic foot wounds classified as grade 2. However, it is advisable to culture deep tissue specimens for wounds of grade ≥3 because swab culturing is associated with a high risk of missing pathogens, especially Gram-negative bacteria. PMID:27123004

  20. Burn wounds infected by contaminated water: case reports, review of the literature and recommendations for treatment.

    PubMed

    Ribeiro, Noel F F; Heath, Christopher H; Kierath, Jessica; Rea, Suzanne; Duncan-Smith, Mark; Wood, Fiona M

    2010-02-01

    First-aid education for the management of burns advocates cool running water over burnt skin to limit soft tissue damage. However, the water used may itself constitute a risk. We report three cases of severe invasive and necrotizing infection in patients who used or immersed themselves in contaminated water in an attempt to extinguish the fire following acute major burns. Wound cultures from all patients yielded Aeromonas hydrophila and two yielded Bacillus cereus. One patient had a complex polymicrobial infection, including zygomycosis with Rhizomucor variabilis. All patients were treated aggressively with wound débridement, including one patient who required bilateral lower limb amputations to control progressive infection. All infections were successfully treated and all patients survived their burn injuries. We review the management of burns complicated by exposure to contaminated water leading to burn wound infections. We describe commonly reported organisms from various water sources, the appropriate initial empirical antimicrobial chemotherapy and present the clinician with a proposed algorithm for managing these serious infections. PMID:19501977

  1. Comparison of dextranomer and streptokinase-streptodornase in the treatment of venous leg ulcers and other infected wounds.

    PubMed

    Hulkko, A; Holopainen, Y V; Orava, S; Kangas, J; Kuusisto, P; Hyvärinen, E; Ervasti, E; Silvennoinen, E

    1981-01-01

    The clinical efficacy of dextranomer (Debrisan) and streptokinase-streptodornase (Varidase) was compared in a controlled randomized in-patient study. There were two patient groups: Group A consisting of 28 patients with a total of 31 venous leg ulcers and Group B consisting of 56 patients with other infected wounds (posttraumatic and postoperative wounds, amputation stumps, burn wounds, arteriosclerotic ulcers, decubital ulcers, ulcers due to bone disease, rheumatic ulcers, ulcers due to erysipelas and wounds of mixed aetiology). Both agents have a good cleansing effect as well as a good effect on infection and wet necrosis. Dextranomer stimulates the formation of granulation tissue faster than streptokinase-streptodornase. PMID:6172073

  2. 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

  3. 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.

  4. Excessive pediatric fasciitis necrotisans due to Pseudomonas aeruginosa infection successfully treated with negative pressure wound therapy.

    PubMed

    Szabó, Levente; Szegedi, István; Kiss, Csongor; Szikszay, Edit; Remenyik, Éva; Csízy, István; Juhász, István

    2015-01-01

    The case of a 10-year old female child is described with a history of myeloproliferative disorder having skin, bone and visceral involvement. Bone marrow biopsy revealed histiocytosis X. During chemotherapy necrotizing fasciitis of the lower abdominal wall was diagnosed. Multiple microbiological cultures taken from the wound base revealed Pseudomonas aeruginosa infection. Surgical necrectomy and application of negative pressure wound therapy (NPWT) was started together with intensive care treatment for sepsis. As both wound and general condition of the patient improved, autologous split thickness skin grafting was carried out in two sitting under continuing NPWT application. The applied skin grafts showed excellent take, the perilesional subcutaneous recesses resolved and complete healing was achieved after 28 days of NPWT treatment. Proper dermatological diagnosis and immediate escharectomy complemented with application of NPWT can be life-saving in the treatment of necrotizing fasciitis. PMID:26032296

  5. Fulminant infection by uncommon organisms in animal bite wounds.

    PubMed Central

    Dutta, J. K.

    1998-01-01

    In 1995 and 1996, 215 patients exposed to different species of animals were treated at the Amarnath Polyclinic, Balasore, in India. Among them were two children infected by uncommon organisms, i.e., Capnocytophaga canimorsus and Pasteurella multocida; the patients recovered with appropriate antibiotic therapy. PMID:10211359

  6. Human Wound Infection with Mannheimia glucosida following Lamb Bite.

    PubMed

    Lau, Jillian S Y; Omaleki, Lida; Turni, Conny; Barber, Stuart Richard; Browning, Glenn Francis; Francis, Michelle J; Graham, Maryza; Korman, Tony M

    2015-10-01

    Mannheimia spp. are veterinary pathogens that can cause mastitis and pneumonia in domestic cattle and sheep. While Mannheimia glucosida can be found as normal flora in oral and respiratory mucosa in sheep, there have been no reported cases of human infection with this organism. PMID:26202121

  7. [Wound management].

    PubMed

    Gresser, J; Bitz, K; Hegglin, J

    1992-07-01

    The following article is a check-list for wound care giving some practical hints. Special interest has been given to the themes of local anesthesia and prevention of infections. The indications and limits of the ambulant wound care are also discussed. Finally, a short explanation is given for the treatment of wounds situated at delicate regions of the body. PMID:1440441

  8. 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

  9. 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

  10. Efficacy of topically delivered moxifloxacin against wound infection by Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus.

    PubMed

    Jacobsen, F; Fisahn, C; Sorkin, M; Thiele, I; Hirsch, T; Stricker, I; Klaassen, T; Roemer, A; Fugmann, B; Steinstraesser, L

    2011-05-01

    Wound infection is a common risk for patients with chronic nonhealing wounds, causing high morbidity and mortality. Currently, systemic antibiotic treatment is the therapy of choice, despite often leading to several side effects and the risk of an insufficient tissue penetration due to impaired blood supply. If systemically delivered, moxifloxacin penetrates well into inflammatory blister fluid, muscle, and subcutaneous adipose tissues and might therefore be a possible option for the topical treatment of skin and infected skin wounds. In this study, topical application of moxifloxacin was investigated in comparison to mupirocin, linezolid, and gentamicin using a porcine wound infection and a rat burn infection model. Both animal models were performed either by an inoculation with methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa. Wound fluid, tissue, and blood samples were taken, and bacterial counts as well as the moxifloxacin concentration were determined for a 14-day follow-up. A histological comparison of the rat burn wound tissues was performed. Both strains were susceptible to moxifloxacin and gentamicin, whereas mupirocin and linezolid were effective only against MRSA. All antibiotics showed efficient reduction of bacterial counts, and except with MRSA, infected burn wounds reached bacterial counts below 10(5) CFU/g tissue. Additionally, moxifloxacin was observed to promote wound healing as determined by histologic analysis, while no induction of bacterial resistance was observed during the treatment period. The use of topical antibiotics for the treatment of infected wounds confers many benefits. Moxifloxacin is therefore an ideal candidate, due to its broad antibacterial spectrum, its high efficiency, and its potential to promote wound healing. PMID:21343458

  11. Efficacy of Topically Delivered Moxifloxacin against Wound Infection by Pseudomonas aeruginosa and Methicillin-Resistant Staphylococcus aureus▿

    PubMed Central

    Jacobsen, F.; Fisahn, C.; Sorkin, M.; Thiele, I.; Hirsch, T.; Stricker, I.; Klaassen, T.; Roemer, A.; Fugmann, B.; Steinstraesser, L.

    2011-01-01

    Wound infection is a common risk for patients with chronic nonhealing wounds, causing high morbidity and mortality. Currently, systemic antibiotic treatment is the therapy of choice, despite often leading to several side effects and the risk of an insufficient tissue penetration due to impaired blood supply. If systemically delivered, moxifloxacin penetrates well into inflammatory blister fluid, muscle, and subcutaneous adipose tissues and might therefore be a possible option for the topical treatment of skin and infected skin wounds. In this study, topical application of moxifloxacin was investigated in comparison to mupirocin, linezolid, and gentamicin using a porcine wound infection and a rat burn infection model. Both animal models were performed either by an inoculation with methicillin-resistant Staphylococcus aureus (MRSA) or Pseudomonas aeruginosa. Wound fluid, tissue, and blood samples were taken, and bacterial counts as well as the moxifloxacin concentration were determined for a 14-day follow-up. A histological comparison of the rat burn wound tissues was performed. Both strains were susceptible to moxifloxacin and gentamicin, whereas mupirocin and linezolid were effective only against MRSA. All antibiotics showed efficient reduction of bacterial counts, and except with MRSA, infected burn wounds reached bacterial counts below 105 CFU/g tissue. Additionally, moxifloxacin was observed to promote wound healing as determined by histologic analysis, while no induction of bacterial resistance was observed during the treatment period. The use of topical antibiotics for the treatment of infected wounds confers many benefits. Moxifloxacin is therefore an ideal candidate, due to its broad antibacterial spectrum, its high efficiency, and its potential to promote wound healing. PMID:21343458

  12. Surface enhanced Raman spectroscopy as a point-of-care diagnostic for infection in wound effluent

    NASA Astrophysics Data System (ADS)

    Ghebremedhin, Meron; Yesupriya, Shubha; Crane, Nicole J.

    2016-03-01

    In military medicine, one of the challenges in dealing with large combat-related injuries is the prevalence of bacterial infection, including multidrug resistant organisms. This can prolong the wound healing process and lead to wound dehiscence. Current methods of identifying bacterial infection rely on culturing microbes from patient material and performing biochemical tests, which together can take 2-3 days to complete. Surface Enhanced Raman Spectroscopy (SERS) is a powerful vibrational spectroscopy technique that allows for highly sensitive structural detection of analytes adsorbed onto specially prepared metal surfaces. In the past, we have been able to discriminate between bacterial isolates grown on solid culture media using standard Raman spectroscopic methods. Here, SERS is utilized to assess the presence of bacteria in wound effluent samples taken directly from patients. To our knowledge, this is the first attempt for the application of SERS directly to wound effluent. The utilization of SERS as a point-of-care diagnostic tool would enable physicians to determine course of treatment and drug administration in a matter of hours.

  13. [Experimental aprobation of the thermo-squirt method of treatment of infected and purulent wounds of the soft tissues].

    PubMed

    Furmanov, Iu A; Gvozdetskiĭ, V S; Terekhov, G V; Savitskaia, I M; Geĭlenko, O A; Titarenko, S N

    2010-01-01

    The influence of thermo-squirt processing on sanation of infected and purulent wounds of soft tissues was investigated in experiment. The possibility of application of the elaborated method for the wound surface disinfection and the tissues healing processes stimulation was proved. PMID:20469694

  14. Negative Pressure Wound Therapy Decreases Mortality in a Murine Model of Burn-Wound Sepsis Involving Pseudomonas aeruginosa Infection

    PubMed Central

    Dong, Maolong; Wang, Yaojun; Li, Xiao; Hu, Dahai

    2014-01-01

    Background The colonization of burn wounds by Pseudomonas aeruginosa can lead to septic shock, organ injuries, and high mortality rates. We hypothesized that negative pressure wound therapy (NPWT) would decrease invasion and proliferation of P. aeruginosa within the burn wound and reduce mortality. Methods Thermal injuries were induced in anesthetized mice, and P. aeruginosa was applied to the wound surface for 24 h. After removing the burn eschar and debridement, the animals were subjected to either NPWT or wet-to-dry (WTD) treatment protocols. The bacterial loads on the wound surface were assessed during 7 d of treatment, as were the concentrations of inflammatory cytokines in the peripheral blood samples. Survival was monitored daily for 14 d after burn induction. Finally, samples of wounded skin, lung, liver, and kidney were collected and subjected to histopathological examination. Results Applying P. aeruginosa to the burn wound surface led to sepsis. During early stages of treatment, NPWT reduced the mortality of the septic animals and levels of P. aeruginosa within the burn wound compared with WTD-treated animals. Circulating levels of cytokines and cytoarchitectural abnormalities were also significantly reduced via NPWT. Conclusions Our data indicate that NPWT inhibits the invasion and proliferation of P. aeruginosa in burn-wounded tissue and decreases early mortality in a murine model of burn-wound sepsis. These therapeutic benefits likely result from the ability of NPWT to decrease bacterial proliferation on the wound surface, reduce cytokine serum concentrations, and prevent damage to internal organs. PMID:24587379

  15. Clostridium glycolicum Wound Infections: Case Reports and Review of the Literature▿

    PubMed Central

    Jiang, Wei; Abrar, Sahibzada; Romagnoli, Mark; Carroll, Karen C.

    2009-01-01

    We describe two cases of Clostridium glycolicum wound infections in immunocompetent adults. The bacterium was identified by 16S rRNA gene sequencing. This is the third published report of the recovery of this organism from human clinical material and highlights the importance of the organism as a potential human pathogen. Our report extends the spectrum of the diseases caused by C. glycolicum. PMID:19261780

  16. 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...

  17. Effectiveness of Natural Antifungal Compounds in Controlling Infection by Grapevine Trunk Disease Pathogens through Pruning Wounds

    PubMed Central

    Cobos, Rebeca; Mateos, Rosa María; Álvarez-Pérez, José Manuel; Olego, Miguel Angel; Sevillano, Silvia; González-García, Sandra; Garzón-Jimeno, Enrique

    2015-01-01

    Grapevine trunk fungal pathogens, such as Diplodia seriata and Phaeomoniella chlamydospora, can infect plants through pruning wounds. They cause grapevine trunk diseases and are involved in grapevine decline. Accordingly, the protection of pruning wounds is crucial for the management of grapevine trunk diseases. The efficacy of different natural antifungals in inhibiting the growth of several fungi causing grapevine trunk diseases was evaluated in vitro. The fungi showing greater in vitro efficacy were tested on autoclaved grape wood assays against D. seriata and P. chlamydospora. Based on results from these assays, chitosan oligosaccharide, vanillin, and garlic extract were selected for further evaluation on pruning wounds inoculated with D. seriata and P. chlamydospora in field trials. A significant decrease in plant mortality was observed after 2 years of growth in the plants treated with the different natural antifungals compared to the mortality rate observed in infected plants that were not treated with antifungals. Also, the infection rate for the inoculated pathogens was significantly reduced in plants treated with the selected natural antifungals. Therefore, natural antifungals represent a promising alternative for disease control and could provide significant economic benefits for the grape-growing industry. PMID:26162882

  18. Effectiveness of Natural Antifungal Compounds in Controlling Infection by Grapevine Trunk Disease Pathogens through Pruning Wounds.

    PubMed

    Cobos, Rebeca; Mateos, Rosa María; Álvarez-Pérez, José Manuel; Olego, Miguel Angel; Sevillano, Silvia; González-García, Sandra; Garzón-Jimeno, Enrique; Coque, Juan José R

    2015-09-01

    Grapevine trunk fungal pathogens, such as Diplodia seriata and Phaeomoniella chlamydospora, can infect plants through pruning wounds. They cause grapevine trunk diseases and are involved in grapevine decline. Accordingly, the protection of pruning wounds is crucial for the management of grapevine trunk diseases. The efficacy of different natural antifungals in inhibiting the growth of several fungi causing grapevine trunk diseases was evaluated in vitro. The fungi showing greater in vitro efficacy were tested on autoclaved grape wood assays against D. seriata and P. chlamydospora. Based on results from these assays, chitosan oligosaccharide, vanillin, and garlic extract were selected for further evaluation on pruning wounds inoculated with D. seriata and P. chlamydospora in field trials. A significant decrease in plant mortality was observed after 2 years of growth in the plants treated with the different natural antifungals compared to the mortality rate observed in infected plants that were not treated with antifungals. Also, the infection rate for the inoculated pathogens was significantly reduced in plants treated with the selected natural antifungals. Therefore, natural antifungals represent a promising alternative for disease control and could provide significant economic benefits for the grape-growing industry. PMID:26162882

  19. Red blood cell ghosts as promising drug carriers to target wound infections.

    PubMed

    Berikkhanova, Kulzhan; Omarbaev, Rustam; Gulyayev, Alexandr; Shulgau, Zarina; Ibrasheva, Dilbar; Adilgozhina, Gulsim; Sergazy, Shynggys; Zhumadilov, Zhaxybay; Askarova, Sholpan

    2016-09-01

    Autologous red blood cell ghosts (RBC ghosts) can carry cytokines to the sites of inflammation. The targeting moiety of the RBC ghosts is associated with the nature of purulent inflammation, where the erythrocytes are phagocyted and encapsulated drugs are released. In the present study we have investigated the healing potential of RBC ghosts loaded with cytokine IL-1β and antibiotic. Additionally, the pharmacokinetic properties of RBC ghosts loaded with IL-1β were studied. 35 Male Wistar rats (250-300g) were used in the pharmacokinetic study and in a wound infection model where a suspension of Staphylococcus aureus was placed into a surgical cut of the skin and subcutaneous tissue in the femoral region. In order to monitor progression of the wound repair processes, wound swabs or aspiration biopsies were taken for analyses on the 1st-6th days. Wound repair dynamics assessment was based on suppression of S. aureus growth, signs of pain, time of disappearance of pus and infiltration around the wound. Visual observations, as well as microbiological and cytological analysis of wound exudates demonstrated a significant acceleration of healing processes in a group of animals treated with a local injection of IL-1β and ceftriaxone encapsulated into RBC ghosts when compared to the animals treated either with a local or IM injection of free drugs. For the pharmacokinetic study, single IV injections of either free or encapsulated IL-1β were made and the concentration of IL-1β in serum samples and tissue homogenates were determined. Encapsulation in RBC ghosts improved pharmacokinetic profiles of IL-1β by increasing the half-life, reducing its clearance, and increasing the deposition of the drug in the liver, spleen and lungs. These data suggest that RBC ghosts are effective drug carriers for targeted delivery of cytokines to the sites of inflammation, and have a potential for improving the treatment outcomes of purulent diseases. PMID:27062487

  20. Combat-Related Pythium aphanidermatum Invasive Wound Infection: Case Report and Discussion of Utility of Molecular Diagnostics

    PubMed Central

    Murray, Clinton K.; Driscoll, Ian R.; Wickes, Brian L.; Wiederhold, Nathan; Sutton, Deanna A.; Sanders, Carmita; Mende, Katrin; Enniss, Brent; Feig, James; Ganesan, Anuradha; Rini, Elizabeth A.; Vento, Todd J.

    2015-01-01

    We describe a 22-year-old soldier with 19% total body surface area burns, polytrauma, and sequence- and culture-confirmed Pythium aphanidermatum wound infection. Antemortem histopathology suggested disseminated Pythium infection, including brain involvement; however, postmortem PCR revealed Cunninghamella elegans, Lichtheimia corymbifera, and Saksenaea vasiformis coinfection. The utility of molecular diagnostics in invasive fungal infections is discussed. PMID:25832301

  1. Combat-Related Pythium aphanidermatum Invasive Wound Infection: Case Report and Discussion of Utility of Molecular Diagnostics.

    PubMed

    Farmer, Aaron R; Murray, Clinton K; Driscoll, Ian R; Wickes, Brian L; Wiederhold, Nathan; Sutton, Deanna A; Sanders, Carmita; Mende, Katrin; Enniss, Brent; Feig, James; Ganesan, Anuradha; Rini, Elizabeth A; Vento, Todd J

    2015-06-01

    We describe a 22-year-old soldier with 19% total body surface area burns, polytrauma, and sequence- and culture-confirmed Pythium aphanidermatum wound infection. Antemortem histopathology suggested disseminated Pythium infection, including brain involvement; however, postmortem PCR revealed Cunninghamella elegans, Lichtheimia corymbifera, and Saksenaea vasiformis coinfection. The utility of molecular diagnostics in invasive fungal infections is discussed. PMID:25832301

  2. Aeromonas jandaei and Aeromonas veronii dual infection of a human wound following aquatic exposure.

    PubMed Central

    Joseph, S W; Carnahan, A M; Brayton, P R; Fanning, G R; Almazan, R; Drabick, C; Trudo, E W; Colwell, R R

    1991-01-01

    Exudate removed from an infection that developed below the left eye of a 10-year-old male following a previously inflicted wound after aquatic exposure was cultured and revealed two different Aeromonas spp. Further characterization showed that one strain was phenotypically identical to Aeromonas veronii, while the other strain was confirmed by DNA hybridization analysis to be Aeromonas jandaei sp. nov. This is the first report of these more recently described aeromonads, thus far rarely reported from clinical disease, occurring simultaneously in a human infection. PMID:2037674

  3. 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

  4. 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 < 0.0001), repeat bacteremia (OR, 17.98, 95% CI, 2.51-161.77, p = 0.004) were risk factors that were associated for sternal 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

  5. Incidence of wound infection in patients undergoing craniotomy: influence of type of shaving.

    PubMed

    Zentner, J; Gilsbach, J; Daschner, F

    1987-01-01

    How the method of shaving affects the incidence of deep postoperative wound infections was examined in 475 patients. It is shown that the rate of infection is not lower after wet shaving than after dry shaving. The overall infection rate was 4.2%, 2.9% in patients who had been shaved wet versus 5.5% in patients shaved dry. The difference is, however, not significant on the 5% level. With respect to dry shaving, the infection rate was not affected by whether the hair was removed with electric clippers alone (2.8%) or whether a disposable razor was also used for additional hair removal in the area of skin incision (3.2%). PMID:3630783

  6. Preparation and characterization of silver nanoparticle loaded amorphous hydrogel of carboxymethylcellulose for infected wounds.

    PubMed

    Das, Anup; Kumar, Ajay; Patil, Niranjan B; Viswanathan, Chandra; Ghosh, Deepa

    2015-10-01

    There is a growing demand for an appropriate and safe antimicrobial dressing to treat infected deep wounds. An amorphous gel formulation (SNP-CMC), containing silver nanoparticles (SNPs) and carboxymethylcellulose (CMC), was prepared in one step by the reduction of silver nitrate in situ. Spectrophotometric and microscopic analysis revealed that the SNPs were 7-21 nm in diameter. In simulated wound experiments, SNP-CMC gel was found to absorb 80.48 ± 4.69% w/w of saline and donate 17.43 ± 0.76% w/w of moisture within 24h indicating its dual fluid affinity. Cytocompatibility of the gel was assessed by proliferation studies with primary human skin cells. The antimicrobial activity studies showed that SNP-CMC containing 50 ppm of SNPs was effective against the growth of both Gram negative and Gram positive strains including methicillin-resistant Staphylococcus aureus (MRSA). These results indicate that SNP-CMC could be ideal for the treatment of deep infected wounds. PMID:26076624

  7. Superficially, longer, intermittent ozone theraphy in the treatment of the chronic, infected wounds.

    PubMed

    Białoszewski, Dariusz; Kowalewski, Michał

    2003-10-30

    Background. Ozone therapy - i.e. the treatment of patients by a mixture of oxygen and ozone - has been used for many years as a method ancillary to basic treatment, especially in those cases in which traditional treatment methods do not give satisfactory results, e.g. skin loss in non-healing wounds, ulcers, pressure sores, fistulae, etc. Material and methods. In the Department of Phisiotherapy of the Medical Faculty and the Department of the Orthopedics and Traumatology of the Locomotor System at the Medical University of Warsaw in the period from January 2001 until November 2002, 23 patients with heavy,chronic, antibiotic resistants septic complications after trauma, surgical procedures and secundary skin infetions were treated with ozone. The ozone therapy was administered using an authorial technique of superficially, longer, intermittent ozone application. Results. In the wounds of the all experienced patients the inhibition of septic processes and wound healing was much faster than normal. Conclusions. Our data confirm the advantages wich result from the technique of superficially, longer, intermittent ozone theraphy in combined treatment for septic complications in the soft tissue, especially in the locomotor system. These technique makes posttraumatic infections and promotes quicker healing of post-surgical and post-traumal complications - chronic septic infections. This method also lowers the cost of antibiotic therapy and is sometimes the only available auxiliary technique to support surgical procedures. PMID:17679848

  8. Can infected wounds be decontaminated with the use of the CO2 laser: An in vivo comparative study

    NASA Astrophysics Data System (ADS)

    Lima Verde Santos, Jose Z.; Barbosa Pinheiro, Antonio L.; Cavalcanti das Neves, Jerlucia; Ribeiro de Sena, Kesia X. d. F.; Matos de Oliveira, Marcos A.

    2003-06-01

    The aim of this study was to compare microbiologically the effects of the CO2 Laser and Chlorohexidine Gluconate (4%) on Staphylococcus aureus infected cutaneous wounds. Wound infection constitutes a big risk for patients and it is usually associated to increased morbidity, mortality and hospital costs. It is accepted that local treatment of these infections is effective. Standardized wounds created on the dorsum of 36 rats were infected with Staphylococcus aureus and treated during six days as follows: Group I: Chlorohexidine Gluconate applied to the wound surface during one minute during six days; Group II: Single CO2 Laser irradiation (8W,CW, unfocused, 8cm focal distance, 81530W/cm2), maintaining surface debris; Group III: Single CO2 Laser irradiation (8W,CW, unfocused, 8cm focal distance, 81530W/cm2), removing the surface debris. Daily samples were taken for microbiological analysis. Seven days after wounding the animals were killed a final sample taken. The use of Chlorohexidine Gluconate solution and the CO2 laser with the removal of the surface debris result in a significant reduction on the infectability of the Staphylococcus aureus when compared to non-treated infected wounds (p=0.00 e p=0.02). However, if the debris is left on the wound surface the resolution of the infection is less significant and results in non-significant differences on the number of Staphylococcus aureus when compared to non treated controls (p=0.14). No difference on infectability of the Staphylococcus aureus was detectable when the debris was removed of the surface of the wounds and when the Chlorohexidine solution was used (p=0.05). Therefore, the use of the CO2 laser would improve the resolution of the infection without further irradiating the tissue and consequently without further impairing wound healing. The fact that significant differences were observed between the two modalities of CO2 treatment indicates that the surface debris acts as a culture medium for bacterial

  9. Antibacterial Efficacy of Silver-Impregnated Polyelectrolyte Multilayers Immobilized on a Biological Dressing in a Murine Wound Infection Model

    PubMed Central

    Guthrie, Kathleen M.; Agarwal, Ankit; Tackes, Dana S.; Johnson, Kevin W.; Abbott, Nicholas L.; Murphy, Christopher J.; Czuprynski, Charles J.; Kierski, Patricia R.; Schurr, Michael J.; McAnulty, Jonathan F.

    2012-01-01

    Objective To investigate the antibacterial effect of augmenting a biological dressing with polymer films containing silver nanoparticles. Background Biological dressings, such as Biobrane, are commonly used for treating partial-thickness wounds and burn injuries. Biological dressings have several advantages over traditional wound dressings. However, as many as 19% of wounds treated with Biobrane become infected, and, once infected, the Biobrane must be removed and a traditional dressing approach should be employed. Silver is a commonly used antimicrobial in wound care products, but current technology uses cytotoxic concentrations of silver in these dressings. We have developed a novel and facile technology that allows immobilization of bioactive molecules on the surfaces of soft materials, demonstrated here by augmentation of Biobrane with nanoparticulate silver. Surfaces modified with nanometer-thick polyelectrolyte multilayers (PEMs) impregnated with silver nanoparticles have been shown previously to result in in vitro antibacterial activity against Staphylococcus epidermidis at loadings of silver that are noncytotoxic. Methods We demonstrated that silver-impregnated PEMs can be nondestructively immobilized onto the surface of Biobrane (Biobrane-Ag) and determined the in vitro antibacterial activity of Biobrane-Ag with Staphylococcus aureus. In this study, we used an in vivo wound infection model in mice induced by topical inoculation of S aureus onto full-thickness 6-mm diameter wounds. After 72 hours, bacterial quantification was performed. Results Wounds treated with Biobrane-Ag had significantly (P < 0.001) fewer colony-forming units than wounds treated with unmodified Biobrane (more than 4 log10 difference). Conclusions The results of our study indicate that immobilizing silver-impregnated PEMs on the wound-contact surface of Biobrane significantly reduces bacterial bioburden in full-thickness murine skin wounds. Further research will investigate whether

  10. Components and Quality Measures of DIME (Devitalized Tissue, Infection/Inflammation, Moisture Balance, and Edge Preparation) in Wound Care

    PubMed Central

    Snyder, Robert J.; Fife, Caroline; Moore, Zena

    2016-01-01

    ABSTRACT OBJECTIVES: To discuss how patient considerations and the initial wound environment can affect wound treatment and summarize the way in which the initial US Wound Registry measures capture aspects of the DIME (Debridement/devitalized tissue, Infection or inflammation, Moisture balance, and wound Edge preparation/wound depth) principles. DISCUSSION: The treatment of chronic wounds often involves extended hospital stays and long-term outpatient follow-up visits with costly advanced therapeutic interventions. As complex care is required for chronic wounds, treatment guidelines such as DIME have evolved to include consideration of patient-centered concerns and etiology, as well as features of wound bed preparation. The US healthcare system is in the midst of transitioning to a quality-based system. However, as wound care is not yet a recognized specialty, it is poorly represented in the current approved quality-based measures. CONCLUSION: This article helps to identify the practice guidelines that are not currently represented by quality metrics. PMID:27089149

  11. Handheld fluorescence imaging device detects subclinical wound infection in an asymptomatic patient with chronic diabetic foot ulcer: a case report.

    PubMed

    Wu, Yichao C; Smith, Marlie; Chu, Ashley; Lindvere-Teene, Liis; Starr, Danielle; Tapang, Kim; Shekhman, Rachel; Wong, Olive; Linden, Ron; DaCosta, Ralph S

    2016-08-01

    Chronic wounds are a significant burden to global patient and health care infrastructures, and there is a need for better methods of early wound diagnosis and treatment. Traditional diagnosis of chronic wound infection by pathogenic bacteria, using clinical signs and symptoms, is based on visual inspection under white light and microbiological sampling (e.g. swabbing and/or biopsy) of the wound, which are subjective and suboptimal. Diagnosing microbial infection based on traditional clinical signs and symptoms in wounds of asymptomatic patients is especially challenging at the bedside. Bacteria are invisible to the unaided eye and wound sampling for diagnostic testing can cause unacceptable delays in diagnosis and treatment. To address this problem, we developed a new prototype handheld, portable fluorescence imaging device that enables non-contact, real-time, high-resolution visualisation of pathogenic bacteria and tissues in wounds. Herein, we report the clinical use of this imaging device in detecting subsurface heavy bacterial load and subclinical local infection in an asymptomatic 50-year-old patient with a non-healing diabetic foot ulcer. PMID:25907362

  12. Intermittent negative pressure wound therapy with instillation for the treatment of persistent periprosthetic hip infections: a report of two cases.

    PubMed

    Söylemez, Mehmet Salih; Özkan, Korhan; Kılıç, Bülent; Erinç, Samet

    2016-01-01

    Intermittent negative pressure wound therapy with instillation (NPWTi) is starting to be used successfully to treat early periprosthetic infections of endoprostheses. However, few articles have reported the outcome of treatment with intermittent NPWTi for late persistent periprosthetic infections of the hip. In this study, we report two cases who underwent several rounds of radical wound debridement for the treatment of a late persistent periprosthetic infection of the hip. Intermittent NPWTi was used in both cases. Patients were treated successfully and there was no recurrence after 3 and 1 years of follow-up, respectively. PMID:26929628

  13. Intermittent negative pressure wound therapy with instillation for the treatment of persistent periprosthetic hip infections: a report of two cases

    PubMed Central

    Söylemez, Mehmet Salih; Özkan, Korhan; Kılıç, Bülent; Erinç, Samet

    2016-01-01

    Intermittent negative pressure wound therapy with instillation (NPWTi) is starting to be used successfully to treat early periprosthetic infections of endoprostheses. However, few articles have reported the outcome of treatment with intermittent NPWTi for late persistent periprosthetic infections of the hip. In this study, we report two cases who underwent several rounds of radical wound debridement for the treatment of a late persistent periprosthetic infection of the hip. Intermittent NPWTi was used in both cases. Patients were treated successfully and there was no recurrence after 3 and 1 years of follow-up, respectively. PMID:26929628

  14. Effect of interferon-gamma treatment on the course of a burn wound infection.

    PubMed

    Hershman, M J; Sonnenfeld, G; Logan, W A; Pietsch, J D; Wellhausen, S R; Polk, H C

    1988-06-01

    Interferon-gamma (IFN-gamma) has been shown to have immunoregulatory properties and is able to modulate resistance to several microbial infections. This study was designed to determine the efficacy of IFN-gamma treatment in a murine burn wound infection model. Bacterial challenge consisted of Klebsiella pneumoniae (10(8) organisms/ml) or Pseudomonas aeruginosa (10(8) organisms/ml), applied topically immediately after burning. Groups of CBA/J mice received either IFN-gamma or RPMI-1640 medium (controls) subcutaneously. IFN-gamma was administered daily at a dose of 7,500 units for 5 days prior to bacterial challenge. Burn without bacterial challenge produced no mortality. Mice treated with IFN-gamma survived significantly longer than controls when the bacterial challenge was K. pneumoniae. There was no difference in survival when bacterial challenge was P. aeruginosa. The Ia antigen expression of peripheral blood mononuclear cells was severely reduced for 3 days post-burn. This drop was prevented on day 3 post-burn in mice treated with IFN-gamma. These data indicate that interferon was effective treatment in a murine model of Klebsiella burn wound infection and was associated with maintenance of Ia antigen expression that may have contributed to the action of the IFN-gamma. PMID:3137276

  15. 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 μg/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.

  16. Novel application of vacuum sealing drainage with continuous irrigation of potassium permanganate for managing infective wounds of gas gangrene.

    PubMed

    Hu, Ning; Wu, Xing-Huo; Liu, Rong; Yang, Shu-Hua; Huang, Wei; Jiang, Dian-Ming; Wu, Qiang; Xia, Tian; Shao, Zeng-Wu; Ye, Zhe-Wei

    2015-08-01

    Traumatic gas gangrene is a fatal infection mainly caused by Clostridium perfringens. It is a challenge to manage gas gangrene in open wounds and control infection after debridement or amputation. The aim of the present study was to use vacuum sealing drainage (VSD) with continuous irrigation of potassium permanganate to manage infective wounds of gas gangrene and observe its clinical efficacy. A total of 48 patients with open traumatic gas gangrene infection were included in this study. Amputations were done for 27 patients, and limb salvage procedures were performed for the others. After amputation or aggressive debridement, the VSD system, including polyvinyl alcohol (PVA) foam dressing and polyurethane (PU) film, with continuous irrigation of 1:5000 potassium permanganate solutions, was applied to the wounds. During the follow-up, all the patients healed without recurrence within 8-18 months. There were four complications. Cardiac arrest during amputation surgery occurred in one patient who suffered from severe septic shock. Emergent resuscitation was performed and the patient returned to stable condition. One patient suffered from mixed infection of Staphylococcal aureus, and a second-stage debridement was performed. One patient suffered from severe pain of the limb after the debridement. Exploratory operation was done and the possible reason was trauma of a local peripheral nerve. Three cases of crush syndrome had dialysis treatment for concomitant renal failure. In conclusion, VSD can convert open wound to closed wound, and evacuate necrotic tissues. Furthermore, potassium permanganate solutions help eliminate anaerobic microenvironment and achieve good therapeutic effect on gas gangrene and mixed infection. VSD with continuous irrigation of potassium permanganate is a novel, simple and feasible alternative for severe traumatic open wounds with gas gangrene infection. PMID:26223928

  17. [Investigation of the effect of ibuprofen on wound healing in experimental Staphylococcus aureus soft tissue infections].

    PubMed

    Çitil, M Uğur; Mete, Ergun; Oğuz, E Oğuzhan; Abban Mete, Gülçin; Şahin, Barbaros; Kaleli, İlknur

    2015-04-01

    Soft tissue infections (STIs) occur as a result of the colonization of pathogenic bacteria upon the destruction of normal skin microbial flora and the skin integrity. Streptococci and staphylococci are the most frequent causes of bacterial STIs. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are often used in STIs because of their analgesic and antipyretic effects. However, evidence suggests that these drugs might delay both epithelization and angiogenesis in the early phases of wound healing because of an antiproliferative effect. The aim of this study was to investigate the effect of ibuprofen on the wound healing in STIs caused by Staphylococcus aureus in immunosuppressed mice. A total of 120 female Balb/c mice were used in the study and the mice were assigned to four test groups and two control groups. The test groups were defined as follows; B (Bacteria group, n= 23), BI (Bacteria + Ibuprofen group, n= 23), BA (Bacteria + Ampicillin group, n= 23), BIA (Bacteria + Ampicillin + Ibuprofen group, n= 21); and the control groups were defined as follows; S1B2 (only immunosuppressed controls, n= 15) and S2B2 (Sham group). Immunosupression was induced with cyclophosphamide and the experimental infection was generated by subcutaneous inoculation of bacterial suspension (2 x 10(8) cfu/ml) of methicillin-sensitive S.aureus ATCC 25923 to the right hind leg. Ibuprofen was given to the mice by gastric gavage (50 mg/kg/day), and ampicillin (100 mg/kg/day) by intramuscular injection. Wound sizes that appear in the animals were measured on a daily basis. Serum and tissue (epithelial tissue, connective tissue, sebaceous glands, sweat glands) samples were obtained on the first, third and seventh days. The tissue samples were examined histopathologically by hematoxylin-eosin (HE) staining method and IL-1, IL-6, TNF-α and VEGF (Vascular Endothelial Growth Factor) levels were determined in serum samples by ELISA method. The tissue cytokine reactions were also

  18. Perioperative hypothermia and incidence of surgical wound infection: a bibliographic study

    PubMed Central

    da Silva, Aline Batista; Peniche, Aparecida de Cassia Giani

    2014-01-01

    The purpose of this review article was to understand and analyze the scientific production related to the occurrence of perioperative hypothermia and the incidence of infection on the surgical site. For this purpose, a search was conducted in the databases LILACS, MEDLINE, PubMed, CINAHL and Cochrane, using the health science descriptors DECS, from 2004 to 2009. A total of 91 articles were found. After eliminating duplicate items and using selection criteria for inclusion, six manuscripts remained for analysis. The studies were classified as retrospective, prospective, case studies, and clinical trials. After analysis, the majority of studies showed that hypothermia must be prevented during the perioperative period to reduce complications in the healing process of the surgical incision. Therefore, unadverted hypothermia directly influences in surgical site healing, increasing the incidence of infection in the surgical wound. PMID:25628208

  19. Differential regulation of a hydroxyproline-rich glycoprotein gene family in wounded and infected plants.

    PubMed Central

    Corbin, D R; Sauer, N; Lamb, C J

    1987-01-01

    We have characterized three different transcripts induced by fungal elicitor, wounding, or infection which encode apoproteins of cell wall hydroxyproline-rich glycoproteins involved in plant defense against infection. The proteins encoded by two of these transcripts contain a proline-rich domain involving tandem repetition of the 16-amino-acid unit Tyr3-Lys-Ser-Pro4-Ser-Pro-Ser-Pro4. The third transcript encodes a protein with a proline-rich domain involving a variant of this 16-mer canonical repeat: Tyr3-His-Ser-Pro4-Lys-His-Ser-Pro4. Each transcript is encoded by a separate gene present at single or low copy number in the haploid genome. These transcripts exhibit markedly different patterns of accumulation in different stress conditions, indicating the operation of several distinct intercellular stress signal systems in higher plants. Images PMID:3437892

  20. 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

  1. Antibacterial activity of honey against strains of Staphylococcus aureus from infected wounds.

    PubMed Central

    Cooper, R A; Molan, P C; Harding, K G

    1999-01-01

    The antibacterial action of honey in infected wounds does not depend wholly on its high osmolarity. We tested the sensitivity of 58 strains of coagulase-positive Staphylococcus aureus, isolated from infected wounds, to a pasture honey and a manuka honey. There was little variation between the isolates in their sensitivity to honey: minimum inhibitory concentrations were all between 2 and 3% (v/v) for the manuka honey and between 3 and 4% for the pasture honey. Thus, these honeys would prevent growth of S. aureus if diluted by body fluids a further seven-fold to fourteen-fold beyond the point where their osmolarity ceased to be completely inhibitory. The antibacterial action of the pasture honey relied on release of hydrogen peroxide, which in vivo might be reduced by catalase activity in tissues or blood. The action of manuka honey stems partly from a phytochemical component, so this type of honey might be more effective in vivo. Comparative clinical trials with standardized honeys are needed. PMID:10472280

  2. 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

  3. Rational Evolution of Antimicrobial Peptides Containing Unnatural Amino Acids to Combat Burn Wound Infections.

    PubMed

    Xiong, Meng; Chen, Ming; Zhang, Jue

    2016-09-01

    Antimicrobial peptides have long been raised as a promising strategy to combat bacterial infection in burn wounds. Here, we attempted to rationally design small antimicrobial peptides containing unnatural amino acids by integrating in silico analysis and in vitro assay. Predictive quantitative sequence-activity models were established and validated rigorously based on a large panel of nonamer antimicrobial peptides with known antibacterial activity. The best quantitative sequence-activity model predictor was employed to guide genetic evolution of a peptide population. In the evolution procedure, a number of unnatural amino acids with desired physicochemical properties were introduced, resulting in a genetic evolution-improved population, from which seven peptide candidates with top scores, containing 1-3 unnatural amino acids, and having diverse structures were successfully identified, and their antibacterial potencies against two antibiotic-resistant bacterial strains isolated from infected burn wounds were measured using in vitro susceptibility test. Consequently, four (WL-Orn-LARKIV-NH2 , ARKRWF-Dab-FL-NH2 , KFI-Hag-IWR-Orn-R-NH2 and YW-Hag-R-Cit-RF-Orn-N-NH2 ) of the seven tested peptides were found to be more potent than reference Bac2A, the smallest naturally occurring broad spectrum antimicrobial peptide. Molecular dynamics simulations revealed that the designed peptides can fold into amphipathic helical structure that allows them to interact directly with microbial membranes. PMID:27062533

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

    PubMed Central

    Alexander, J. Wesley; Supp, Dorothy M.

    2014-01-01

    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

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

    PubMed Central

    Głowacka, Anna; Poznańska-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. PMID:25821423

  6. Gentamicin-Impregnated Collagen Sponge: Effectiveness in Preventing Sternal Wound Infection in High-Risk Cardiac Surgery

    PubMed Central

    Rapetto, Filippo; Bruno, Vito D.; Guida, Gustavo; Marsico, Roberto; Chivasso, Pierpaolo; Zebele, Carlo

    2016-01-01

    Sternal wound infections represent one of the most frequent complications after cardiac surgery and are associated with high postoperative mortality. Several preventive methods have been introduced, and recently, gentamicin-impregnated collagen sponges (GICSs) have shown a promising effect in reducing the incidence of this type of complications. Gentamicin is an aminoglycoside antibiotic that has been widely used to treat infections caused by multiresistant bacteria; despite its effectiveness, its systemic use carries a risk of toxicity. GICSs appear to overcome this side effect, topically delivering high antibiotic concentrations to the wound and thus reducing the toxic-related events. Although several retrospective analyses and randomized controlled trials have studied the use of GICSs in cardiac surgery, conclusions regarding their efficacy in preventing sternal wound infection are inconsistent. We have reviewed the current literature focusing on high-risk patients. PMID:27279734

  7. Longitudinal study of horses for carriage of methicillin-resistant Staphylococcus aureus following wound infections.

    PubMed

    Bergström, Karin; Bengtsson, Björn; Nyman, Ann; Grönlund Andersson, Ulrika

    2013-05-01

    An outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infections in horses in Sweden raised questions concerning the risk posed by horses to their surroundings following MRSA infections. This initiated a longitudinal study to investigate how long MRSA-infected horses remained positive and to test the sensitivity of different anatomical sampling sites for detection of MRSA. Between October 2008 and June 2010, 9 of 15 horses notified as having MRSA-infected wounds fitted the case criteria for the study. The cases were sampled at five anatomical sites (nostrils, corner of mouth, pastern, perineum, and previous infection site) on six to seven occasions or more during approximately 12-18 months. MRSA-specific broth and agar were used for culture. Verified MRSA isolates were spa-typed. The sensitivity of sampling sites was calculated. The most sensitive sampling site was the nostrils, with a sensitivity of 0.91 (95% CI: 0.59-1.00). The other test sites had a sensitivity of 0-0.09. Individual cases tested positive, but with time all tested negative. The observed carriage time ranged from 55 to 711 days (median=143, IQR: 111-172 days), but these data should be interpreted with caution since only a small number of cases were studied. PMID:23428383

  8. PET-CT imaging in patients with chronic sternal wound infections prior to reconstructive surgery: A case series.

    PubMed

    Read, Charlotte; Branford, Olivier A; Verjee, Liaquat S; Wood, Simon H

    2015-08-01

    Late presenting and recurrent sternal wound infections post-sternotomy are difficult to treat, with the clinical picture not necessarily reflecting the underlying problem. As a result of our experience, we suggest that these chronic cases should be managed using a different algorithm to acute sternal wound infection. Positron emission tomography combined with computerized tomography (PET-CT) imaging may be potentially useful in enabling accurate localization of disease sites, which guides adequate debridement prior to definitive reconstruction. It may also allow for disease surveillance and monitoring of the response to antimicrobial treatment. We present three cases which support the need for pre-operative imaging using PET-CT. PMID:25986418

  9. In Vitro Antibacterial Activity of Curcumin-Polymyxin B Combinations against Multidrug-Resistant Bacteria Associated with Traumatic Wound Infections.

    PubMed

    Betts, Jonathan W; Sharili, Amir S; La Ragione, Roberto M; Wareham, David W

    2016-06-24

    Bacterial infections resulting from nonsurgical traumatic wounds can be life threatening, especially those caused by multidrug-resistant (MDR) bacteria with limited therapeutic options. The antimicrobial activity of polymyxin B (1) and curcumin (2) alone and in combination was determined versus MDR bacterial isolates associated with traumatic wound infections. Cytotoxicity assays for 1 and 2 were undertaken in keratinocyte cell lines. Minimum inhibitory concentrations of 1 were significantly reduced in the presence of 2 (3- to 10-fold reduction), with synergy observed. Time-kill assays showed the combinations produced bactericidal activity. Cytotoxicity assays indicate the toxicity of 2 was reduced in the presence of 1. PMID:27295561

  10. Diffuse lymphatic leakage after continuous vacuum-assisted closure therapy for thoracic wound infection after rib stabilization.

    PubMed

    Dackam, Sandrine; Furrer, Katarzyna; Haug, Martin; Lardinois, D

    2015-01-01

    Vacuum-assisted closure (VAC) therapy is a useful tool in the management of a wide spectrum of complex wounds in cardiothoracic surgery. It promotes healing through the application of a controlled and localized negative pressure on porous polyurethane absorbent foams. Known advantages of the VAC therapy are the acceleration of wound healing, stimulation of granulation tissue and reduced tissue edema. Despite its excellent properties, some related complications after and during the therapy have been reported. We report the case of a 47-year-old female with a thoracic wound infection after rib stabilization, managed with open surgery and VAC therapy, which was complicated by a diffuse lymphatic leakage. This is the first case described of diffuse lymphatic leakage followed by partial necrosis of the breast after continuous VAC therapy. We recommend the application of a lower pressure level of this device for complex wounds of the chest wall near the breast. PMID:26675995

  11. The use of gentamicin-PMMA chains in abdominal surgery: a pilot study of prophylaxis against wound infection.

    PubMed

    Aubrey, D A; Jenkins, N H; Morgan, W P; Thomas, M

    1986-01-01

    A prospective study was carried out to examine the effectiveness of gentamicin-impregnated polymethylmethacrylate beads in the prevention of wound sepsis after gastro-intestinal surgery. The beads were laid in the abdominal and perineal incisions (61 wounds) of 55 patients at the end of the operative procedures, and were withdrawn in stages from the fifth post-operative day. This method of administration results in a sustained high antibiotic concentration in the wound with low serum and urine concentrations, thus eliminating the dangers of gentamicin toxicity. Wound infection occurred in only 1 instance, a favourable result when compared to historical controls. It is suggested that further controlled studies of this method of topical prophylactic antibiotic administration are indicated. PMID:3714759

  12. Dual delivery of chlorhexidine and platelet-derived growth factor-BB for enhanced wound healing and infection control.

    PubMed

    Jiang, Bin; Zhang, Gehan; Brey, Eric M

    2013-02-01

    Wound treatment can require molecules that both enhance healing and control infection. As in many biomedical applications, the options for therapeutic molecules may include both hydrophilic and hydrophobic molecules. The goal of this study was to investigate a polymer system for drug delivery that simultaneously delivers platelet-derived growth factor (PDGF)-BB, a hydrophilic protein known to promote wound healing, and chlorhexidine (CHX), a hydrophobic antimicrobial agent for infection treatment. Poly(lactic-co-glycolic acid) (PLGA) microspheres were prepared using different polymer formulations in a double emulsion process. CHX encapsulation efficiency was 19.6±0.8% and 28.9±1.5% for PLGA 50:50 and 85:15, respectively. The presence of CHX significantly increased PDGF-BB encapsulation efficiency relative to PDGF-BB alone. Both molecules could be released for up to 50 days and exhibited bioactivity for greater than 3 (PLGA 85:15) or 8 (PLGA 50:50) weeks using in vitro bacteria and cellular assays. An infected wound model was used to evaluate the system in vivo. Wounds treated with the dual delivery system showed decreased levels of infection and increased healing. Vascular analysis of wound tissues also showed higher levels of mature vasculature with the delivery of PDGF-BB. In conclusion, we have evaluated a drug delivery system for simultaneous delivery of hydrophobic and hydrophilic molecules and have shown that this system can improve healing and reduce bacteria levels in an infected wound model. This system could be applied to other therapeutic applications where sustained delivery of hydrophobic and hydrophilic molecules is required. PMID:23063555

  13. Serum Neopterin and Procalcitonin Levels in Relationship with Pediatric Burn Wound Infections.

    PubMed

    Pilanci, Ozgur; Ergin, Sevgi; Sirekbasan, Serhat; Ersin, Idris; Habip, Zafer; Yuksel, Pelin; Kuvat, Nuray; Aslan, Mustafa; Dinc, Oyku; Saribas, Suat; Kocazeybek, Bekir

    2016-03-01

    Infection and septic complications in burn patients can be monitored by procalcitonin (PCT) and neopterin plasma values. The aim of the study was to investigate serum neopterin and PCT levels with WBC (white blood cell) and CRP (C-reactive protein) levels in patient group (PG) and healthy control group (HCG) and to investigate the relationship of these markers with burn wound infections (BWI). As the PG, 23 patients between 0-12 ages and up to 30% Total Body Surface Area (TBSA) burned and 15 HCG were included. PCT, neopterin, WBC, and CRP results on the first, the seventh, the fourteenth and the 21st day have been compared. During the follow-up period, 11 patients with BWI and 12 patients without BWI were classified as infected and non-infected patients, respectively. PCT and neopterin levels were detected higher in patients with BWI but no significant difference were present. Also, PCT and neopterin levels within the first 24 hours following the burn were detected higher in PG than HCG. CRP and WBC levels were detected high due to burn trauma. PCT and neopterin levels were increased in patients with BWI. PCT levels were increased during the pre-infectious period, while neopterin levels increased during the post-infectious period. PMID:27020868

  14. An update review on risk factors and scales for prediction of deep sternal wound infections.

    PubMed

    Buja, Alessandra; Zampieron, Alessandra; Cavalet, Sara; Chiffi, Daniele; Sandonà, Paolo; Vinelli, Angela; Baldovin, Tatjana; Baldo, Vincenzo

    2012-08-01

    Surgical site infections are the most common nosocomial infections in surgical patients. The preventable and the unmodifiable risk factors for deep sternal wound infections (DSWI) have been amply assessed in the literature. The aim of this review was to describe the results of the numerous published studies to describe all the DSWI risk factors and the scales devised to predict SWI, with a view to providing an update on this issue. A comprehensive search of the Medline and Embase databases was performed (considering studies from January 1995 to April 2011); and a manual search was also conducted using references cited in original publications and relevant review articles. There are several risk factors associated with DSWI, which could be classified in four categories as demographic (e.g. sex and age), behavioural (e.g. smoking and obesity), baseline clinical conditions (e.g. diabetes, hypertension and COPD) and surgical operative risk factors (e.g. duration of operation and emergency operation). Six scales for predicting the risk of DSWI are described in the literature: they vary not only in accuracy but also in ease of application and they are applied at different times (some only preoperatively and others also postoperatively). This study provides a broad update on our knowledge of the risk factors for DSWI and the scales for prediction with a view to improving the management of infections at cardiosurgery units. PMID:22151350

  15. 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

  16. Phospholipid structured microemulsion as effective carrier system with potential in methicillin sensitive Staphylococcus aureus (MSSA) involved burn wound infection.

    PubMed

    Chhibber, Tanya; Wadhwa, Sheetu; Chadha, Parul; Sharma, Gajanand; Katare, Om Prakash

    2015-12-01

    Burn wounds are foremost site for bacterial colonization and multiplication. Staphylococcus aureus is one of the most predominant pathogen found in burn wounds. Fusidic acid (FA) is widely employed in the treatment of complicated skin infections caused by Staphylococcus aureus. Hence, the aim of this study was to investigate the usefulness and efficacy of topical FA (2% w/w) loaded biocompatible microemulsion-based-system (FA-ME) in eradicating MSSA bacterial infections which otherwise was less effective when dealt with conventional formulations. For construction of pseudoternary phase diagram, ratio of oil (IPM):water:Smix is 20:30:50% w/w and proportion of Smix (Phospholipid:Tween 80 (T80):Ethanol) is in the ratio of 1:2:1, respectively. The hypothesis relates here to the role of phospholipids as part of the nano-scale structure of microemulsion systems to overcome the hurdles of drug delivery. The prepared FA-ME system was evaluated for its therapeutic efficacy and carrier-specific characteristics such as globule size, % transmittance, transmission electron microscopy, drug content and stability. Selected microemulsion system was incorporated into gel form and evaluated for texture analysis, drug permeation in 24 h and treatment of burn wounds. Burn wound infection was established with MSSA ATCC 25923 in BALB/c mice and the process of wound healing as well as bacterial loading in the wound was estimated. The developed nanosized FA-ME system demonstrated improved wound healing, better spreadability and enhanced therapeutic efficacy due to the changes in the behavior of the drug molecules by way of carrier-characteristics. PMID:26004269

  17. Enhanced efficacy and anti-biofilm activity of novel nanoemulsions against skin burn wound multi-drug resistant MRSA infections.

    PubMed

    Song, Zhen; Sun, Hongwu; Yang, Yun; Jing, Haiming; Yang, Liuyang; Tong, Yanan; Wei, Chao; Wang, Zelin; Zou, Quanming; Zeng, Hao

    2016-08-01

    Multi-drug resistant MRSA (methicillin-resistant Staphylococcus aureus) is a global problem for human health, especially skin burn wound patients. Therefore, we estimated the antibacterial and anti-biofilm activity of a chlorhexidine acetate nanoemulsion (CNE) by previously ourselves designed against skin burn wound MRSA infections. Compared with its water solution (CHX), CNE showed a better and faster action against MRSA both in vitro and in vivo. Importantly, CNE was more effective at inhibiting biofilm formation and clearing the biofilm. We also found that the cell walls and membranes of MRSA were severely disrupted after treatment with CNE. Moreover, the relative electrical conductivity and the leakage of alkaline phosphates, K(+), Mg(2+), DNA and protein obviously increased because the cell wall and membrane were damaged. These data show that novel CNE is a promising potential antimicrobial candidate, especially for skin burn wound MRSA infections. PMID:26961464

  18. [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

  19. Topical silver treatment after escharectomy of infected full thickness burn wounds in rats.

    PubMed

    Chu, Chi-Sing; McManus, Albert T; Mason, Arthur D; Pruitt, Basil A

    2005-05-01

    White male Sprague Dawley rats (200 g.) with 20% full thickness scald burns seeded with 10 Pseudomonas aeruginosa, strain 59-1244, were used as experimental animals. Studies including the following: (1). Control groups. (2). DC pretreatment groups. (3). Treatment groups. P. aeruginosa infected burn wounds were excised, and then treated with either autograft or silver-nylon dressings, with (SNDC) or without (SN) application direct current. Excision and treatment were initiated 1, 2, 3, 4 or 5 days after burning and inoculation. (4). Groups for antimicrobial barrier function study. Mortality of each group was recorded at 21 days PB. With burns alone, there was no mortality. Without treatment 19 of 20 burn inoculated controls died. In the pretreatment study, the mortality of the group pretreated with SN was 95% while that of the group pretreated with SNDC was only 30%. With excision and autografting, PB mortality rose from 5/20 at day 2 PB to 19/20 at day 3 PB. In the excision and SN groups, mortality rose from 5/20 at day 3 PB to 18/20 at day 4 PB. In the excision and SNDC groups, mortality rose from 5/20 at day 3 PB to 18/20 at day 4 PB. In the antimicrobial barrier function study, the 10% mortality in the SN dressing group was significantly less than that of 95% in the plain nylon dressed group. Histologic examination revealed progressively deepening colonization of non-viable wound tissue, progressing to invasion of underlying viable tissue by PB day 4. With wound excision, SN, SNDC, and autografting were equally protective for the first two days, but only SN and SNDC extended this effect to the third PB day. In conclusion, SN and SNDC have a strong local anti-microbial effect on the burn wound when applied within 72 hours of the time of bacterial inoculation, but little effect if applied after the bacteria have invaded unburned vessels and viable tissue adjacent to the burn. PMID:15920422

  20. Tyrothricin--An underrated agent for the treatment of bacterial skin infections and superficial wounds?

    PubMed

    Lang, C; Staiger, C

    2016-06-01

    The antimicrobial agent tyrothricin is a representative of the group of antimicrobial peptides (AMP). It is produced by Bacillus brevis and consists of tyrocidines and gramicidins. The compound mixture shows activity against bacteria, fungi and some viruses. A very interesting feature of AMPs is the fact, that even in vitro it is almost impossible to induce resistances. Therefore, this class of molecules is discussed as one group that could serve as next generation antibiotics and overcome the increasing problem of bacterial resistances. In daily practice, the application of tyrothricin containing formulations is relatively limited: It is used in sore throat medications and in agents for the healing of infected superficial and small-area wounds. However, due to the broad spectrum antimicrobial activity and the low risk of resistance development it is worth to consider further fields of application. PMID:27455547

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

    PubMed Central

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

    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 efficacious 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. PMID:17065626

  2. ‘This wound has spoilt everything’: emotional capital and the experience of surgical site infections

    PubMed Central

    Brown, Brian; Tanner, Judith; Padley, Wendy

    2014-01-01

    In this article we explore the experience of suffering from a surgical site infection, a common complication of surgery affecting around 5 per cent of surgical patients, via an interview study of 17 patients in the Midlands in the UK. Despite their prevalence, the experience of surgical site infections has received little attention so far. In spite of the impairment resulting from these iatrogenic problems, participants expressed considerable stoicism and we interpret this via the notion of emotional capital. This idea derives from the work of Pierre Bourdieu, Helga Nowotny and Diane Reay and helps us conceptualise the emotional resources accumulated and expended in managing illness and in gaining the most from healthcare services. Participants were frequently at pains not to blame healthcare personnel or hospitals, often discounting the infection's severity, and attributing it to chance, to ‘germs’ or to their own failure to buy and apply wound care products. The participants' stoicism was thus partly afforded by their refusal to blame healthcare institutions or personnel. Where anger was described, this was either defused or expressed on behalf of another person. Emotional capital is associated with deflecting the possibility of complaint and sustaining a deferential and grateful position in relation to the healthcare system. PMID:25470322

  3. The use of desiccation to treat Staphylococcus aureus biofilm-infected wounds.

    PubMed

    Park, Eugene; Long, Sarah A; Seth, Akhil K; Geringer, Matthew; Xu, Wei; Chavez-Munoz, Claudia; Leung, Kai; Hong, Seok Jong; Galiano, Robert D; Mustoe, Thomas A

    2016-03-01

    Chronic wounds colonized with biofilm present a major burden to our healthcare system. While the current paradigm for wound healing is to maintain a moist environment, we sought to evaluate the effects of desiccation, and the ability of honey to desiccate wounds, on wound healing characteristics in Staphylococcus aureus biofilm wounds. In vivo biofilm wound healing after exposure to open-air desiccation, honey, molasses, and saline was analyzed using a rabbit ear model of S. aureus biofilm wounds previously developed by our group. Wound morphology was examined using scanning electron microscopy and granulation tissue deposition was measured using light microscopy with hematoxylin and eosin staining. Viable bacterial counts in rabbit ear biofilm wounds and scabs were measured using a drop dilution method. In vitro S. aureus growth curves were established using tryptic soy broth containing honey and glycerol. Gene expression analysis of rabbit ear wounds was performed using reverse transcription quantitative PCR. Rabbit ear S. aureus biofilm wounds exposed to open-air desiccation, honey, and molasses developed a dry scab, which displaced the majority of biofilm bacteria off of the wound bed. Wounds treated with open-air desiccation, honey, and molasses expressed lower levels of the inflammatory markers tumor necrosis factor-α and interleukin-1β at postoperative day 12 compared with wounds treated with saline, and had increased levels of granulation tissue formation. In vitro growth of S. aureus in tryptic soy broth was inhibited by the presence of honey to a greater extent than by the presence of osmolality-matched glycerol. Desiccation of chronic wounds colonized with biofilm via exposure to open air or honey leads to improved wound healing by decreasing bacterial burden and inflammation, and increasing granulation tissue formation. The ability of honey to help heal chronic wounds is at least in part due to its ability to desiccate bacterial biofilm, but other

  4. Effects of phosphate supplementation on Pseudomonas aeruginosa invasive behavior in burn wound infections: A simple approach to a big problem.

    PubMed

    Mohammadi-Samani, Soliman; Kouroshfard, Shahriyar; Azarpira, Negar

    2016-03-01

    This study was designed to investigate the effect of inorganic phosphate supplementation on invasive behavior of Pseudomonas aeruginosa in burn wound infections. An emulsion-based lotion containing sodium dihydrogen phosphate was formulated and then 50 female Sprague-Dawley rats with burn wounds were used to assess the effect of phosphate supplementation on swarming motility of P. aeruginosa. On the second day after burn, four groups of rats were inoculated with P. aeruginosa and one group was left as negative control. The treatment was started on day 3 and the animals were followed up for 4 weeks. Significant improvement in wound healing was observed in the phosphate-receiving group after the 4-week follow-up, compared to the negative control, positive control, and silver sulfadiazine-receiving groups. Histopathological assessment of the tissue samples also indicated the healing process in phosphate-enriched lotion receiving group. The results showed that inorganic phosphate supplementation results in alteration of the virulence behavior of P. aeruginosa and improvement in the wound healing process. In conclusion, phosphate supplementation would be a rational strategy in the eradication of P. aeruginosa wound infection. PMID:26787129

  5. Polyvinyl alcohol nanofiber formulation of the designer antimicrobial peptide APO sterilizes Acinetobacter baumannii-infected skin wounds in mice.

    PubMed

    Sebe, Istvan; Ostorhazi, Eszter; Fekete, Aron; Kovacs, Krisztian N; Zelko, Romana; Kovalszky, Ilona; Li, Wenyi; Wade, John D; Szabo, Dora; Otvos, Laszlo

    2016-01-01

    Native and designer cationic antimicrobial peptides are increasingly acknowledged as host defense molecules rather than true antimicrobials. Due to their ability to activate the innate immune system, these structures are used to treat uninfected and bacterially-infected wounds, including those harboring Acinetobacter baumannii. Previously we documented that when administered intramuscularly or topically in liquid formulations, the proline-rich host defense peptide dimer A3-APO accelerates uninfected wound re-epithelization and eliminates systemic and local A. baumannii, methicillin-resistant Staphylococcus aureus and other pathogen load from infected lesions better than conventional antibiotics. In the current study we sought to produce and characterize a novel delivery system, suitable for immediate and convenient application in non-hospital environments. The APO monomer was incorporated into polyvinyl alcohol nanofibers and the complex was polymerized into a solid patch dressing. Mice were subjected to skin abrasion where the wounds were either left uninfected or were inoculated with a near lethal dose of multidrug resistant A. baumannii strain. Analyzed after 3 days, APO monomer-containing patches improved wound appearance significantly better than polymer patches without antibiotics. When compared to colistin, the APO patches accelerated wound healing, and statistically significantly reduced wound size and wound bacterial load. The in vivo antimicrobial effect was more extensive than after intramuscular administration of the peptide drug, by using only one tenth of the active pharmaceutical ingredient. These data suggest that the APO monomer-impregnated nanofiber dressing can be developed as an economical first-line treatment option to skin injuries in general and battlefield burn and blast injuries in particular. PMID:26319645

  6. Povidone-iodine: an adjunct in the treatmen of wound infections, dehiscences, and fistulas in head and neck surgery.

    PubMed

    Dedo, D D; Alonso, W A; Ogura, J H

    1977-01-01

    Extensive research has been done to elucidate the cellular and biochemical events of a healing wound. Similarly, new techniques are continually being investigated which would stimulate and augment the reparative process. This paper describes the uses and biochemistry of povidone-iodine which has gained widespread acceptance as a surgical preparation. However, its use as a topical agent for treating head and neck wound infections, dehiscences, and salivary fistulas has gained little recognition. Povidone-iodine is a unique compound formed by binding free iodine to polyvinylpyrrolidone. Previously, the toxic effects of iodine limited its use to preparation of the skin for surgery. When bound to the pyrrolidine molecule, iodine becomes water soluble and markedly less toxic. As a result, the broad antimicrobial spectrum of iodine may be used topically to control wound sepsis. It can be applied to mucosal surfaces without producing burns. The brown color acts as an indicator of its clinical effectiveness. When the dressings become light yellow or pale, free iodine is no longer being released and the dressing should be changed. Povidone-iodine is not a panacea for correcting interruption in the healing process during the postoperative period. The basic management of wound infections, dehiscences, and fistulas remains unchanged. Incision and drainage, debridement and flap contracture, lateralization, and diversion are necessary to initiate the healing process. Familarity with each phase of healing provides the basis for managing each of these surgical problems. Topical povidone-iodine not only controls wound sepsis but augments wound healing. The physiologic correlation with each phase of wound healing for these various surgical problems is elaborated and clinical cases presented. PMID:857382

  7. Enzyme-responsive nanocomposites for wound infection prophylaxis in burn management: in vitro evaluation of their compatibility with healing processes

    PubMed Central

    Grützner, Verena; Unger, Ronald E; Baier, Grit; Choritz, Lars; Freese, Christian; Böse, Thomas; Landfester, Katharina; Kirkpatrick, C James

    2015-01-01

    Responsive, theranostic nanosystems, capable of both signaling and treating wound infections, is a sophisticated approach to reduce the most common and potentially traumatizing side effects of burn wound treatment: slowed wound healing due to prophylactic anti-infective drug exposure as well as frequent painful dressing changes. Antimicrobials as well as dye molecules have been incorporated into biodegradable nanosystems that release their content only in the presence of pathogens. Following nanocarrier degradation by bacterial enzymes, any infection will thus emit a visible signal and be effectively treated at its source. In this study, we investigated the effect of fluorescent-labeled hyaluronan nanocapsules containing polyhexanide biguanide and poly-L-lactic acid nanoparticles loaded with octenidine on primary human dermal microvascular endothelial cells, which play a major role in cutaneous wound healing. Microscopic and flow cytometric analysis indicated a time-dependent uptake of both the nanocapsules and the nanoparticles. However, enzyme immunoassays showed no significant influence on the expression of pro-inflammatory cell adhesion molecules and cytokines by the endothelial cells. Under angiogenic-stimulating conditions, the potential to form capillary-like structures in co-culture with dermal fibroblasts was not inhibited. Furthermore, cytotoxicity studies (the MTS and crystal violet assay) after short- and long-term exposure to the materials demonstrated that both systems exhibited less toxicity than solutions of the antiseptic agents alone in comparable concentrations. The results indicate that responsive antimicrobial nanocomposites could be used as an advanced drug delivery system and a promising addition to current best practice wound infection prophylaxis with few side effects. PMID:26150717

  8. Microbiological study of pathogenic bacteria isolated from paediatric wound infections following the 2008 Wenchuan earthquake.

    PubMed

    Ran, Ying-Chun; Ao, Xiao-Xiao; Liu, Lan; Fu, Yi-Long; Tuo, Hui; Xu, Feng

    2010-05-01

    On 12 May 2008, the Wenchuan earthquake struck in Sichuan, China. Within 1 month after the earthquake, 98 injured children were admitted to the Children's Hospital of Chongqing Medical University. According to clinical manifestations, 50 children were diagnosed with wound infections. Wound secretions were cultured for bacteria. Pathogen distribution and drug resistance were analyzed. A total of 99 pathogens were isolated; 16 (16%) were Gram-positive bacteria and 81 (82%) were Gram-negative bacteria. The distribution of pathogens isolated within 1 month after the earthquake was different to the distribution of pathogens in 546 general hospitalized cases in the y before the earthquake. The pathogens most frequently isolated 1 month after the earthquake were Acinetobacter baumannii (27%), Enterobacter cloacae (18%) and Pseudomonas aeruginosa (13%). The pathogens most frequently isolated in the y prior to the earthquake were Escherichia coli (27%), Staphylococcus aureus (23%) and coagulase-negative staphylococci (9%). The rate of isolated drug-resistant bacteria was higher in the earthquake cases than in the general hospitalized cases. In the cases injured in the earthquake, the rates of isolation of methicillin-resistant Staphylococcus aureus and extended-spectrum beta-lactamase-producing E. cloacae, E. coli and Klebsiella pneumoniae were higher than in the cases from before the earthquake. Multidrug-resistant and pandrug-resistant A. baumannii were isolated at a higher rate in cases after the earthquake than in those before the earthquake. These changes in the spectrum of pathogens and in the drug resistance of the pathogens isolated following an earthquake will provide the basis for emergency treatment after earthquakes. PMID:20095936

  9. A Prospective Randomized Trial of Open Wound Treatment vs Occlusive Dressings in Elective Surgical Cases with Respect to Surgical Site Infections

    PubMed Central

    Grover, Anmol; Sidhu, D S

    2015-01-01

    Background Surgical wounds heal by primary intention in all the elective and emergency surgical procedures. Current practice is to place dressing over the closed wound before the patient leaves the sterile environment of the operating theatre. Dressing is a material applied to protect a wound and favour its healing. However, to leave wound open in direct contact to environment following any procedure by just applying some ointment on it, the so called open wound treatment is still controversial one. In the present study we have compared open wound treatment vs occlusive dressings in elective surgical cases with respect to surgical site infections. Materials and Methods The present study was conducted on 100 patients admitted for elective general surgery after taking written informed consent. Patients were divided randomly in to two equal groups each comprising of 50 patients. In Group A, patients had occlusive dressing till removal of stitches and in Group B, patients wounds were kept exposed to environment after the surgical procedure. Results In present study we observed total 7% of postoperative wounds were infected of all the clean and clean contaminated wounds we studied. In Group A, patients had occlusive dressing and these patients had 8% infection rate whereas in Group B patients, wounds were kept exposed to environment and these patients had 6% infection rate. Conclusion It is hereby concluded that in the elective surgical cases there is no harm in leaving the wounds open postoperatively. This method not only helps in arresting the infective pathology at a lesser stage but also saves surgeon’s time and patient’s money. PMID:26266164

  10. 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

  11. Sternal wound infection after cardiac surgery: incidence and risk factors according to clinical presentation.

    PubMed

    Lemaignen, A; Birgand, G; Ghodhbane, W; Alkhoder, S; Lolom, I; Belorgey, S; Lescure, F-X; Armand-Lefevre, L; Raffoul, R; Dilly, M-P; Nataf, P; Lucet, J C

    2015-07-01

    The incidence of surgical site infection (SSI) after cardiac surgery depends on the definition used. A distinction is generally made between mediastinitis, as defined by the US Centers for Disease Control and Prevention (CDC), and superficial SSI. Our objective was to decipher these entities in terms of presentation and risk factors. We performed a 7-year single centre analysis of prospective surveillance of patients with cardiac surgery via median sternotomy. SSI was defined as the need for reoperation due to infection. Among 7170 patients, 292 (4.1%) developed SSI, including 145 CDC-defined mediastinitis (CDC-positive SSI, 2.0%) and 147 superficial SSI without associated bloodstream infection (CDC-negative SSI, 2.1%). Median time to reoperation for CDC-negative SSI was 18 days (interquartile range, 14-26) and 16 (interquartile range, 11-24) for CDC-positive SSI (p 0.02). Microorganisms associated with CDC-negative SSI were mainly skin commensals (62/147, 41%) or originated in the digestive tract (62/147, 42%); only six were due to Staphylococcus aureus (4%), while CDC-positive SSI were mostly due to S. aureus (52/145, 36%) and germs from the digestive tract (52/145, 36%). Risk factors for SSI were older age, obesity, chronic obstructive bronchopneumonia, diabetes mellitus, critical preoperative state, postoperative vasopressive support, transfusion or prolonged ventilation and coronary artery bypass grafting, especially if using both internal thoracic arteries in female patients. The number of internal thoracic arteries used and factors affecting wound healing were primarily associated with CDC-negative SSI, whereas comorbidities and perioperative complications were mainly associated with CDC-positive SSI. These 2 entities differed in time to revision surgery, bacteriology and risk factors, suggesting a differing pathophysiology. PMID:25882356

  12. 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

  13. Microbial profiling of combat wound infection through detection microarray and next-generation sequencing.

    PubMed

    Be, Nicholas A; 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; Jaing, Crystal J

    2014-07-01

    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

  14. 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

  15. 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

  16. Comparative study of the effects of the use of the CO2 laser and of cholorhexidine on the healing of cutaneous wounds infected by the staphylococcus aureus

    NASA Astrophysics Data System (ADS)

    Matos de Oliveira, Marcos A.; Barbosa Pinheiro, Antonio L.; Azevedo Moreira, Ana C.; Pedreira Ramalho, Luciana M.; Brugnera, Aldo, Jr.; Zanin, Fatima A. A.; Costa Lima, Taciano L.

    2003-06-01

    The aim of this study was to compare histologic and microbiogically the use of the CO2 Laser and Chlorohexidine Gluconate (0.5% and 2%) on cutaneous wounds infected by Staphylococcus aureus. Wound infection constitutes a risk for the patients and it is usually associated to increase morbidity, mortality and hospital costs. It is accepted that local treatment of these infections is effective. Standardised wounds created on the dorsum of Wistar rats were infected with Staphylococcus aureus and treated as follows: Group 1: control; Group 2: Chlorohexidien Gluconate (0.5%), 1 min, six days; Group 3: Chlorohexidine Gluconate (2%), 1 min, six days; Group 4: CO2 Laser, CW, RSP, 8W, 10s, single application, maintaining surface debris; Group 5: CO2 Laser, CW, RSP, 8W, 10s, single application, removing surface debris. Eight days after wounding material from the surface of the wound was collected for microbiology and the animals were sacrificed and specimens taken for light microscopy. Microbiological examinations showed that on group 2 the bacteria were not found on 50% of the animals. On group 3 83% were germ-free, on group 4 50% and on group 5 66%. Histological examination showed a better result for CO2 laser treated wounds compared to others. It is concluded that the use of a 2% Cholohexidine solution was more effective on decontaminating the wounds. However, wounds treated with the CO2 laer and with the removal of surface debris healed better than the others.

  17. 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

  18. Dual-functional Polyurea Microcapsules for Chronic Wound Care Dressings: Sustained Drug Delivery and Non-leaching Infection Control

    NASA Astrophysics Data System (ADS)

    He, Wei

    A new design of dual-functional polyurea microcapsules was proposed for chronic wound dressings to provide both non-leaching infection control and sustained topical drug delivery functionalities. Quaternary ammonium functionalized polyurea microcapsules (MCQs) were synthesized under mild conditions through an interfacial crosslinking reaction between branched polyethylenimine (PEI) and 2,4-toluene diisocyanate (TDI) in a dimethylformamide/cyclohexane emulsion. An in-situ modification method was developed to endow non-leaching surface antimicrobial properties to MCQs via bonding antimicrobial surfactants to surface isocyanate residues on the polyurea shells. The resultant robust MCQs with both non-leaching antimicrobial properties and sustained drug releasing properties have potential applications in medical textiles, such as chronic wound dressings, for infection control and drug delivery.

  19. Biobased silver nanocolloid coating on silk fibers for prevention of post-surgical wound infections

    PubMed Central

    Dhas, Sindhu Priya; Anbarasan, Suruthi; Mukherjee, Amitava; Chandrasekaran, Natarajan

    2015-01-01

    Bombyx mori silk fibers are an important biomaterial and are used in surgical sutures due to their remarkable biocompatibility. The major drawback to the application of biomaterials is the risk of bacterial invasion, leading to clinical complications. We have developed an easy and cost-effective method for fabrication of antibacterial silk fibers loaded with silver nanoparticles (AgNPs) by an in situ and ex situ process using an aqueous extract of Rhizophora apiculata leaf. Scanning electron microscopy revealed that well dispersed nanoparticles impregnated the silk fibers both in situ and ex situ. The crystalline nature of the AgNPs in the silk fibers was demonstrated by X-ray diffraction. The thermal and mechanical properties of the silk fibers were enhanced after they were impregnated with AgNPs. The silver-coated silk fibers fabricated by the in situ and ex situ method exhibited more than 90% inhibition against Pseudomonas aeruginosa and Staphylococcus aureus. Silk fibers doped with AgNPs were found to be biocompatible with 3T3 fibroblasts. The results obtained represent an important advance towards the clinical application of biocompatible AgNP-loaded silk fibers for prevention of surgical wound infections. PMID:26491317

  20. Prosthetic Vascular Graft Infections: Bacterial Cultures from Negative-Pressure-Wound-Therapy Foams Do Not Improve Diagnostics.

    PubMed

    Scherrer, Alexandra U; Bloemberg, Guido; Zbinden, Reinhard; Zinkernagel, Annelies S; Fuchs, Claudio; Frauenfelder, Sandra; Rancic, Zoran; Mayer, Dieter; Hasse, Barbara

    2016-08-01

    We analyzed the diagnostic value of microorganisms cultured from negative-pressure-wound-therapy (NPWT) foam samples compared to that of microorganisms cultured from deep tissue samples from patients with vascular graft infections. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 58%, 86%, 81%, and 66%, respectively. The diagnostic value of microbiological cultures from NPWT foams was poor. PMID:27252462

  1. Update and validation of the Society for Vascular Surgery wound, ischemia, and foot infection threatened limb classification system.

    PubMed

    Mills, Joseph L

    2014-03-01

    The diagnosis of critical limb ischemia, first defined in 1982, was intended to delineate a patient cohort with a threatened limb and at risk for amputation due to severe peripheral arterial disease. The influence of diabetes and its associated neuropathy on the pathogenesis-threatened limb was an excluded comorbidity, despite its known contribution to amputation risk. The Fontaine and Rutherford classifications of limb ischemia severity have also been used to predict amputation risk and the likelihood of tissue healing. The dramatic increase in the prevalence of diabetes mellitus and the expanding techniques of arterial revascularization has prompted modification of peripheral arterial disease classification schemes to improve outcomes analysis for patients with threatened limbs. The diabetic patient with foot ulceration and infection is at risk for limb loss, with abnormal arterial perfusion as only one determinant of outcome. The wound extent and severity of infection also impact the likelihood of limb loss. To better predict amputation risk, the Society for Vascular Surgery Lower Extremity Guidelines Committee developed a classification of the threatened lower extremity that reflects these important clinical considerations. Risk stratification is based on three major factors that impact amputation risk and clinical management: wound, ischemia, and foot infection. This classification scheme is relevant to the patient with critical limb ischemia because many are also diabetic. Implementation of the wound, ischemia, and foot infection classification system in critical limb ischemia patients is recommended and should assist the clinician in more meaningful analysis of outcomes for various forms of wound and arterial revascularizations procedures required in this challenging, patient population. PMID:25812755

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

    PubMed Central

    Calvert, Melanie; Bartlett, David C; Gheorghe, Adrian; Redman, Val; Dowswell, George; Hawkins, William; Mak, Tony; Youssef, Haney; Richardson, Caroline; Hornby, Steven; Magill, Laura; Haslop, Richard; Wilson, Sue; Morton, Dion

    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

  3. A genetic approach to the development of new therapeutic phages to fight pseudomonas aeruginosa in wound infections.

    PubMed

    Krylov, Victor; Shaburova, Olga; Krylov, Sergey; Pleteneva, Elena

    2013-01-01

    Pseudomonas aeruginosa is a frequent participant in wound infections. Emergence of multiple antibiotic resistant strains has created significant problems in the treatment of infected wounds. Phage therapy (PT) has been proposed as a possible alternative approach. Infected wounds are the perfect place for PT applications, since the basic condition for PT is ensured; namely, the direct contact of bacteria and their viruses. Plenty of virulent ("lytic") and temperate ("lysogenic") bacteriophages are known in P. aeruginosa. However, the number of virulent phage species acceptable for PT and their mutability are limited. Besides, there are different deviations in the behavior of virulent (and temperate) phages from their expected canonical models of development. We consider some examples of non-canonical phage-bacterium interactions and the possibility of their use in PT. In addition, some optimal approaches to the development of phage therapy will be discussed from the point of view of a biologist, considering the danger of phage-assisted horizontal gene transfer (HGT), and from the point of view of a surgeon who has accepted the Hippocrates Oath to cure patients by all possible means. It is also time now to discuss the possible approaches in international cooperation for the development of PT. We think it would be advantageous to make phage therapy a kind of personalized medicine. PMID:23344559

  4. A Genetic Approach to the Development of New Therapeutic Phages to Fight Pseudomonas Aeruginosa in Wound Infections

    PubMed Central

    Krylov, Victor; Shaburova, Olga; Krylov, Sergey; Pleteneva, Elena

    2012-01-01

    Pseudomonas aeruginosa is a frequent participant in wound infections. Emergence of multiple antibiotic resistant strains has created significant problems in the treatment of infected wounds. Phage therapy (PT) has been proposed as a possible alternative approach. Infected wounds are the perfect place for PT applications, since the basic condition for PT is ensured; namely, the direct contact of bacteria and their viruses. Plenty of virulent (“lytic”) and temperate (“lysogenic”) bacteriophages are known in P. aeruginosa. However, the number of virulent phage species acceptable for PT and their mutability are limited. Besides, there are different deviations in the behavior of virulent (and temperate) phages from their expected canonical models of development. We consider some examples of non-canonical phage-bacterium interactions and the possibility of their use in PT. In addition, some optimal approaches to the development of phage therapy will be discussed from the point of view of a biologist, considering the danger of phage-assisted horizontal gene transfer (HGT), and from the point of view of a surgeon who has accepted the Hippocrates Oath to cure patients by all possible means. It is also time now to discuss the possible approaches in international cooperation for the development of PT. We think it would be advantageous to make phage therapy a kind of personalized medicine. PMID:23344559

  5. Methylene Blue-Loaded Dissolving Microneedles: Potential Use in Photodynamic Antimicrobial Chemotherapy of Infected Wounds

    PubMed Central

    Caffarel-Salvador, Ester; Kearney, Mary-Carmel; Mairs, Rachel; Gallo, Luigi; Stewart, Sarah A.; Brady, Aaron J.; Donnelly, Ryan F.

    2015-01-01

    Photodynamic therapy involves delivery of a photosensitising drug that is activated by light of a specific wavelength, resulting in generation of highly reactive radicals. This activated species can cause destruction of targeted cells. Application of this process for treatment of microbial infections has been termed “photodynamic antimicrobial chemotherapy” (PACT). In the treatment of chronic wounds, the delivery of photosensitising agents is often impeded by the presence of a thick hyperkeratotic/necrotic tissue layer, reducing their therapeutic efficacy. Microneedles (MNs) are an emerging drug delivery technology that have been demonstrated to successfully penetrate the outer layers of the skin, whilst minimising damage to skin barrier function. Delivering photosensitising drugs using this platform has been demonstrated to have several advantages over conventional photodynamic therapy, such as, painless application, reduced erythema, enhanced cosmetic results and improved intradermal delivery. The aim of this study was to physically characterise dissolving MNs loaded with the photosensitising agent, methylene blue and assess their photodynamic antimicrobial activity. Dissolving MNs were fabricated from aqueous blends of Gantrez® AN-139 co-polymer containing varying loadings of methylene blue. A height reduction of 29.8% was observed for MNs prepared from blends containing 0.5% w/w methylene blue following application of a total force of 70.56 N/array. A previously validated insertion test was used to assess the effect of drug loading on MN insertion into a wound model. Staphylococcus aureus, Escherichia coli and Candida albicans biofilms were incubated with various methylene blue concentrations within the range delivered by MNs in vitro (0.1–2.5 mg/mL) and either irradiated at 635 nm using a Paterson Lamp or subjected to a dark period. Microbial susceptibility to PACT was determined by assessing the total viable count. Kill rates of >96%, were achieved for

  6. Negative Pressure Wound Therapy on Surgical Site Infections in Women Undergoing Elective Caesarean Sections: A Pilot RCT

    PubMed Central

    Chaboyer, Wendy; Anderson, Vinah; Webster, Joan; Sneddon, Anne; Thalib, Lukman; Gillespie, Brigid M.

    2014-01-01

    Obese women undergoing caesarean section (CS) are at increased risk of surgical site infection (SSI). Negative Pressure Wound Therapy (NPWT) is growing in use as a prophylactic approach to prevent wound complications such as SSI, yet there is little evidence of its benefits. This pilot randomized controlled trial (RCT) assessed the effect of NPWT on SSI and other wound complications in obese women undergoing elective caesarean sections (CS) and also the feasibility of conducting a definitive trial. Ninety-two obese women undergoing elective CS were randomized in theatre via a central web based system using a parallel 1:1 process to two groups i.e., 46 women received the intervention (NPWT PICO™ dressing) and 46 women received standard care (Comfeel Plus® dressing). All women received the intended dressing following wound closure. The relative risk of SSI in the intervention group was 0.81 (95% CI 0.38–1.68); for the number of complications excluding SSI it was 0.98 (95% CI 0.34–2.79). A sample size of 784 (392 per group) would be required to find a statistically significant difference in SSI between the two groups with 90% power. These results demonstrate that a larger definitive trial is feasible and that careful planning and site selection is critical to the success of the overall study.

  7. Negative Pressure Wound Treatment of Infections Caused By Extensively Drug-Resistant Gram-Negative Bacteria After Liver Transplantation: Two Case Reports.

    PubMed

    Dondossola, D; Cavenago, M; Piconi, S; Antonelli, B; Melada, E; Lonati, C; Gatti, S; Rossi, G

    2015-09-01

    Although survival after liver transplantation (LT) has progressively improved over the last years, an increased prevalence of clinically relevant infections in LT patients is well documented. In particular, the spread of infections sustained by extensively drug-resistant bacteria (XDR) produced an increase in the incidence of wound infections. Implementation of treatments for these life-threatening events is mandatory. This study describes 2 LT patients in whom XDR wound infection was effectively treated using negative pressure wound treatment (NPWT) combined with targeted local and systemic antibiotic therapy. Over the last 3 years, 2 of 8 patients with XDR infection admitted to our unit developed wound infection caused by XDR Klebsiella pneumoniae (KP-XDR). Positive results of the abdominal fluid culture and of the wound swab for KP-XDR were followed by sepsis. In both cases wound debridement was required and deep fascial layer dehiscence was detected. Combination antibiotic therapy was administered for sepsis treatment and, after failure of conventional NPWT, a NPWT with local instillation (NPWTi; V.A.C.-Ulta/VeraFlo-Instillation Therapy-KCI USA, Inc., San Antonio, TX, USA) of colistin-rifampicin was applied. After NPWTi application a reduction in bacterial load and exudate was observed with reduction in inflammatory markers. A complete healing of wound was achieved and both patients are currently alive. Instillation and NPWT are widely discussed in the literature. Results of the present study indicate beneficial effects of NPWT combined with targeted local and systemic antibiotic therapy; in both cases a life-threatening complication was cured. We consider local instillation of selected antibiotics applied to NPWTi a valuable tool for deep wound infection sustained by XDR bacteria. PMID:26361664

  8. Beneficial effects of silver foam dressing on healing of wounds with ulcers and infection control of burn patients

    PubMed Central

    Yang, Bo; Wang, Xudong; Li, Zhonghua; Qu, Qi; Qiu, Yan

    2015-01-01

    Objective: To assess the beneficial effects of silver foam dressing on the healing of wounds with ulcers and infection control of burn patients. Methods: Eighty-four second-degree burn patients were selected and divided into a study group and a control group (n=42). After disinfection and cleaning, wound beds of the study group were covered with silver-containing soft-silicone foam dressing, and wound surfaces of the control group were wiped with 1% silver sulfadiazine cream (60 g/100 cm2). The two groups were checked weekly to observe wound healing progress and adverse reactions of the skin around wounds. Wound secretions were collected and subjected to bacterial culture. Related indices were recorded and quantified. Results: Thirty seven cases of the study group (88.1%) and 36 cases of the control group (85.7%) recovered to normal, and 3 (7.1%) and 2 cases (4.8%) in the two groups failed to recover. The recovery rates of the two groups were similar (P>0.05), but unrecovered patients in the study group had significantly higher proportions of repaired wounds (P<0.05). Wounds of the study group were healed significantly more rapidly than those of the control group (22.3±3.1 vs. 25.1±4.4, P<0.05). The study group had significantly higher proportions of repaired wounds from Day 7 to Day 21 (P<0.05), but the difference became less obvious with extended time to Day 28. The bacterial culture-positive (exceeding 105 organisms per gram of tissue) rates of both groups significantly reduced after treatment (Day 7 for the study group and Day 14 for the control group), and the rate of the study group was significantly lower at last (P<0.05). The study and control groups were observed 134 and 149 person-times respectively, with the normal wound-surrounding skin rates of 96.3% (129/134) and 88.6% (132/149) (P>0.05 except for on Day 14). Except for on Day 28, the study group had significantly lower pain scores than those of the control group (P<0.05), especially on Day 7 and

  9. Charts versus Discharge ICD-10 Coding for Sternal Wound Infection Following Coronary Artery Bypass Grafting

    PubMed Central

    Southern, Danielle A.; Doherty, Christopher; De Souza, Michael A.; Quan, Hude; Harrop, A. Robertson; Nickerson, Duncan; Rabi, Doreen

    2015-01-01

    Background Sternal wound infection (SWI) in patients undergoing coronary artery bypass grafting (CABG) can carry a significant risk of morbidity and mortality. The objective of this work is to describe the methods used to identify cases of SWI in an administrative database and to demonstrate the effectiveness of using an International Classification of Diseases, Tenth Revision (ICD-10) coding algorithm for this purpose. Methods ICD-10 codes were used to identify cases of SWI within one year of CABG between April 2002 and November 2009. We randomly chose 200 charts for detailed chart review (100 from each of the groups coded as having SWI and not having SWI) to determine the utility of the ICD-10 coding algorithm. Results There were 2,820 patients undergoing CABG. Of these, 264 (9.4 percent) were coded as having SWI. Thirty-eight cases of SWI were identified by chart review. The ICD-10 coding algorithm of T81.3 or T81.4 was able to identify incident SWI with a positive predictive value of 35 percent and a negative predictive value of 97 percent. The agreement between the ICD-10 coding algorithm and presence of SWI remained fair, with an overall kappa coefficient of 0.32 (95 percent confidence interval, 0.22–0.43). The effectiveness of identifying deep SWI cases is also presented. Conclusions This article describes an effective algorithm for identifying a cohort of patients with SWI following open sternotomy in large databases using ICD-10 coding. In addition, alternative search strategies are presented to suit researchers' needs. PMID:26396556

  10. A case report of the use of nanocrystalline silver dressing in the management of acute surgical site wound infected with MRSA to prevent cutaneous necrosis following revision surgery.

    PubMed

    Bhattacharyya, Mayukh; Bradley, Helen

    2008-03-01

    The authors report the use of nanocrystalline silver (Acticoat 7, Smith and Nephew, London, UK) in an acute surgical wound to prevent localized skin necrosis due to infection, thereby avoiding skin grafting as a secondary procedure. Two patients were successfully treated with Acticoat 7 dressings without using systemic antimicrobials after developing methicillin-resistant Staphylococcus aureus infection in the surgical site. Despite a history of smoking and incision through scar tissues, the wound did not progress into deep infection nor was there recurrence of infection at 2 years follow-up. The intention was to use this particular dressing to assess the effect of silver on infected keratinocytes in an acute wound environment. It is possible that the use of Acticoat 7 may reduce the bacterial loading at the wound site, thereby decreasing a propensity for skin necrosis caused by the infective process. This case report demonstrates that the acute surgical wound with impending cutaneous necrosis due to localized infection may be treated without oral antimicrobials. PMID:18372271

  11. The novel antibacterial drug XF-70 is a potent inhibitor of Staphylococcus aureus infection of the burn wound.

    PubMed

    Hurtuk, Michael G; He, L-K; Szilagyi, Andrea; Gamelli, Richard L; Hecht, David W; Kennedy, Richard H; Rhys-Williams, William; Love, William G; Shankar, Ravi

    2010-01-01

    The authors report the findings of in vivo studies of XF-70 (a novel, dicationic porphyrin) against Staphylococcus aureus in a murine model of a burn wound infection. Mice received a 15% total body scald burn wound, which were inoculated with S. aureus (1.8 x 10 CFU). After 24 hours, escharectomies were performed and groups (n = 8) received single or two doses (6 hours apart) of XF-70* (100 microg/wound) or silver sulfadiazine, Acticoat, or saline applied topically. Viable bacteria were quantified from homogenized burn tissue biopsies and the spleen by plating dilutions onto agar plates and CFU determination. A single dose of XF-70 reduced bacterial burden by 98.77% (untreated: 2.78 +/- 2.96 x 10 CFU/g vs XF-70 treated: 3.4 +/- 0.19 x 10 CFU/g, P < .01). Two XF-70 doses reduced the growth of S. aureus by 99.96% (1.2 +/- 0.6 x 10 CFU/g, P < .01). These results were similar to the results obtained from commonly used topical antibacterials silver sulfadiazine and Acticoat. The spleens of mice treated with saline had a robust growth of S. aureus (7.0 +/- 1.97 x 10 CFU/g) whereas those treated with one or two XF-70 doses grew only 3.5 +/- 0.002 x 10 CFU/g and 5.7 +/- 0.002 x 10 CFU/g, respectively, a significant (P < .001) reduction in S. aureus dissemination. Single and multiple doses of XF-70 were effective in controlling S. aureus growth in burn wounds and inhibited systemic dissemination of S. aureus. Early treatment of burn wounds with XF-70 may be effective in slowing bacterial dissemination to other tissues. PMID:20453736

  12. Post-bariatric abdominoplasty resulting in wound infection and dehiscence—Conservative treatment with medical grade honey: A case report and review of literature

    PubMed Central

    Dina Jarjis, Reem; Thomas Crewe, Bjørn; Henrik Matzen, Steen

    2016-01-01

    Introduction Wound complications in post-bariatric patients undergoing body-contouring surgery after massive weight loss are not uncommon and often, surgical debridement or conservative management is necessary. Honey is one of the most ancient remedies for wound care and it is also considered to possess debriding effects. Current research has demonstrated promising results showing that honey can improve wound granulation and epithelialization, reduce exudate and shorten healing times. Methods This case report has been reported in line with the CARE criteria. Presentation of case A 40 year-old female suffered wound infection and dehiscence after undergoing post-bariatric abdominoplasty. The patient was not interested in surgical revision and split skin grafting. Therefore, conservative wound treatment with topical Manuka honey was instituted resulting in significant clinical improvement and effective healing concurrently with good patient satisfaction. Discussion Surgical wound complications in post-bariatric patients undergoing abdominoplasty are common and often require surgical revision or conservative wound treatment. No previous publication has addressed outpatient treatment of post-bariatric abdominoplasty wound complications with medical grade honey. Conclusion Although more research is needed for definitive conclusions of honey’s efficacy, it is safe and as presented in our case, it may under certain circumstances reduce the need of surgical wound debridement and serve as a remedy for conservative treatment. PMID:26773204

  13. [Importance of modern treatment procedures for infected and colonized wounds in dermatology].

    PubMed

    Daeschlein, G; Lutze, S; Arnold, A; von Podewils, S; Jünger, M

    2014-11-01

    In the coming years increasing numbers of patients with chronic ulcers and tumor wounds are to be expected, both of which are typically multifaceted diseases requiring complex and increasingly long-term ambulatory therapy. Therefore, in recent years special medical emphasis has been placed on efficacious therapies with good tolerability and also suitability regarding feasibility for outpatient treatment. Some of these methods, such as cold plasma therapy, extracorporeal shock wave therapy (ESWT), water-filtered infrared therapy (wIRA), electrostimulation (ES) and low level laser therapy (LLLT) have a good chance of success when applied as an adjuvant method in the multimodal treatment concept for patients with recalcitrant wounds. All of these methods have at least indirect antimicrobial properties which can be advantageous in cases of microbial infiltration of wounds. As for all other methods for treating recalcitrant wounds, the promising application of the aforementioned methods requires great expertise in wound healing together with a broad and continuous interdisciplinary diagnostics and therapy (wound center). PMID:25336295

  14. Synergistic Antibacterial Activity of Plant Peptide MBP-1 and Silver Nanoparticles Combination on Healing of Infected Wound Due to Staphylococcus aureus

    PubMed Central

    Salouti, Mojtaba; Mirzaei, Fatemeh; Shapouri, Reza; Ahangari, Azam

    2016-01-01

    Background: Wound infection is a common problem in hospitals and is typically caused by the antibiotic-resistant Staphylococcus aureus, which is a major pathogen for skin and soft tissue infections worldwide. Objectives: The aim of this study was to investigate the synergistic antibacterial effect of plant peptide MBP-1 and silver nanoparticles on infected wounds caused by S. aureus. Materials and Methods: The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of MBP-1 and silver nanoparticles both on their own and in combination form were determined against S. aureus via macrodilution and microdilution methods. The synergistic antibacterial effect of silver nanoparticles and MBP-1 was investigated on infected wounds caused by S. aureus in a mouse model. Results: The MIC and MBC of MBP-1 were found to be 0.6 and 0.7 mg/mL, respectively. MIC and MBC of silver nanoparticles were determined to be 6.25 and 12.5 mg/L, respectively. MIC and MBC of the silver nanoparticles and MBP-1 combination were found to be 3.125 mg/mL, 0.5 mg/L; and 6.25 mg/mL, 0.6 mg/L, respectively. The infected wound healed properly after the combined use of MBP-1 and silver nanoparticles. Conclusions: The synergistic effect was found on the healing of infected wounds caused by S. aureus by using an MBP-1 and silver nanoparticles combination in a mouse model. PMID:27099683

  15. A retrospective study of deep sternal wound infections: clinical and microbiological characteristics, treatment, and risk factors for complications.

    PubMed

    Chan, Monica; Yusuf, Erlangga; Giulieri, Stefano; Perrottet, Nancy; Von Segesser, Ludwig; Borens, Olivier; Trampuz, Andrej

    2016-03-01

    Deep sternal wound infection (DSWI) is a feared complication following cardiac surgery. This study describes clinical, microbiological, and treatment outcomes of DSWI and determines risk factors for complications. Of 55 patients with DSWI, 66% were male and mean age was 68.2years. Initial sternotomy was for coronary artery bypass graft in 49% of patients. Sternal debridement at mean 25.4±18.3days showed monomicrobial (94%), mainly Gram-positive infection. Secondary sternal wound infection (SSWI) occurred in 31% of patients, was mostly polymicrobial (71%), and was predominantly due to Gram-negative bacilli. Risk factors for SSWI were at least 1 revision surgery (odds ratio [OR] 4.8 [95% confidence interval {CI} 1.0-22.4], P=0.047), sternal closure by muscle flap (OR 4.6 [1.3-16.8], P=0.02), delayed sternal closure (mean 27 versus 14days, P=0.03), and use of vacuum-assisted closure device (100% versus 58%, P=0.008). Hospital stay was significantly longer in patients with SSWI (69days versus 48days, P=0.04). PMID:26707065

  16. Porous CS based membranes with improved antimicrobial properties for the treatment of infected wound in veterinary applications.

    PubMed

    Tonda-Turo, C; Ruini, F; Argentati, M; Di Girolamo, N; Robino, P; Nebbia, P; Ciardelli, G

    2016-03-01

    Recently, much attention has been given to the use of innovative solution for the treatment of infected wounds in animals. Current applied treatments are often un-effective leading to infection propagation and animal death. Novel engineered membranes based on chitosan (CS) can be prepared to combine local antimicrobial effect, high flexibility and easy manipulation. In this work, CS crosslinked porous membranes with improved antimicrobial properties were prepared via freeze-drying technique to promote wound healing and to reduce the bacterial proliferation in infected injuries. Silver nanoparticles (AgNPs) and gentamicin sulfate (GS) were incorporated into the CS matrices to impart antibacterial properties on a wild range of strains. CS based porous membranes were tested for their physicochemical, thermal, mechanical as well as swelling and degradation behavior at physiological condition. Additionally, GS release profile was investigated, showing a moderate burst effect in the first days followed by a decreasing release rate which it was maintained for at least 56 days. Moreover, porous membranes loaded with GS or AgNPs showed good bactericidal activity against both of Gram-positive and Gram-negative bacteria. The bacterial strains used in this work were collected in chelonians after carapace injuries to better mimic the environment after trauma. PMID:26706548

  17. 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

    Hundenborn, Jörg; Thurig, Steffi; Kommerell, Mechthild; Haag, Heike; Nolte, Oliver

    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

  18. 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

  19. Contamination of an operating theatre by Gram-negative bacteria. Examination of water supplies, cleaning methods and wound infections

    PubMed Central

    Thomas, Mair E. M.; Piper, Elizabeth; Maurer, Isobel M.

    1972-01-01

    This paper describes a search for Gram-negative bacteria in an operating theatre and the steps taken to reduce the level of environmental contamination. A high rate of infection in clean wounds prompted a bacteriological survey. Potential sources of infection found, and the measures employed are described in the hope that others may be encouraged to examine familiar equipment critically and to improve hygiene even in old premises. The choice, design, use and care of cleaning and sterilizing equipment were open to criticism. In particular, a currently popular floor-scrubbing machine provided a breeding ground for Pseudomonas aeruginosa and was distributing it in the theatre environment. ImagesPlate 1 PMID:4622481

  20. Aloe vera Gel: Effective Therapeutic Agent against Multidrug-Resistant Pseudomonas aeruginosa Isolates Recovered from Burn Wound Infections

    PubMed Central

    Goudarzi, Mehdi; Fazeli, Maryam; Azad, Mehdi; Seyedjavadi, Sima Sadat; Mousavi, Reza

    2015-01-01

    Objective. Aloe vera is an herbal medicinal plant with biological activities, such as antimicrobial, anticancer, anti-inflammatory, and antidiabetic ones, and immunomodulatory properties. The purpose of this study was investigation of in vitro antimicrobial activity of A. vera gel against multidrug-resistant (MDR) Pseudomonas aeruginosa isolated from patients with burn wound infections. Methods. During a 6-month study, 140 clinical isolates of P. aeruginosa were collected from patients admitted to the burn wards of a hospital in Tehran, Iran. Antimicrobial susceptibility test was carried out against the pathogens using the A. vera gel and antibiotics (imipenem, gentamicin, and ciprofloxacin). Results. The antibiogram revealed that 47 (33.6%) of all isolates were MDR P. aeruginosa. The extract isolated from A. vera has antibacterial activity against all of isolates. Also, 42 (89.4%) isolates were inhibited by A. vera gel extract at minimum inhibitory concentration (MIC) ≤ 200 µg/mL. MIC value of A. vera gel for other isolates (10.6%) was 800 µg/mL. All of MDR P. aeruginosa strains were inhibited by A. vera at similar MIC50 and MIC90 200 µg/mL. Conclusion. Based on our results, A. vera gel at various concentrations can be used as an effective antibacterial agent in order to prevent wound infection caused by P. aeruginosa. PMID:26266047

  1. Therapy of infections in mice irradiated in mixed neutron/photon fields and inflicted with wound trauma: A review of current work. (Reannouncement with new availability information)

    SciTech Connect

    Ledney, G.D.; Madonna, G.S.; Elliott, T.B.; Moore, M.M.; Jackson, W.E.

    1991-12-31

    When host antimicrobial defenses are severely compromised by radiation or trauma in conjunction with radiation, death from sepsis results. To evaluate therapies for sepsis in radiation casualties, the authors developed models of acquired and induced bacterial infections in irradiated and irradiated-wounded mice. Animals were exposed to either a mixed radiation field of equal proportions of neutrons and gamma rays (n/gamma = 1) from a TRIGA reactor or pure gamma rays from 60 (Co sources). Skin wounds (15% of total body surface area) were inflicted under methoxyflurane anesthesia 1 h after irradiation. In all mice, wounding after irradiation decreased resistance to infection. Treatments with the immunomodulator synthetic trehalose dicorynomycolate (S-TDCM) before or after mixed neutron-gamma irradiation or gamma irradiation increased survival. Therapy with S-TDCM for mice irradiated with either a mixed field or gamma rays increased resistance to Klebsiella pneumoniae-induced infections.

  2. 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

  3. Chloramphenicol encapsulated in poly-ε-caprolactone–pluronic composite: nanoparticles for treatment of MRSA-infected burn wounds

    PubMed Central

    Kalita, Sanjeeb; Devi, Banasmita; Kandimalla, Raghuram; Sharma, Kaustav Kalyan; Sharma, Arup; Kalita, Kasturi; Kataki, Amal Chandra; Kotoky, Jibon

    2015-01-01

    The emergence of methicillin-resistant Staphylococcus aureus (MRSA) infection has increased precipitously over the past several decades, with far-reaching health care and societal costs. MRSA infections in the context of burn wounds lead to invasive disease that could potentially cause mortality. Chloramphenicol is a well-known broad-spectrum bacteriostatic antibiotic that has been used since 1949, but due to its hydrophobicity, poor penetration in skin, fast degradation, and toxicity, its application has been hindered. Furthermore, it has been demonstrated that old antibiotics such as chloramphenicol remained active against a large number of currently prevalent resistant bacterial isolates due to their low-level use in the past. Recently, the novel nanoparticulate drug-delivery system has been used and reported to be exceptionally useful for topical therapeutics, due to its distinctive physical characteristics such as a high surface-to-volume ratio and minuscule size. It helps to achieve better hydrophilicity, bioavailability, and controlled delivery with enhanced therapeutic index, which has resulted in decreased toxicity levels compared to the crude drug. Here, we report a novel chloramphenicol loaded with poly(ε-caprolactone) (PCL)-pluronic composite nanoparticles (CAM-PCL-P NPs), physicochemical characterizations, and its bioactivity evaluation in a MRSA-infected burn-wound animal model. CAM-PCL-P NPs could encapsulate 98.3% of the drug in the nanoparticles and release 81% of the encapsulated drug over 36 days with a time to 50% drug release of 72 hours (51%). Nanoparticle suspensions maintained the initial properties with respect to size and encapsulation efficiency, even after 6 months of storage at 4°C and 25°C, respectively (P>0.05). Significant reduction in the level of toxicity was observed for CAM-PCL-P NPs compared with that of free drug as confirmed from hemolytic activity against human blood erythrocytes and cytotoxicity assay against an MCF-7

  4. Negative Pressure Wound Therapy With Instillation (NPWTi) Better Reduces Post-debridement Bioburden in Chronically Infected Lower Extremity Wounds Than NPWT Alone

    PubMed Central

    Goss, S.G.; Schwartz, J.A.; Facchin, F.; Avdagic, E.; Gendics, C.; Lantis, J.C.

    2014-01-01

    Objective An overabundance of bacteria in the chronic wound plays a significant role in the decreased ability for primary closure. One means of decreasing the bioburden in a wound is to operatively debride the wound for wound bed optimization prior to application of other therapy, such as Negative Pressure Wound Therapy (NPWT). We undertook a prospective pilot study to assess the efficacy of wound bed preparation for a standard algorithm (sharp surgical debridement followed by NPWT) versus one employing sharp surgical debridement followed by Negative Pressure Wound Therapy with Instillation (NPWTi). Methods Thirteen patients, corresponding to 16 chronic lower leg and foot wounds were taken to the operating room for debridement. The patients were sequentially enrolled in 2 treatment groups: the first receiving treatment with operative debridement followed by 1 week of NPWT with the instillation of quarter strength bleach solution; the other receiving a standard algorithm consisting of operative debridement and 1 week of NPWT. Quantitative cultures were taken pre-operatively after sterile preparation and draping of the wound site (POD # 0, pre-op), post-operatively once debridement was completed (POD # 0, post-op), and on post-operative day 7 after operative debridement (POD # 7, post-op). Results After operative debridement (post-operative day 0) there was a mean of 3 (±1) types of bacteria per wound. The mean CFU/gram tissue culture was statistically greater – 3.7 × 106 (±4 × 106) in the NPWTi group, while in the standard group (NPWT) the mean was 1.8 × 106 (±2.36 × 106) CFU/gram tissue culture (p = 0.016); at the end of therapy there was no statistical difference between the two groups (p = 0.44). Wounds treated with NPWTi had a mean of 2.6 × 105 (±3 × 105) CFU/gram of tissue culture while wounds treated with NPWT had a mean of 2.79 × 106 (±3.18 × 106) CFU/gram of tissue culture (p = 0.43). The mean absolute reduction in

  5. Wound Care.

    PubMed

    Balsa, Ingrid M; Culp, William T N

    2015-09-01

    Wound care requires an understanding of normal wound healing, causes of delays of wound healing, and the management of wounds. Every wound must be treated as an individual with regard to cause, chronicity, location, and level of microbial contamination, as well as patient factors that affect wound healing. Knowledge of wound care products available and when negative pressure wound therapy and drain placement is appropriate can improve outcomes with wound healing. Inappropriate product use can cause delays in healing. As a wound healing progresses, management of a wound and the bandage material used must evolve. PMID:26022525

  6. Intervention for Postpartum Infections Following Caesarean Section

    ClinicalTrials.gov

    2015-04-20

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

  7. The protective effect of topical rifamycin treatment against sternal wound infection in diabetic patients undergoing on-pump coronary artery bypass graft surgery

    PubMed Central

    Aygun, Fatih; Kuzgun, Ahmet; Ulucan, Seref; Keser, Ahmet; Akpek, Mahmut; Kaya, Mehmet G

    2014-01-01

    Summary Objectives The aim of this study was to investigate the protective effect of topical rifamycin SV treatment against sternal wound infection (SWI) in diabetic patients undergoing on-pump coronary artery bypass graft (CABG) surgery. Methods One hundred and fifty-nine diabetic patients who were scheduled to undergo isolated on-pump CABG surgery were included. Eight were excluded for various reasons. Of the 151 patients, 51 were on insulin therapy and 100 were on oral anti-diabetics. The risk of mediastinitis was assessed using the American College of Cardiology/American Heart Association 2004 guideline update for CABG surgery. According to the risk scores, patients were divided into two comparable groups: the rifamycin group (n = 78) received topical rifamycin treatment after on-pump CABG surgery, and the control group (n = 73) received no topical treatment. Results Deep sternal wound infection (mediastinitis) was not observed in either group (0/78 vs 0/73, p = 1.0). No superficial sternal wound infection was observed in the rifamycin group, however, it did occur in one patient in the control group (0/78 vs 1/73, p = 0.303). Wound culture was performed and coagulase-negative staphylococci were observed. The infection regressed on initiation of antibiotic therapy against isolated bacteria and the patient was discharged after a full recovery. Conclusion Although the difference in rate of superficial sternal wound infection (SSWI) in the rifamycin and control groups was not statistically significant, locally applied rifamycin SV during closure of the sternum in the CABG operation may have had a protective affect against SWI. PMID:24687038

  8. Common questions about wound care.

    PubMed

    Worster, Brooke; Zawora, Michelle Q; Hsieh, Christine

    2015-01-15

    Lacerations, abrasions, burns, and puncture wounds are common in the outpatient setting. Because wounds can quickly become infected, the most important aspect of treating a minor wound is irrigation and cleaning. There is no evidence that antiseptic irrigation is superior to sterile saline or tap water. Occlusion of the wound is key to preventing contamination. Suturing, if required, can be completed up to 24 hours after the trauma occurs, depending on the wound site. Tissue adhesives are equally effective for low-tension wounds with linear edges that can be evenly approximated. Although patients are often instructed to keep their wounds covered and dry after suturing, they can get wet within the first 24 to 48 hours without increasing the risk of infection. There is no evidence that prophylactic antibiotics improve outcomes for most simple wounds. Tetanus toxoid should be administered as soon as possible to patients who have not received a booster in the past 10 years. Superficial mild wound infections can be treated with topical agents, whereas deeper mild and moderate infections should be treated with oral antibiotics. Most severe infections, and moderate infections in high-risk patients, require initial parenteral antibiotics. Severe burns and wounds that cover large areas of the body or involve the face, joints, bone, tendons, or nerves should generally be referred to wound care specialists. PMID:25591209

  9. Analysis of Healing Effect of Alginate Sulfate Hydrogel Dressing Containing Antimicrobial Peptide on Wound Infection Caused by Methicillin-Resistant Staphylococcus aureus

    PubMed Central

    Babavalian, Hamid; Latifi, Ali Mohammad; Shokrgozar, Mohammad Ali; Bonakdar, Shahin; Mohammadi, Sajjad; Moosazadeh Moghaddam, Mehrdad

    2015-01-01

    Background: Wound infections caused by methicillin-resistant Staphylococcus aureus are a health problem worldwide; therefore, it is necessary to develop new antimicrobial compounds. Considering broad-spectrum antimicrobial activity and low probability of drug resistance to peptides, applications these peptides are being studied extensively. Objectives: In this study, to control drug release over time, an alginate sulfate-based hydrogel impregnated with the CM11 peptide as the antimicrobial agent was developed, and its healing effects were tested on skin infections caused by methicillin-resistant S. aureus strains in a mouse model. Materials and Methods: Minimum inhibitory and minimum bactericidal concentrations of the CM11 peptide and alginate hydrogel in combination with the peptide were determined. Forty mice were divided into 4 groups: 1 group as a negative control (without treatment; however, 5 mice received hydrogel dressing without peptide), 1 group as a positive control (2% mupirocin treatment), and 2 groups as test groups. To establish skin infection, 200 μL of bacterial suspension with 3 × 108 CFU/mL concentration was subcutaneously injected in the scapular region of the mice. On the basis of the in vitro minimal bactericidal concentration of the alginate hydrogel containing peptide for 15 clinical isolates, hydrogel containing 128 mg/L of peptide was used for wound dressing over an 8-day period. Results: The highest and lowest numbers of wounds were observed on day 2 in the negative and positive control groups, respectively. During the 8-day period, the positive control and hydrogel containing peptide treatment groups showed similar levels of wound healing. Conclusions: This study showed that compared to standard drug treatment, treatment with hydrogel containing peptide had substantial antibacterial effects on S. aureus wound infections in mice. PMID:26487923

  10. 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 10μM HB:La+3 and a light-emitting diode (LED) emitting at λ=460nm+/-20nm and a LED emitting at λ=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.

  11. Evaluation of Gallium Citrate Formulations against a Multidrug-Resistant Strain of Klebsiella pneumoniae in a Murine Wound Model of Infection

    PubMed Central

    Thompson, Mitchell G.; Truong-Le, Vu; Alamneh, Yonas A.; Black, Chad C.; Anderl, Jeff; Honnold, Cary L.; Pavlicek, Rebecca L.; Abu-Taleb, Rania; Wise, Matthew C.; Hall, Eric R.; Wagar, Eric J.; Patzer, Eric

    2015-01-01

    Skin and soft tissue infections (SSTIs) are a common occurrence in health care facilities with a heightened risk for immunocompromised patients. Klebsiella pneumoniae has been increasingly implicated as the bacterial agent responsible for SSTIs, and treatment can be challenging as more strains become multidrug resistant (MDR). Therefore, new treatments are needed to counter this bacterial pathogen. Gallium complexes exhibit antimicrobial activity and are currently being evaluated as potential treatment for bacterial infections. In this study, we tested a topical formulation containing gallium citrate (GaCi) for the treatment of wounds infected with K. pneumoniae. First, the MIC against K. pneumoniae ranged from 0.125 to 2.0 μg/ml GaCi. After this in vitro efficacy was established, two topical formulations with GaCi (0.1% [wt/vol] and 0.3% [wt/vol]) were tested in a murine wound model of MDR K. pneumoniae infection. Gross pathology and histopathology revealed K. pneumoniae-infected wounds appeared to close faster with GaCi treatment and were accompanied by reduced inflammation compared to those of untreated controls. Similarly, quantitative indications of infection remediation, such as reduced weight loss and wound area, suggested that treatment improved outcomes compared to those of untreated controls. Bacterial burdens were measured 1 and 3 days following inoculation, and a 0.5 to 1.5 log reduction of CFU was observed. Lastly, upon scanning electron microscopy analysis, GaCi treatment appeared to prevent biofilm formation on dressings compared to those of untreated controls. These results suggest that with more preclinical testing, a topical application of GaCi may be a promising alternative treatment strategy for K. pneumoniae SSTI. PMID:26239978

  12. Evaluation of Gallium Citrate Formulations against a Multidrug-Resistant Strain of Klebsiella pneumoniae in a Murine Wound Model of Infection.

    PubMed

    Thompson, Mitchell G; Truong-Le, Vu; Alamneh, Yonas A; Black, Chad C; Anderl, Jeff; Honnold, Cary L; Pavlicek, Rebecca L; Abu-Taleb, Rania; Wise, Matthew C; Hall, Eric R; Wagar, Eric J; Patzer, Eric; Zurawski, Daniel V

    2015-10-01

    Skin and soft tissue infections (SSTIs) are a common occurrence in health care facilities with a heightened risk for immunocompromised patients. Klebsiella pneumoniae has been increasingly implicated as the bacterial agent responsible for SSTIs, and treatment can be challenging as more strains become multidrug resistant (MDR). Therefore, new treatments are needed to counter this bacterial pathogen. Gallium complexes exhibit antimicrobial activity and are currently being evaluated as potential treatment for bacterial infections. In this study, we tested a topical formulation containing gallium citrate (GaCi) for the treatment of wounds infected with K. pneumoniae. First, the MIC against K. pneumoniae ranged from 0.125 to 2.0 μg/ml GaCi. After this in vitro efficacy was established, two topical formulations with GaCi (0.1% [wt/vol] and 0.3% [wt/vol]) were tested in a murine wound model of MDR K. pneumoniae infection. Gross pathology and histopathology revealed K. pneumoniae-infected wounds appeared to close faster with GaCi treatment and were accompanied by reduced inflammation compared to those of untreated controls. Similarly, quantitative indications of infection remediation, such as reduced weight loss and wound area, suggested that treatment improved outcomes compared to those of untreated controls. Bacterial burdens were measured 1 and 3 days following inoculation, and a 0.5 to 1.5 log reduction of CFU was observed. Lastly, upon scanning electron microscopy analysis, GaCi treatment appeared to prevent biofilm formation on dressings compared to those of untreated controls. These results suggest that with more preclinical testing, a topical application of GaCi may be a promising alternative treatment strategy for K. pneumoniae SSTI. PMID:26239978

  13. Reconstruction of severely infected gluteal osteoradionecrosis using negative-pressure wound therapy and latissimus dorsi musculocutaneous flaps.

    PubMed

    Kim, Sang Wha; Youn, Dong Geun; Hwang, Kyu Tae; Kim, Jeong Tae; Kim, Youn Hwan

    2016-01-01

    Radiotherapy is mandatory for aggressive cancer treatment. Unfortunately, the high-energy radiation used can lead to severe osteoradionecrosis. Radical debridement of devitalized bone and soft tissue coupled with reconstruction using well-vascularized tissues is the accepted treatment for this condition. However, osteoradionecrosis cannot be controlled easily or rapidly. The aim of this study was to present the results of the use of serial negative-pressure wound therapy (NPWT) in combination with a latissimus dorsi myocutaneous flap for treatment of gluteal osteoradionecrosis in a consecutive series of patients. Between January 2003 and December 2012, nine patients underwent reconstruction using serial NPWT and latissimus dorsi myocutaneous flaps. We applied negative-pressure dressings for at least 8 weeks. Final reconstruction was performed after the infection was controlled. The superior gluteal artery and vein were used as recipient vessels in all the cases. The mean interval between operation and radiation therapy was 28.3 ± 8.3 years, and the mean number of debridement performed was 6.3 ± 1. NPWT dressings were applied for 8-12 weeks (mean, 9.3 ± 2 weeks). The defects ranged in size from 14 × 8 cm to 18 × 15 cm. The flap size ranged from 15 × 10 cm to 18 × 15 cm. All flaps survived uneventfully except in one patient who experienced chronic seroma and wound dehiscence. There were no recurrences of osteomyelitis during the follow-up periods (mean, 14 ± 6.1 months). Based on the results obtained from this consecutive series of patients, we suggest that this methodology may provide an alternative approach for the treatment of severe osteoradionecrosis of the gluteal region. PMID:25641653

  14. Exploration of alginate hydrogel/nano zinc oxide composite bandages for infected wounds

    PubMed Central

    Mohandas, Annapoorna; PT, Sudheesh Kumar; Raja, Biswas; Lakshmanan, Vinoth-Kumar; Jayakumar, Rangasamy

    2015-01-01

    Alginate hydrogel/zinc oxide nanoparticles (nZnO) composite bandage was developed by freeze-dry method from the mixture of nZnO and alginate hydrogel. The developed composite bandage was porous with porosity at a range of 60%–70%. The swelling ratios of the bandages decreased with increasing concentrations of nZnO. The composite bandages with nZnO incorporation showed controlled degradation profile and faster blood clotting ability when compared to the KALTOSTAT® and control bandages without nZnO. The prepared composite bandages exhibited excellent antimicrobial activity against Escherichia coli, Staphylococcus aureus, Candida albicans, and methicillin resistant S. aureus (MRSA). Cytocompatibility evaluation of the prepared composite bandages done on human dermal fibroblast cells by Alamar assay and infiltration studies proved that the bandages have a non-toxic nature at lower concentrations of nZnO whereas slight reduction in viability was seen with increasing nZnO concentrations. The qualitative analysis of ex-vivo re-epithelialization on porcine skin revealed keratinocyte infiltration toward wound area for nZnO alginate bandages. PMID:26491307

  15. Symbiosis theory-directed green synthesis of silver nanoparticles and their application in infected wound healing

    PubMed Central

    Wen, Lu; Zeng, Pei; Zhang, Liping; Huang, Wenli; Wang, Hui; Chen, Gang

    2016-01-01

    In this study, silver nanoparticles (AgNPs) were synthesized for the first time using an antibacterial endophytic fungus of Chinese medicinal herb Orchidantha chinensis, which has anti-inflammatory and antimicrobial activities. The AgNPs were analyzed by various characterization techniques to reveal their morphology, chemical composition, and stability. Also, the relationship between Chinese medicinal herbs, endophytic fungi, and the property of AgNPs was investigated for the first time. Interestingly, an experiment performed in this study revealed the proteins produced by the endophytic fungus to be capped on the nanoparticles, which led to an increase in the stability of spherical and polydispersed AgNPs with low aggregation for over 6 months. More importantly, further study demonstrated that the AgNPs possessed superior antibacterial activity and effectively promoted wound healing. Altogether, the biosynthesis of active AgNPs using the endophytic fungus from Chinese medicinal herb based on the symbiosis theory is simple, eco-friendly, and promising. PMID:27358563

  16. Factors Affecting Wound Healing

    PubMed Central

    Guo, S.; DiPietro, L.A.

    2010-01-01

    Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing. This article reviews the recent literature on the most significant factors that affect cutaneous wound healing and the potential cellular and/or molecular mechanisms involved. The factors discussed include oxygenation, infection, age and sex hormones, stress, diabetes, obesity, medications, alcoholism, smoking, and nutrition. A better understanding of the influence of these factors on repair may lead to therapeutics that improve wound healing and resolve impaired wounds. PMID:20139336

  17. Efficacy of the Quorum Sensing Inhibitor FS10 Alone and in Combination with Tigecycline in an Animal Model of Staphylococcal Infected Wound

    PubMed Central

    Cacciatore, Ivana; Baldassarre, Leonardo; Orlando, Fiorenza; Pierpaoli, Elisa; Lucarini, Guendalina; Orsetti, Elena; Provinciali, Mauro; Fornasari, Erika; Di Stefano, Antonio; Giacometti, Andrea; Offidani, Annamaria

    2016-01-01

    In staphylococci, quorum sensing regulates both biofilm formation and toxin production, moreover it has been demonstrated to be inhibited by RNAIII inhibiting peptide (RIP). Aim our study was to evaluate the in vitro activity and its in vivo efficacy of the combined administration of FS10, a novel RIP derivative, and tigecycline in an animal model of methicillin-resistant (MR) and methicillin-sensitive (MS) Staphylococcus aureus wound infection. Using a 1.x2 cm template, one full thickness wound was established through the panniculus carnosus on the back subcutaneous tissue of each animal. Infection was determined by inoculation of 5x107 CFU/ml of bacteria, that produced an abscess within 24 h, after this, treatment was initiated. The study included, for each strain, a control group without infection, a control infected group that did not receive any treatment and a control infected group with drug-free foam dressing, and three infected groups treated, respectively, with: FS10-soaked foam dressing (containing 20 μg FS10), daily intraperitoneal tigecycline (7 mg/Kg), FS10-soaked foam dressing (containing 20 μg FS10) and daily intraperitoneal injections of tigecycline (7 mg/Kg). The main outcome measures were quantitative culture and histological examination of tissue repair. The highest inhibition of infection was achieved in the group that received FS10-soaked and parenteral tigecycline reducing the bacterial load from 107 CFU/ml to about 103 CFU/g for MSSA and to about 104 CFU/g for MRSA. The group treated with FS10-soaked foam dressing associated with parenteral tigecycline showed, histologically, better overall healing with epithelialization and collagen scores significantly higher than those of the other groups in both strains. In conclusion, the combined use of topical FS10 with i.p. tigecycline induced positive interaction in vivo, resulting in an enhanced therapeutic benefit versus staphylococcal infections in murine wound models. PMID:27253706

  18. Frequency of Pseudomonas aeruginosa serotypes in burn wound infections and their resistance to antibiotics.

    PubMed

    Estahbanati, Hamid Karimi; Kashani, Parnian Pour; Ghanaatpisheh, Fahimeh

    2002-06-01

    Pseudomonas aeruginosa plays a prominent role as an etiological agent involved in serious infections in burned patients. In this study P. aeruginosa infections were analyzed at the Motahari Burn Center in Tehran (from 22 December 1998 to April 1999) to estimate their frequency, antibiotic susceptibility and serotypes. One hundred and eighty-four positive cultures and 205 bacterial strains were isolated among swabs or biopsy specimens during the study period. Pseudomonas was found to be the most common (57%) followed by Acinetobacter (17%), Escherichia coli (12%), Staphylococcus aureus (8%) and other organisms (6%). The frequency of P. aeruginosa resistance to gentamicin, ceftizoxime, carbenicillin, cephalothin and ceftazidime was over 90%. The antibiotics to which P. aeruginosa was most sensitive were amikacin and tetracyclin. The "O" serotypes isolated from the 117 Pseudomona aeroginosa isolates were serotypes O:2, O:5, O:6, O:8, O:11, O:12 and O:16. The most common serotype was O:6 (20/17%) followed by O:11 (18/15%) and O:5 (14/12%). The serotype most resistant was O:16 (8%) and the most sensitive was O:8 (2%). Since treatment of infection with available antibiotics according to the results attained proved to be difficult, prevention of infection in the burned patients is considered as an appropriate means of conquering overcoming infection problems. The sum of frequencies of serotypes O:6, O:11, O:5 and O:16 was more than 60%, therefore vaccination of burn patients with polyvalent antiserum to these serotypes could possibly produce immunity in more than half of the burned patients. PMID:12052372

  19. Efficacy of topical and systemic antibiotic treatment of meticillin-resistant Staphylococcus aureus in a murine superficial skin wound infection model.

    PubMed

    Vingsbo Lundberg, Carina; Frimodt-Møller, Niels

    2013-09-01

    Meticillin-resistant Staphylococcus aureus (MRSA) is a rapidly spreading pathogen associated predominantly with skin infections. The lack of clinical evidence indicating the best treatment strategy to combat MRSA skin infections prompted us to investigate the efficacy of available treatment options in an experimental skin wound infection model in mice. Mice were treated either topically with retapamulin (1%), fusidic acid (2%) or mupirocin (2%) or systemically with linezolid (50-100 mg/kg/day) or vancomycin (50-200 mg/kg/day) twice daily for 3 days or 6 days and the total bacterial loads in the skin lesions were determined. Retapamulin, fusidic acid and mupirocin treatment for 3 days reduced the bacterial loads by 2.5, 2.9 and 2.0 log(10) CFU, respectively, and treatment for 6 days by 5.0, 4.2 and 5.1 log(10) CFU, respectively, compared with non-treated controls (P < 0.001). Systemic treatment with linezolid for 6 days reduced the bacterial loads by 1.6 log(10) CFU compared with non-treated mice (P < 0.001), whereas vancomycin treatment showed no effect on reducing the bacterial loads in infected skin lesions. These findings suggest that topical treatment with retapamulin and mupirocin is significantly more effective than systemic treatment with linezolid and vancomycin in eradicating MRSA in skin wounds. Retapamulin and mupirocin may provide an alternative to fusidic acid treatment of MRSA in skin wounds when resistance to fusidic acid is suspected. PMID:23837927

  20. The influence of moisture wound healing on the incidence of bacterial infection and histological changes in healthy human skin after treatment of interactive dressings.

    PubMed

    Koupil, J; Brychta, P; Horký, D; Smola, J; Prásek, J

    2003-01-01

    In this article the authors discuss the problem faced by physicians when trying to use moisture-retentive dressing in pressure sores (decubitus ulcers). First, they report the results of an in vitro study using a new model of experimental wound (radio-isotopic investigation) that assesses the release of Ringer's solution from interactive dressings continually during fourteen hours. Second, they perform an animal experiment that assesses the incidence of wound infection in defects treated conventionally or using interactive dressings. The defects treated with interactive pads had lower incidence of wound infection, and the process of wound healing was rapid. Finally, the authors discuss their experience in four paraplegic patients with decubitus ulcers where they used moisture-retentive dressing on ulcers and on the surrounding intact skin before surgical procedure to detect the possibility of maceration of healthy skin. Histological evaluation was performed in order to find microscopically changes after moisture healing. The changes of healthy skin were not significant after treatment of moisture-retentive dressings. PMID:14733252

  1. Chronic Wound Biofilm Model

    PubMed Central

    Ganesh, Kasturi; Sinha, Mithun; Mathew-Steiner, Shomita S.; Das, Amitava; Roy, Sashwati; Sen, Chandan K.

    2015-01-01

    Significance: Multispecies microbial biofilms may contribute to wound chronicity by derailing the inherent reparative process of the host tissue. In the biofilm form, bacteria are encased within an extracellular polymeric substance and become recalcitrant to antimicrobials and host defenses. For biofilms of relevance to human health, there are two primary contributing factors: the microbial species involved and host response which, in turn, shapes microbial processes over time. This progressive interaction between microbial species and the host is an iterative process that helps evolve an acute-phase infection to a pathogenic chronic biofilm. Thus, long-term wound infection studies are needed to understand the longitudinal cascade of events that culminate into a pathogenic wound biofilm. Recent Advances: Our laboratory has recently published the first long-term (2 month) study of polymicrobial wound biofilm infection in a translationally valuable porcine wound model. Critical Issues: It is widely recognized that the porcine system represents the most translationally valuable approach to experimentally model human skin wounds. A meaningful experimental biofilm model must be in vivo, include mixed species of clinically relevant microbes, and be studied longitudinally long term. Cross-validation of such experimental findings with findings from biofilm-infected patient wounds is critically important. Future Directions: Additional value may be added to the experimental system described above by studying pigs with underlying health complications (e.g., metabolic syndrome), as is typically seen in patient populations. PMID:26155380

  2. Wound healing for the clinician.

    PubMed

    Zitelli, J

    1987-01-01

    Wound healing is a complex sequence of events, beginning with tissue injury, mediated by inflammation, and ending long after reepithelialization is complete. Research and controlled clinical experience have provided a better understanding so that clinicians can influence the events of healing to decrease pain, control bleeding, infection, and cosmetic result as well as speed the time for complete healing. The following is a summary of guidelines for the management of wound healing: (1) wound creation; wounds should be created with minimal necrosis of tissue in order to prevent delays in healing. Electrosurgical, cryosurgical, and laser surgical wounds heal more slowly than wounds created by scalpel excision or curettage. Electro-coagulation should be used sparingly in sutured wounds. Large lesions are best treated in a single stage rather than in divided treatments since the rate of wound healing is not proportional to the area but instead to the logarithm of the area. Thus, the total healing time is much shorter if done in a single treatment session. (2) use of drugs; corticosteroids given before or within three days of wounding in dose of prednisone 40 mg or greater will inhibit wound healing. Vitamin A topically or systemically may reverse this inhibition. Aspirin and other nonsteroidal anti-inflammatory agents are more important for their effects on platelet function and bleeding than on wound healing. (3) wound dressings; the use of occlusive dressings to promote moist wound healing is the most significant advance in wound management. Occlusive dressings shorten the time for healing, decrease pain, reduce wound contamination, and improve the cosmetic result. (4) control of wound contraction and scar formation; at the time of wound formation, guiding sutures may be helpful in wound healing by secondary intention in order to control the direction of wound contraction and prevent distortion. Intralesional steroids may be useful for hypertrophic scars and keloids

  3. Systemic inflammatory responses and multiple organ dysfunction syndrome following skin burn wound and Pseudomonas aeruginosa infection in mice.

    PubMed

    Li, Na; Hu, Xiaolong; Liu, Yang; Wang, Yaojun; Wang, Yunchuan; Liu, Jiaqi; Cai, Weixia; Bai, Xiaozhi; Zhu, Xiongxiang; Han, Juntao; Hu, Dahai

    2013-08-01

    Burn wound-related sepsis is associated with the development of systemic inflammatory response syndrome and multiple organ dysfunction syndrome (MODS). This study is aimed at investigating the development and progression of SIS and MODS in a mouse model of skin burn sepsis. C57BL/6J mice were randomly divided into the sham, burn, Pseudomonas, and burn/Pseudomonas groups. The back skin of the sham, burn, and burn/Pseudomonas groups was burned about 10% of total area with using 37°C or 98°C water for 8 s, respectively, followed by inoculating with Pseudomonas aeruginosa. The Pseudomonas group was infected with P. aeruginosa without burn injury. Their body weights, mortality, organ histology, and function as well as systemic inflammation were measured longitudinally. The burn/Pseudomonas mice lost more body weights than did mice from the other groups and had a significantly higher mortality rate (P < 0.05). The burn/Pseudomonas mice exhibited significantly higher levels of bacterial loads in different organs and serum endotoxin, interleukin 1β, interleukin 6, tumor necrosis factor α, and C-reactive protein than those in mice from the other groups (P < 0.05). The burn/Pseudomonas mice also displayed more severe liver, lung, and kidney tissue damage and impaired organ functions, particularly at 72 h after inoculation than did the burn and Pseudomonas groups of mice. Our data indicate that burn and P. aeruginosa infection induced severe sepsis and rapidly progressed into systemic inflammatory response syndrome and MODS in mice. PMID:23707977

  4. Streptococcus hongkongensis sp. nov., isolated from a patient with an infected puncture wound and from a marine flatfish.

    PubMed

    Lau, Susanna K P; Curreem, Shirly O T; Lin, Cherry C N; Fung, Ami M Y; Yuen, Kwok-Yung; Woo, Patrick C Y

    2013-07-01

    A bacterium, HKU30(T), was isolated from the infected tissue of a patient with wound infection after puncture by a fish fin. Cells are facultative anaerobic, non-spore-forming, non-motile, Gram-positive cocci arranged in chains. Colonies were non-haemolytic. The strain was catalase, oxidase, urease and Voges-Proskauer test negative. It reacted with Lancefield's group G antisera and was resistant to optochin. It grew on bile aesculin agar and in 5 % NaCl. It was unidentified by three commercial identification systems. 16S rRNA gene sequence analysis indicated that the bacterium shared 98.2, 97.7, 97.4 and 97.1 % nucleotide identities with Streptococcus iniae, Streptococcus pseudoporcinus, Streptococcus parauberis and Streptococcus uberis, respectively. The DNA G+C content was 35.6 ± 0.9 mol% (mean ± sd). In view of the occupational exposure of the patient, an epidemiological study was performed to isolate the bacterium from marine fish. Two strains, with similar phenotypic and genotypic characteristics to those of HKU30(T), were isolated from a three-lined tongue sole (Cynoglossus abbreviatus) and an olive flounder (Paralichthys olivaceus) respectively. Phylogenetic analysis of four additional housekeeping genes, groEL, gyrB, sodA and rpoB, showed that the three isolates formed a distinct branch among known species of the genus Streptococcus, being most closely related to S. parauberis (CCUG 39954(T)). DNA-DNA hybridization demonstrated ≤ 53.8 % DNA relatedness between the three isolates and related species of the genus Streptococcus. A novel species, Streptococcus hongkongensis sp. nov., is proposed. The type strain is HKU30(T) ( = DSM 26014(T) = CECT 8154(T)). PMID:23264498

  5. IL-15 Superagonist Expands mCD8+ T, NK and NKT Cells after Burn Injury but Fails to Improve Outcome during Burn Wound Infection

    PubMed Central

    Patil, Naeem K.; Luan, Liming; Bohannon, Julia K.; Guo, Yin; Hernandez, Antonio; Fensterheim, Benjamin; Sherwood, Edward R.

    2016-01-01

    Background Severely burned patients are highly susceptible to opportunistic infections and sepsis, owing to the loss of the protective skin barrier and immunological dysfunction. Interleukin-15 (IL-15) belongs to the IL-2 family of common gamma chain cytokines and stimulates the proliferation and activation of T (specifically memory CD8), NK and NKT cells. It has been shown to preserve T cell function and improve survival during cecal ligation and puncture (CLP)-induced sepsis in mice. However, the therapeutic efficacy of IL-15 or IL-15 superagonist (SA) during infection after burn injury has not been evaluated. Moreover, very few, if any, studies have examined, in detail, the effect of burn injury and infection on the adaptive immune system. Thus, we examined the effect of burn and sepsis on adaptive immune cell populations and the effect of IL-15 SA treatment on the host response to infection. Methods Mice were subjected to a 35% total body surface area burn, followed by wound infection with Pseudomonas aeruginosa. In some experiments, IL-15 SA was administered after burn injury, but before infection. Leukocytes in spleen, liver and peritoneal cavity were characterized using flow cytometry. Bacterial clearance, organ injury and survival were also assessed. Results Burn wound infection led to a significant decline in total white blood cell and lymphocyte counts and induced organ injury and sepsis. Burn injury caused decline in CD4+ and CD8+ T cells in the spleen, which was worsened by infection. IL-15 treatment inhibited this decline and significantly increased cell numbers and activation, as determined by CD69 expression, of CD4+, CD8+, B, NK and NKT cells in the spleen and liver after burn injury. However, IL-15 SA treatment failed to prevent burn wound sepsis-induced loss of CD4+, CD8+, B, NK and NKT cells and failed to improve bacterial clearance and survival. Conclusion Cutaneous burn injury and infection cause significant adaptive immune dysfunction. IL-15

  6. Pyoderma Gangrenosum Mimicking an Infected Wound following Dynamic Hip Screw Fixation

    PubMed Central

    Nizamoglu, Metin

    2015-01-01

    Pyoderma gangrenosum (PG) is an inflammatory ulcerative neutrophilic dermatosis that can occur following skin trauma. The correct diagnosis is not often made immediately as the condition can mimic an infective appearance. This leads to delays in the appropriate management of high dose steroids. Although debridement can offer aid in resolving lesions, this is contraindicated in the acute phase as this can cause acceleration of the pathogenic process. Biopsy of the lesion does not offer a definitive diagnosis; therefore suspicion must be maintained as the diagnosis is ultimately a clinical one. Any postoperative pustular ulcerative lesion not improving despite antibiotic therapy that also yields negative bacteriological and fungal studies should lead to consideration of this diagnosis. We document the first case of PG developing following intertrochanteric femur fracture fixation using dynamic hip screw. PMID:26380139

  7. Effects of inoculum density and wounding on stem infection of three Eastern U.S. forest species by Phytophthora ramorum

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Seedlings of three Eastern US forest species (red maple, northern red oak, and chestnut oak) were inoculated by applying Phytophthora ramorum sporangia to stems at different inoculum densities with and without wounding. Disease occurred in all treatments involving wounds, and no disease was observe...

  8. 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

  9. [Negative pressure wound therapy - review].

    PubMed

    Gudmundsdottir, Ingibjorg; Steingrimsson, Steinn; Valsdottir, Elsa; Gudbjartsson, Tomas

    2014-04-01

    Negative pressure wound therapy (NPWT) is a new therapeutic option in wound healing and was first described in its present form in 1997. A vacuum source is used to create sub-atmospheric pressure in the local wound environment to promote healing. This is achieved by connecting a vacuum pump to a tube that is threaded into a wound gauze or foam filler dressing covered with a drape. This concept in wound treatment has been shown to be useful in treating different wound infections, including diabetic wounds as well as complex infections of the abdomen and thorax. NPWT has been used in Iceland for over a decade and its use is steadily increasing. This review describes the indications and outcome of NPWT and is aimed at a broad group of doctors and nurses where recent Icelandic studies on the subject are covered. PMID:24713539

  10. Possible healthcare-associated transmission as a cause of secondary infection and population structure of Staphylococcus aureus isolates from two wound treatment centres in Ghana.

    PubMed

    Kpeli, G; Darko Otchere, I; Lamelas, A; Buultjens, A L; Bulach, D; Baines, S L; Seemann, T; Giulieri, S; Nakobu, Z; Aboagye, S Y; Owusu-Mireku, E; Pluschke, G; Stinear, T P; Yeboah-Manu, D

    2016-09-01

    We have previously shown that secondary infections of Buruli ulcer wounds were frequently caused by Staphylococcus aureus. To gain understanding into possible routes of secondary infection, we characterized S. aureus isolates from patient lesions and surrounding environments across two Ghanaian health centres. One hundred and one S. aureus isolates were isolated from wounds (n = 93, 92.1%) and the hospital environment (n = 8, 7.9%) and characterized by the spa gene, mecA and the Panton-Valentine leucocidin toxin followed by spa sequencing and whole genome sequencing of a subset of 49 isolates. Spa typing and sequencing of the spa gene from 91 isolates identified 29 different spa types with t355 (ST152), t186 (ST88), and t346 dominating. Although many distinct strains were isolated from both health centres, genotype clustering was identified within centres. In addition, we identified a cluster consisting of isolates from a healthcare worker, patients dressed that same day and forceps used for dressing, pointing to possible healthcare-associated transmission. These clusters were confirmed by phylogenomic analysis. Twenty-four (22.8%) isolates were identified as methicillin-resistant S. aureus and lukFS genes encoding Panton-Valentine leucocidin were identified in 67 (63.8%) of the isolates. Phenotype screening showed widespread resistance to tetracycline, erythromycin, rifampicin, amikacin and streptomycin. Genomics confirmed the widespread presence of antibiotic resistance genes to β-lactams, chloramphenicol, trimethoprim, quinolone, streptomycin and tetracycline. Our findings indicate that the healthcare environment probably contributes to the superinfection of Buruli ulcer wounds and calls for improved training in wound management and infection control techniques. PMID:27547406

  11. 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

  12. New Is Old, and Old Is New: Recent Advances in Antibiotic-Based, Antibiotic-Free and Ethnomedical Treatments against Methicillin-Resistant Staphylococcus aureus Wound Infections

    PubMed Central

    Dou, Jian-Lin; Jiang, Yi-Wei; Xie, Jun-Qiu; Zhang, Xiao-Gang

    2016-01-01

    Staphylococcus aureus is the most common pathogen of wound infections. Thus far, methicillin-resistant S. aureus (MRSA) has become the major causative agent in wound infections, especially for nosocomial infections. MRSA infections are seldom eradicated by routine antimicrobial therapies. More concerning, some strains have become resistant to the newest antibiotics of last resort. Furthermore, horizontal transfer of a polymyxin resistance gene, mcr-1, has been identified in Enterobacteriaceae, by which resistance to the last group of antibiotics will likely spread rapidly. The worst-case scenario, “a return to the pre-antibiotic era”, is likely in sight. A perpetual goal for antibiotic research is the discovery of an antibiotic that lacks resistance potential, such as the recent discovery of teixobactin. However, when considering the issue from an ecological and evolutionary standpoint, it is evident that it is insufficient to solve the antibiotic dilemma through the use of antibiotics themselves. In this review, we summarized recent advances in antibiotic-based, antibiotic-free and ethnomedical treatments against MRSA wound infections to identify new clues to solve the antibiotic dilemma. One potential solution is to use ethnomedical drugs topically. Some ethnomedical drugs have been demonstrated to be effective antimicrobials against MRSA. A decline in antibiotic resistance can therefore be expected, as has been demonstrated when antibiotic-free treatments were used to limit the use of antibiotics. It is also anticipated that these drugs will have low resistance potential, although there is only minimal evidence to support this claim to date. More clinical trials and animal tests should be conducted on this topic. PMID:27120596

  13. New Is Old, and Old Is New: Recent Advances in Antibiotic-Based, Antibiotic-Free and Ethnomedical Treatments against Methicillin-Resistant Staphylococcus aureus Wound Infections.

    PubMed

    Dou, Jian-Lin; Jiang, Yi-Wei; Xie, Jun-Qiu; Zhang, Xiao-Gang

    2016-01-01

    Staphylococcus aureus is the most common pathogen of wound infections. Thus far, methicillin-resistant S. aureus (MRSA) has become the major causative agent in wound infections, especially for nosocomial infections. MRSA infections are seldom eradicated by routine antimicrobial therapies. More concerning, some strains have become resistant to the newest antibiotics of last resort. Furthermore, horizontal transfer of a polymyxin resistance gene, mcr-1, has been identified in Enterobacteriaceae, by which resistance to the last group of antibiotics will likely spread rapidly. The worst-case scenario, "a return to the pre-antibiotic era", is likely in sight. A perpetual goal for antibiotic research is the discovery of an antibiotic that lacks resistance potential, such as the recent discovery of teixobactin. However, when considering the issue from an ecological and evolutionary standpoint, it is evident that it is insufficient to solve the antibiotic dilemma through the use of antibiotics themselves. In this review, we summarized recent advances in antibiotic-based, antibiotic-free and ethnomedical treatments against MRSA wound infections to identify new clues to solve the antibiotic dilemma. One potential solution is to use ethnomedical drugs topically. Some ethnomedical drugs have been demonstrated to be effective antimicrobials against MRSA. A decline in antibiotic resistance can therefore be expected, as has been demonstrated when antibiotic-free treatments were used to limit the use of antibiotics. It is also anticipated that these drugs will have low resistance potential, although there is only minimal evidence to support this claim to date. More clinical trials and animal tests should be conducted on this topic. PMID:27120596

  14. Pressure ulcers. Local wound care.

    PubMed

    Goode, P S; Thomas, D R

    1997-08-01

    Local care of pressure ulcers includes wound cleansing, débridement, and dressings. Wound cleansing should remove loose debris and exudate but should not damage viable tissue. Saline irrigation is the standard. Débridement is often necessary for Stage III and IV pressure ulcers and can be performed autolytically, mechanically, enzymatically, or sharply. Prompt débridement is essential for infected wounds. Dressings should keep the wound bed continuously moist, should not be toxic to granulation tissue, and should keep the surrounding intact skin dry. Randomized, controlled clinical trials are necessary to define optimal local wound care further. PMID:9227943

  15. Wound dressings: selecting the most appropriate type.

    PubMed

    Broussard, Karen C; Powers, Jennifer Gloeckner

    2013-12-01

    Appropriate wound dressing selection is guided by an understanding of wound dressing properties and an ability to match the level of drainage and depth of a wound. Wounds should be assessed for necrosis and infection, which need to be addressed prior to selecting an ideal dressing. Moisture-retentive dressings include films, hydrogels, hydrocolloids, foams, alginates, and hydrofibers and are useful in a variety of clinical settings. Antimicrobial-impregnated dressings can be useful in wounds that are superficially infected or are at higher risk for infection. For refractory wounds that need more growth stimulation, tissue-engineered dressings have become a viable option in the past few decades, especially those that have been approved for burns, venous ulcers, and diabetic ulcers. As wounds heal, the ideal dressing type may change, depending on the amount of exudate and depth of the wound; thus success in wound dressing selection hinges on recognition of the changing healing environment. PMID:24062083

  16. Skin tissue engineering for the infected wound site: biodegradable PLA nanofibers and a novel approach for silver ion release evaluated in a 3D coculture system of keratinocytes and Staphylococcus aureus.

    PubMed

    Mohiti-Asli, Mahsa; Pourdeyhimi, Behnam; Loboa, Elizabeth G

    2014-10-01

    Wound infection presents a challenging and growing problem. With the increased prevalence and growth of multidrug-resistant bacteria, there is a mounting need to reduce and eliminate wound infections using methodologies that limit the ability of bacteria to evolve into further drug-resistant strains. A well-known strategy for combating bacterial infection and preventing wound sepsis is through the delivery of silver ions to the wound site. High surface area silver nanoparticles (AgNPs) allowing extensive silver ion release have therefore been explored in different wound dressings and/or skin substitutes. However, it has been recently shown that AgNPs can penetrate into the stratum corneum of skin or diffuse into the cellular plasma membrane, and may interfere with a variety of cellular mechanisms. The goal of this study was to introduce and evaluate a new type of high surface area metallic silver in the form of highly porous silver microparticles (AgMPs). Polylactic acid (PLA) nanofibers were successfully loaded with either highly porous AgMPs or AgNPs and the antimicrobial efficacy and cytotoxicity of the two silver-based wound dressings were assessed and compared. To better mimic the physiological environment in vivo where both human cells and bacteria are present, a novel coculture system combining human epidermal keratinocytes and Staphylococcus aureus bacteria was designed to simultaneously evaluate human skin cell cytotoxicity with antimicrobial efficacy in a three-dimensional environment. We found that highly porous AgMPs could be successfully incorporated in nanofibrous wound dressings, and exhibited comparable antimicrobial efficacy and cytotoxicity to AgNPs. Further, PLA nanofibers containing highly porous AgMPs exhibited steady silver ion release, at a greater rate of release, than nanofibers containing AgNPs. The replacement of AgNPs with the newly introduced AgMPs overcomes concerns regarding the use of nanoparticles and holds great promise as skin

  17. Skin Tissue Engineering for the Infected Wound Site: Biodegradable PLA Nanofibers and a Novel Approach for Silver Ion Release Evaluated in a 3D Coculture System of Keratinocytes and Staphylococcus aureus

    PubMed Central

    Mohiti-Asli, Mahsa; Pourdeyhimi, Behnam

    2014-01-01

    Wound infection presents a challenging and growing problem. With the increased prevalence and growth of multidrug-resistant bacteria, there is a mounting need to reduce and eliminate wound infections using methodologies that limit the ability of bacteria to evolve into further drug-resistant strains. A well-known strategy for combating bacterial infection and preventing wound sepsis is through the delivery of silver ions to the wound site. High surface area silver nanoparticles (AgNPs) allowing extensive silver ion release have therefore been explored in different wound dressings and/or skin substitutes. However, it has been recently shown that AgNPs can penetrate into the stratum corneum of skin or diffuse into the cellular plasma membrane, and may interfere with a variety of cellular mechanisms. The goal of this study was to introduce and evaluate a new type of high surface area metallic silver in the form of highly porous silver microparticles (AgMPs). Polylactic acid (PLA) nanofibers were successfully loaded with either highly porous AgMPs or AgNPs and the antimicrobial efficacy and cytotoxicity of the two silver-based wound dressings were assessed and compared. To better mimic the physiological environment in vivo where both human cells and bacteria are present, a novel coculture system combining human epidermal keratinocytes and Staphylococcus aureus bacteria was designed to simultaneously evaluate human skin cell cytotoxicity with antimicrobial efficacy in a three-dimensional environment. We found that highly porous AgMPs could be successfully incorporated in nanofibrous wound dressings, and exhibited comparable antimicrobial efficacy and cytotoxicity to AgNPs. Further, PLA nanofibers containing highly porous AgMPs exhibited steady silver ion release, at a greater rate of release, than nanofibers containing AgNPs. The replacement of AgNPs with the newly introduced AgMPs overcomes concerns regarding the use of nanoparticles and holds great promise as skin

  18. Comparison of negative pressure wound therapy (NPWT) &conventional wound dressings in the open fracture wounds

    PubMed Central

    Arti, Hamidreza; Khorami, Mohsen; Ebrahimi-Nejad, Vahid

    2016-01-01

    Objective: Successful closure is a primary step of treatment in open fracture wounds. Delayed healing or complications can lead to increased treatment duration, costs and disability rates. The aim of this study was to compare Negative Pressure Wound Therapy (NPWT) and conventional wound dressings in patients with open fracture wounds. Methods: In a prospective randomized clinical trial study, 90 patients with open fractures that were referred for treatment were enrolled between February 2013 to March 2015. Patients were divided into two groups. Group I underwent NPWT and group II underwent conventional wound dressing. Then patients were followed up for one month. Within the one month, the number of dressing change varied based on the extent of the wound. Duration of wound healing, presence of infection and the number of hospitalization days in these patients were recorded and compared at the end of the study between the two groups. Questionnaires and check lists were used to collect data. Analysis was done with SPSS 20, paired sample T-test, and chi-square tests. P<0.05 was considered significant. Results: There was a significant difference between the rate of wound healing in the group one or NPWT group and group II (conventional wound dressings) P<0.05. There was no significant difference between two groups in incidence of infection (P=0.6). Conclusion: Using NPWT expedites the healing process of extremity wounds. It is more economical and can be considered as a substitute for the treatment of extremity wounds. PMID:27022347

  19. Negative Pressure Wound Therapy

    PubMed Central

    2006-01-01

    Executive Summary Objective This review was conducted to assess the effectiveness of negative pressure wound therapy. Clinical Need: Target Population and Condition Many wounds are difficult to heal, despite medical and nursing care. They may result from complications of an underlying disease, like diabetes; or from surgery, constant pressure, trauma, or burns. Chronic wounds are more often found in elderly people and in those with immunologic or chronic diseases. Chronic wounds may lead to impaired quality of life and functioning, to amputation, or even to death. The prevalence of chronic ulcers is difficult to ascertain. It varies by condition and complications due to the condition that caused the ulcer. There are, however, some data on condition-specific prevalence rates; for example, of patients with diabetes, 15% are thought to have foot ulcers at some time during their lives. The approximate community care cost of treating leg ulcers in Canada, without reference to cause, has been estimated at upward of $100 million per year. Surgically created wounds can also become chronic, especially if they become infected. For example, the reported incidence of sternal wound infections after median sternotomy is 1% to 5%. Abdominal surgery also creates large open wounds. Because it is sometimes necessary to leave these wounds open and allow them to heal on their own (secondary intention), some may become infected and be difficult to heal. Yet, little is known about the wound healing process, and this makes treating wounds challenging. Many types of interventions are used to treat wounds. Current best practice for the treatment of ulcers and other chronic wounds includes debridement (the removal of dead or contaminated tissue), which can be surgical, mechanical, or chemical; bacterial balance; and moisture balance. Treating the cause, ensuring good nutrition, and preventing primary infection also help wounds to heal. Saline or wet-to-moist dressings are reported as

  20. Wound Care: Preventing Infection

    MedlinePlus

    ... your pharmacist to recommend a nonperfumed, pH-balanced lotion. Wash anything that comes into contact with your ... check manufacturer’s instructions). Do not use alcohol-based lotions on your skin, as it dries it out ...

  1. [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

  2. Choosing a Wound Dressing Based on Common Wound Characteristics

    PubMed Central

    Dabiri, Ganary; Damstetter, Elizabeth; Phillips, Tania

    2016-01-01

    Significance: Chronic wounds are a major healthcare burden.The practitioner should have an appropriate understanding of both the etiology of the wound as well as the optimal type of dressings to use. Fundamental wound characteristics may be used to guide the practitioner's choice of dressings. The identification of optimal dressings to use for a particular wound type is an important element in facilitating wound healing. Recent Advances: Researchers have sought to design wound dressings that aim to optimize each stage in the healing process. In addition, dressings have been designed to target and kill infection-causing bacteria, with the incorporation of antimicrobial agents. Critical Issues: Chronic wounds are frequently dynamic in presentation, and the numerous wound dressings available make dressing selection challenging for the practitioner. Choosing the correct dressing decreases time to healing, provides cost-effective care, and improves patient quality of life. Future Directions: Research into the mechanisms of wound healing has enhanced our ability to heal chronic wounds at a faster rate through the use of moisture-retentive dressings. Newer dressings are incorporating the use of nanotechnology by incorporating miniature electrical sensors into the dressing. These dressings are engineered to detect changes in a wound environment and alert the patient or practitioner by altering the color of the dressing or sending a message to a smartphone. Additional investigations are underway that incorporate biologic material such as stem cells into dressings. PMID:26858913

  3. Emerging new drugs for wound repair.

    PubMed

    Meier, Karen; Nanney, Lillian B

    2006-03-01

    Every year, millions of people experience burns, suffer from nonhealing wounds, or have acute wounds that become complicated by infection, dehiscence or problematic scarring. Effective wound treatment requires carefully considered interventions often requiring multiple clinic or hospital visits. The resulting costs of wound care are staggering, and more efficacious and cost-effective therapies are needed to decrease this burden. Unfortunately, the expenses and difficulties encountered in performing clinical trials have led to a relatively slow growth of new treatment options for the wound management. Research efforts attempting to examine wound pathophysiology have been hampered by the lack of an adequate chronic wound healing model, and the complexity of the wound healing cascade has limited attempts at pharmacological modification. As such, currently available wound healing therapies are only partially effective. Therefore, many new therapies are emerging that target various aspects of wound repair and the promise of new therapeutic interventions is on the immediate horizon. PMID:16503824

  4. Office management of minor wounds.

    PubMed Central

    Gouin, S.; Patel, H.

    2001-01-01

    OBJECTIVE: To review office interventions for minor wounds not requiring sutures, such as abrasions, bites, and lacerations. QUALITY OF EVIDENCE: Most information on minor wound management comes from descriptive studies. Few comparative studies examine the effectiveness of topical antisepsis for minor wounds. Several clinical trials have demonstrated that tissue adhesives produce short- and long-term cosmetic results equivalent to those achieved with suture materials. MAIN MESSAGE: Sterile saline is the least toxic solution for wound irrigation. Chlorhexidine (2%) and povidone iodine (10%) have been the most investigated antiseptic solutions. Systemic antibiotics are unnecessary for wounds unlikely to be infected. All bite wounds require special attention. Primary closure of bite wounds is indicated in certain circumstances: less than 12-hour-old nonpuncture wounds, uninfected wounds, and low-risk lesions (such as on the face). In spite of their many advantages, skin tapes should be used for low-tension wounds only. The popularity of tissue adhesives has greatly increased. Since the advent of newer products (with increased bonding strength and flexibility), adhesives are used to manage most lacerations except those in areas of high tension (e.g., joints) and on mucosal surfaces. CONCLUSION: Minor wounds not requiring sutures can be managed easily in the office. PMID:11340758

  5. Delayed wound healing and postoperative surgical site infections in patients with rheumatoid arthritis treated with or without biological disease-modifying antirheumatic drugs.

    PubMed

    Tada, Masahiro; Inui, Kentaro; Sugioka, Yuko; Mamoto, Kenji; Okano, Tadashi; Kinoshita, Takuya; Hidaka, Noriaki; Koike, Tatsuya

    2016-06-01

    Biological disease-modifying antirheumatic drugs (bDMARDs) have become more popular for treating rheumatoid arthritis (RA). Whether or not bDMARDs increase the postoperative risk of surgical site infection (SSI) has remained controversial. We aimed to clarify the effects of bDMARDs on the outcomes of elective orthopedic surgery. We used multivariate logistic regression analysis to analyze risk factors for SSI and delayed wound healing among 227 patients with RA (mean age, 65.0 years; disease duration, 16.9 years) after 332 elective orthopedic surgeries. We also attempted to evaluate the effects of individual medications on infection. Rates of bDMARD and conventional synthetic DMARD (csDMARD) administration were 30.4 and 91.0 %, respectively. Risk factors for SSI were advanced age (odds ratio [OR], 1.11; P = 0.045), prolonged surgery (OR, 1.02; P = 0.03), and preoperative white blood cell count >10,000/μL (OR, 3.66; P = 0.003). Those for delayed wound healing were advanced age (OR, 1.16; P = 0.001), prolonged surgery (OR, 1.02; P = 0.007), preoperative white blood cell count >10,000/μL (OR, 4.56; P = 0.02), and foot surgery (OR, 6.60; P = 0.001). Risk factors for SSI and medications did not significantly differ. No DMARDs were risk factors for any outcome examined. Biological DMARDs were not risk factors for postoperative SSI. Foot surgery was a risk factor for delayed wound healing. PMID:27129711

  6. 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

  7. Genotype-dependent expression of specific members of potato protease inhibitor gene families in different tissues and in response to wounding and nematode infection.

    PubMed

    Turrà, David; Bellin, Diana; Lorito, Matteo; Gebhardt, Christiane

    2009-05-01

    Protease inhibitors (PIs) are small ubiquitous proteins with a variety of biological functions in plants, including protein stabilization, modulation of apoptosis and defense against pathogens. Kunitz-like inhibitors (PKPIs) and proteinase inhibitors 1 (PI-1) are abundant in storage organs of potato plants and are up-regulated in other tissues in response to biotic and abiotic stress. However, little information is available on genotype-dependent regulation of individual PKPI group- and PI-1 genes. We isolated, sequenced and characterized four novel full-length PI-1 cDNAs (PPI3A2, PPI3A4, PPI2C4 and PPI2C1A) from Solanum tuberosum cv. Desirée. Specific primers were developed for PI-1 genes PPI3A2, PPI3B2 and PPI2C4 and the three PKPI homology groups A, B and C. Their expression profiles were studied by semi-quantitative RT-PCR in comparison with transcripts of the PI-1, Pin2 and PR1 gene families in various tissues, after wounding and Globodera rostochiensis infection of nematode-resistant genotypes P40 and LB7/4/c-I-7, and susceptible cv. Desirée. Individual PI-1 genes and PKPI homology groups were expressed in a tissue- and genotype-dependent manner after wounding and nematode infection. The differences in PI expression patterns were related to the intensity, type of inhibitors produced, and the kinetics of induction. Therefore, different genotype-environment combinations produce different sets of PI transcripts. Potato plants reacted to G. rostochiensis infection by modulating PKPI, PI-1 and Pin2, but not PR1 gene expression, suggesting that the jasmonic acid but not the salicylic acid defense signaling pathway is activated. PI expression profiles were not correlated with the resistance status of the potato genotype infected with G. rostochiensis. PMID:19095329

  8. Wound care in venous ulcers.

    PubMed

    Mosti, G

    2013-03-01

    Wound dressings: ulcer dressings should create and maintain a moist environment on the ulcer surface. It has been shown that in an ulcer with a hard crust and desiccated bed, the healing process is significantly slowed and sometimes completely blocked so favouring infection, inflammation and pain. In contrast a moist environment promotes autolytic debridement, angiogenesis and the more rapid formation of granulation tissue, favours keratinocytes migration and accelerates healing of wounds. Apart from these common characteristics, wound dressings are completely different in other aspects and must be used according to the ulcer stage. In necrotic ulcers, autolytic debridement by means of hydrogel and hydrocolloids or with enzymatic paste is preferred. In case of largely exuding wounds alginate or hydrofibre are indicated. When bleeding occurs alginate is indicated due to its haemostatic power. Where ulcers are covered by granulation tissue, polyurethane foams are preferred. When infection coexists antiseptics are necessary: dressing containing silver or iodine with large antibacterial spectrum have proved to be very effective. In the epithelization stage polyurethane films or membranes, thin hydrocolloids or collagen based dressings are very useful to favour advancement of the healing wound edge. Despite these considerations, a Cochrane review failed to find advantages for any dressing type compared with low-adherent dressings applied beneath compression. Surgical debridement and grafting of wounds, negative wound pressure treatment: surgical and hydrosurgical debridement are indicated in large, necrotic and infected wounds as these treatments are able to get rid of necrotic, infected tissue very quickly in a single surgical session, thereby significantly accelerating wound bed preparation and healing time. Negative wound pressure treatment creating a negative pressure on ulcer bed is able to favour granulation tissue and shorten healing time. In case of hard

  9. A new flexible DBD device for treating infected wounds: in vitro and ex vivo evaluation and comparison with a RF argon plasma jet

    NASA Astrophysics Data System (ADS)

    Boekema, B. K. H. L.; Vlig, M.; Guijt, D.; Hijnen, K.; Hofmann, S.; Smits, P.; Sobota, A.; van Veldhuizen, E. M.; Bruggeman, P.; Middelkoop, E.

    2016-02-01

    Cold plasma has been shown to provide a promising alternative antimicrobial treatment for wound healing. We developed and tested a flexible surface dielectric barrier discharge (DBD) and compared it to an argon gas based plasma jet operated remotely with a distance between plasma plume and sample of 8 mm. Tests were conducted using different models: on cultured cells, on ex vivo human skin and on bacteria (Pseudomonas aeruginosa) (on agar, in suspension, in collagen/elastin matrix or on ex vivo human skin), allowing us to directly compare bactericidal with safety aspects under identical conditions. Both plasma devices were highly efficient when used on bacteria in non-buffered solutions, but DBD was faster in reaching the maximum bacterial reduction. Treatment of bacteria on intact skin with DBD resulted in up to 6 log reductions in 3 min. The jet was far less efficient on intact skin. Even after 8 min treatment no more than 2 log reductions were obtained with the jet. Treatment of bacteria in burn wound models with DBD for 6 min resulted in a 4.5 log reduction. Even when using DBD for 6 min on infected burn wound models with colonizing or biofilm phase bacteria, the log reductions were 3.8 or 3.2 respectively. DBD plasma treatment for 6 min did not affect fibroblast viability, whereas a treatment for 8 min was detrimental. Similarly, treatment with DBD or plasma jet for 6 min did also not affect the metabolic activity of skin biopsies. After treatment for 8 min with DBD or plasma jet, 78% or 60% of activity in skin biopsies remained, respectively. Multiple treatments of in vitro burn wound models with surface DBD for 6 min or with plasma jet for 8 min did not affect re-epithelialization. With the flexible surface DBD plasma strip we were able to quickly inactivate large numbers of bacteria on and in skin. Under the same conditions, viability of skin cells or re-epithelialization was not affected. The DBD source has potential for treating

  10. Wound dressings.

    PubMed

    Lionelli, Gerald T; Lawrence, W Thomas

    2003-06-01

    There are currently hundreds of dressings on the market to aid in wound management. Before selecting a dressing for a particular wound, a practitioner must assess carefully the needs of the wound to understand which dressing would provide maximal benefit. Frequently, there is not one clear best choice, and it is crucial that the pros and cons of each dressing modality be understood. This article has provided a framework to assist in dressing assessment. PMID:12822729

  11. Wound bed preparation: TIME for an update.

    PubMed

    Harries, Rhiannon L; Bosanquet, David C; Harding, Keith G

    2016-09-01

    While the overwhelming majority of wounds heal rapidly, a significant proportion fail to progress through the wound-healing process. These resultant chronic wounds cause considerable morbidity and are costly to treat. Wound bed preparation, summarised by the TIME (Tissue, Inflammation/infection, Moisture imbalance, Epithelial edge advancement) concept, is a systematic approach for assessing chronic wounds. Each of these components needs to be addressed and optimised to improve the chances of successful wound closure. We present an up-to-date literature review of the most important recent aspects of wound bed preparation. While there are many novel therapies that are available to the treating clinician, often, there are limited data on which to assess their clinical value, and a lack of appreciation for adequate wound bed preparation needed before expensive therapy is used to heal a wound. PMID:27547958

  12. [Wounds and dermatoses].

    PubMed

    Bulić, Suzana Ozanić; Kotrulja, Lena; Sjerobabski-Masnec, Ines

    2012-10-01

    Wounds are a hallmark of various skin diseases. Most patients with wounds suffer from chronic venous insufficiency or other vascular diseases. Autoimmune, infective, metabolic, malignant, some psychiatric and diseases caused by environmental factors like radiation, present with skin and mucosal erosions and ulcerations. Lichen planus, lichen sclerosus, toxic epidermal necrolysis, Kaposi sarcoma, genodermatoses like Hailey-Hailey and Darier's disease belong to different dermatological entities, they have different etiology, pathogenesis and clinical presentation, but at some stage ulcerations and erosions dominate through the disease course as a result of complications of untreated disease or as part of a complex clinical presentation. Wounds demand a different multidisciplinary therapeutic approach, sometimes even in intensive care unit, where special care is available. Most patients are followed-up to avoid fatal complications like sepsis, as well as a potential malignant transformation of cells in the environment of chronic inflammation. Wounds are found in female genital lichen planus and lichen sclerosus. Oral lichen planus has a potential for malignant transformation and is considered a precancerous disease. Toxic epidermal necrolysis is a life threatening disease similar to burns. Wounds cover most of the body surface as well as mucosa. The high mortality rate is due to complications like sepsis, loss of thermoregulation, electrolyte and fluid disbalance and shock. Chronic wounds are also a hallmark of skin tumors and other skin malignancies like Kaposi sarcoma and lymphoma. The primary treatment goal in genodermatoses like epidermolysis bullosa is wound care, and to a less extent in other inherited skin diseases like Hailey-Hailey and Darier's disease wound healing is important for sustaining a good quality of life in affected individuals. PMID:23193818

  13. Factor Associated with Neutral Sphingomyelinase Activity Mediates Navigational Capacity of Leukocytes Responding to Wounds and Infection: Live Imaging Studies in Zebrafish Larvae

    PubMed Central

    Boecke, Alexandra; Sieger, Dirk; Neacsu, Cristian Dan; Kashkar, Hamid

    2012-01-01

    Factor associated with neutral sphingomyelinase activity (FAN) is an adaptor protein that specifically binds to the p55 receptor for TNF (TNF-RI). Our previous investigations demonstrated that FAN plays a role in TNF-induced actin reorganization by connecting the plasma membrane with actin cytoskeleton, suggesting that FAN may impact on cellular motility in response to TNF and in the context of immune inflammatory conditions. In this study, we used the translucent zebrafish larvae for in vivo analysis of leukocyte migration after morpholino knockdown of FAN. FAN-deficient zebrafish leukocytes were impaired in their migration toward tail fin wounds, leading to a reduced number of cells reaching the wound. Furthermore, FAN-deficient leukocytes show an impaired response to bacterial infections, suggesting that FAN is generally required for the directed chemotactic response of immune cells independent of the nature of the stimulus. Cell-tracking analysis up to 3 h after injury revealed that the reduced number of leukocytes is not due to a reduction in random motility or speed of movement. Leukocytes from FAN-deficient embryos protrude pseudopodia in all directions instead of having one clear leading edge. Our results suggest that FAN-deficient leukocytes exhibit an impaired navigational capacity, leading to a disrupted chemotactic response. PMID:22802420

  14. Topical versus Systemic Vancomycin for Deep Sternal Wound Infection Caused by Methicillin-Resistant Staphylococcus aureus in a Rodent Experimental Model

    PubMed Central

    Ozcan, Ali V.; Demir, Melek; Onem, Gokhan; Goksin, Ibrahim; Baltalarli, Ahmet; Topkara, Veli K.; Kaleli, Ilknur

    2006-01-01

    In 37 Wistar albino rats, we investigated the effects of topical vancomycin on deep sternal wound infection caused by methicillin-resistant Staphylococcus aureus. Partial median sternotomy was performed under sterile conditions. Group I (n=6) was the sham, and group II (n=7) was the control. Group III (n=8) received topical vancomycin, group IV (n=8) received systemic vancomycin, and group V (n=8) received topical and systemic vancomycin (combined). Rats in groups II through V were inoculated with 0.5 mL × 108 CFU/mL methicillin-resistant S. aureus in the mediastinum and sternum. No medication was given to groups I and II. Twenty-four hours after surgery, 40 mg/kg/day vancomycin was given topically in group III; systemically in group IV; and topically and systemically in group V. After 7 days, smear samples from the mediastinum and tissue cultures from the sternum were obtained. We found 5.00 ± 0 CFU/mL microorganisms in the mediastinum in group II, 1.90 ± 1.70 in group III, 3.33 ± 0.48 in group IV, and 1.70 ± 1.08 in group V. The quantity of microorganisms per gram of tissue in the sternum was 7.36 ± 0.23 in group II, 6.01 ± 0.33 in group III, 5.81 ± 0.81 in group IV, and 3.99 ± 2.47 in group V. The quantity of microorganisms was less in the 3 treatment groups than in the control group (P <0.05). We conclude that topical plus systemic vancomycin treatment might be more effective in patients with deep sternal wound infections caused by methicillin-resistant S. aureus. PMID:16878608

  15. 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

  16. 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 ...

  17. Diabetic foot wounds: the value of negative pressure wound therapy with instillation.

    PubMed

    Dalla Paola, Luca

    2013-12-01

    Chronic wounds such as diabetic foot wounds are a tremendous burden to the health care system and often require a multidisciplinary approach to prevent amputations. Advanced technologies such as negative pressure wound therapy (NPWT) and bioengineered tissues have been successfully used in the treatment of these types of complex wounds. However, the introduction of NPWT with instillation (NPWTi) has provided an alternative treatment for treating complex and difficult-to-heal wounds. This article provides an overview of NPWT and the new NPWTi system and describes preliminary experience using NPWTi on patients with complicated infected diabetic foot wounds after surgical debridement and in a multidisciplinary setting. PMID:24251841

  18. Risk of wound infection and safety profile of amoxicillin in healthy patients which required third molar surgery: a systematic review and meta-analysis.

    PubMed

    Isiordia-Espinoza, M A; Aragon-Martinez, O H; Martínez-Morales, J F; Zapata-Morales, J R

    2015-11-01

    The aim of this systematic review and meta-analysis was to assess the risk of surgical wound infection and the adverse effects of amoxicillin in healthy patients who required excision of third molars. We identified eligible reports from searches of PubMed, Medline®, the Cochrane Library, Imbiomed, LILACS, and Google Scholar. Studies that met our minimum requirements were evaluated using inclusion and exclusion criteria and the Oxford Quality Scale. Those with a score of 3 or more on this Scale were included and their data were extracted and analysed. For evaluation of the risk of infection the absolute risk reduction, number needed to treat, and 95% CI were calculated. For evaluation of the risk of an adverse effect the absolute risk increase, number needed to harm, and 95% CI were calculated using the Risk Reduction Calculator. Each meta-analysis was made with the help of the Mantel-Haenszel random effects model, and estimates of risk (OR) and 95% CI were calculated using the Review Manager 5.3, from the Cochrane Library. A significant risk was assumed when the lower limit of the 95% CI was greater than 1. Probabilities of less than 0.05 were accepted as significant. The results showed that there was no reduction in the risk of infection when amoxicillin was given before or after operation compared with an untreated group or placebo. In conclusion, this study suggests that amoxicillin given prophylactically or postoperatively does not reduce the risk of infection in healthy patients having their third molars extracted. PMID:26316017

  19. 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

  20. Predicting complex acute wound healing in patients from a wound expertise centre registry: a prognostic study.

    PubMed

    Ubbink, Dirk T; Lindeboom, Robert; Eskes, Anne M; Brull, Huub; Legemate, Dink A; Vermeulen, Hester

    2015-10-01

    It is important for caregivers and patients to know which wounds are at risk of prolonged wound healing to enable timely communication and treatment. Available prognostic models predict wound healing in chronic ulcers, but not in acute wounds, that is, originating after trauma or surgery. We developed a model to detect which factors can predict (prolonged) healing of complex acute wounds in patients treated in a large wound expertise centre (WEC). Using Cox and linear regression analyses, we determined which patient- and wound-related characteristics best predict time to complete wound healing and derived a prediction formula to estimate how long this may take. We selected 563 patients with acute wounds, documented in the WEC registry between 2007 and 2012. Wounds had existed for a median of 19 days (range 6-46 days). The majority of these were located on the leg (52%). Five significant independent predictors of prolonged wound healing were identified: wound location on the trunk [hazard ratio (HR) 0·565, 95% confidence interval (CI) 0·405-0·788; P = 0·001], wound infection (HR 0·728, 95% CI 0·534-0·991; P = 0·044), wound size (HR 0·993, 95% CI 0·988-0·997; P = 0·001), wound duration (HR 0·998, 95% CI 0·996-0·999; P = 0·005) and patient's age (HR 1·009, 95% CI 1·001-1·018; P = 0·020), but not diabetes. Awareness of the five factors predicting the healing of complex acute wounds, particularly wound infection and location on the trunk, may help caregivers to predict wound healing time and to detect, refer and focus on patients who need additional attention. PMID:24007311

  1. [Wound healing in the elderly].

    PubMed

    Eming, S A; Wlaschek, M; Scharffetter-Kochanek, K

    2016-02-01

    Restoration of tissue integrity is essential for host defense and protection of the organism. The efficacy and quality of skin repair varies significantly over a person's lifetime. Whereas prenatal wound healing is characterized by regeneration and scarless healing, scarring, fibrosis, and loss of function are features of postnatal repair. In fact, aging is the prominent risk factor for chronic wounds, skin fragility, infections, comorbidities, and decreased quality of life. Current strategies for restoration of tissue integrity and wound therapy are not sufficient and require further investigation of the underlying pathomechanisms and the development of causal-based concepts. PMID:26728073

  2. 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 μm). 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

  3. 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...

  4. Gordonia bronchialis sternal wound infection in 3 patients following open heart surgery: intraoperative transmission from a healthcare worker.

    PubMed

    Wright, Shaneka N; Gerry, Joanna S; Busowski, Mary T; Klochko, Alena Y; McNulty, Steven G; Brown, Scott A; Sieger, Barry E; Ken Michaels, P; Wallace, Mark R

    2012-12-01

    We describe an investigation of 3 postoperative Gordonia bronchialis sternal infections. A nurse anesthetist was identified as the source of the outbreak, her scrubs likely becoming contaminated by her home washing machine. The outbreak ended after disposal of the implicated washing machine. Domestic laundering of surgical scrubs may need reevaluation. PMID:23143362

  5. Bacterial Wound Culture

    MedlinePlus

    ... Home Visit Global Sites Search Help? Bacterial Wound Culture Share this page: Was this page helpful? Also known as: Aerobic Wound Culture; Anaerobic Wound Culture Formal name: Culture, wound Related ...

  6. Current wound healing procedures and potential care

    PubMed Central

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

    2015-01-01

    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 micro RNA, and stem cell therapy. In addition, environment sensors can also potentially utilize to monitor and manage micro environment 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

  7. [Wound healing and wound irrigation in cesarean section of cattle].

    PubMed

    de Kruif, A; van den Brand, L P; van Kuyk, M M; Raymakers, R J; Sietsma, C; Westerbeek, A J

    1987-09-01

    Calves were delivered by Caesarean section in 128 cases during the early months of 1984. All animals were allocated alternately to a trial group and a group of controls. When the peritoneum and transverse muscle had been sutured, the wounds of the animals in the trial group were irrigated and washed with 300 ml. of Betadine (10 per cent of PVP-iodine in water). This was followed by closure of the wound. The animals of the group of controls were not treated. The procedure was performed in ninety-four primiparae (73 per cent) and thirty-four multiparae (27 per cent). The indication for Caesarean section consisted in fetal oversize in 119 cases (93 per cent). Eight calves (6 per cent) were stillborn or died immediately post partum. The proportion of animals in which the placentae were retained, was 9 per cent. Two animals died from peritonitis and intra-abdominal haemorrhage respectively. Irrigation of the wound did not have any effect on the number of wound infections (Table 3). Wound infection occurred in nineteen animals (15 per cent). The operations were performed by six veterinary surgeons (Table 4). The trial group and group of controls treated by each veterinarian did not differ essentially as regards wound healing. PMID:3672464

  8. Understanding the role of nutrition and wound healing.

    PubMed

    Stechmiller, Joyce K

    2010-02-01

    Optimal wound healing requires adequate nutrition. Nutrition deficiencies impede the normal processes that allow progression through stages of wound healing. Malnutrition has also been related to decreased wound tensile strength and increased infection rates. Malnourished patients can develop pressure ulcers, infections, and delayed wound healing that result in chronic nonhealing wounds. Chronic wounds are a significant cause of morbidity and mortality for many patients and therefore constitute a serious clinical concern. Because most patients with chronic skin ulcers suffer micronutrient status alterations and malnutrition to some degree, current nutrition therapies are aimed at correcting nutrition deficiencies responsible for delayed wound healing. This review provides current information on nutrition management for simple acute wounds and complex nonhealing wounds and offers some insights into innovative future treatments. PMID:20130158

  9. 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

    Krychowiak, Marta; Grinholc, Mariusz; Banasiuk, Rafal; Krauze-Baranowska, Miroslawa; Głód, 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

  10. 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; Głód, 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. Wound management in perforated appendicitis.

    PubMed

    Lemieur, T P; Rodriguez, J L; Jacobs, D M; Bennett, M E; West, M A

    1999-05-01

    Open wound management after perforated appendicitis was common practice but, recently, primary closure has been advocated to reduce costs and morbidity. Hospital records from 319 adults who underwent appendectomy from 1993 to 1996 were reviewed to identify surgical wound infections (SWIs) and examine risk factors. Information about age, length of stay (LOS), operative time, white blood cell count, and antibiotic administration were obtained. Perforation was either noted at operation or identified microscopically by the pathologist. If primary wound closure was performed, patients with acute appendicitis and perforation had a 4-fold higher readmission rate, a 5-fold increase in SWI, and twice the LOS compared with patients with acute appendicitis without perforation. Patients with grossly perforated acute appendicitis had no difference in LOS if the wound was treated open or closed primarily. No patient with microscopic perforation and primary wound closure developed SWI. Primary wound closure after acute appendicitis was safe in the absence of clinical perforation. In the presence of clinical appendiceal perforation the wound should be left open. PMID:10231213

  16. 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 μg/mL, and for enterococci was 1 μg/mL. The MIC90s for enteric Gram-negative rods was 0.125 μg/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 μg/mL and for clostridia 1 μg/mL. Avibactam improved ceftaroline's MIC90s for Bacteroides fragilis from >32 to 2 μg/mL and for Prevotella spp. from >32 to 1 μg/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

  17. In vitro antibiogram pattern of Staphylococcus aureus isolated from wound infection and molecular analysis of mecA gene and restriction sites in methicillin resistant Staphylococcus aureus

    PubMed Central

    Hemamalini, V.; Kavitha, V.; Ramachandran, Sridhar

    2015-01-01

    Staphylococcus aureus is a common nosocomial pathogen with property to develop resistance to antimicrobial agents. But in the modern era, drug resistance had been developed by microbes due to its continuous usage of antibiotics. This study was carried out to evaluate antibiotic resistant pattern of methicillin resistant Staphylococcus aureus (MRSA) using molecular genotyping. In view of the present problem, the study has been conducted to detect the molecular genotyping of mecA gene from MRSA and confirmation of its restriction sites using EcoRI and BamHI. The pus samples were swabbed out, and clinical strains were isolated using standard microbiological procedures. Then the strains were subjected to in vitro antibiotic susceptibility assay and identified MRSA. Further molecular genotyping of mecA gene was determined by polymerase chain reaction technique. The percentage analysis was done. The clinical strains were isolated from the wound infected patients. A total of 60 samples were collected, of 60 samples, 40 (66.7%) were showed positive to strains of S. aureus. The in vitro antibiotic susceptibility assay was carried to find the drug sensitive and resistant patterns. Further methicillin resistant strains (35%) of S. aureus were screened and subjected to molecular genotyping of mecA gene and was confirmed by restriction digestion. Overall, 70% of plasmids show positive for the presence of mecA gene, although all strains have restriction sites. Hence, the present study revealed that the early detection of antibiotic resistant character using molecular genotyping will help the infected patient to cure short period and will reduce the development of multidrug resistance. PMID:26605158

  18. Staphylococcal Infections

    MedlinePlus

    ... best way to prevent staph is to keep hands and wounds clean. Most staph skin infections are easily treated with antibiotics or by draining the infection. Some staph bacteria such as MRSA (methicillin-resistant Staphylococcus aureus) are ...

  19. Management of Sports-Induced Skin Wounds

    PubMed Central

    Foster, Danny T.; Rowedder, Laura J.; Reese, Steven K.

    1995-01-01

    Skin wounds are common in sports but are rarely documented by the certified athletic trainer. The literature is unclear about wound types, and none of the articles reviewed reported frequencies. The purpose of this paper is to discuss the frequency of common athletic skin wounds and their specific management. Management of skin wounds can sometimes be problematic. Hydrogen peroxide has been used on wounds since 1947, yet some researchers report that hydrogen peroxide and iodophor solution can delay or interfere with wound healing, or cause damage to the wounded area if use is intense and prolonged. Occlusive dressings have been reported to have considerable advantage in maintaining a moist wound bed and in decreasing healing time. Infection rates beneath occlusive dressings, however, are similar to those associated with other types of dressings. Complications to wounds, with or without the use of occlusive dressings, such as keloids and seborrheic dermatitis, occur in low frequencies. Due to a lack of specific information about sports-induced skin wounds and their management, we recommend that standardized documentation for common wounds be developed along with further study of techniques for management. PMID:16558324

  20. 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

  1. 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

  2. Wound botulism after traumatic open fracture in Italy.

    PubMed

    De Rosa, Francesco Giuseppe; Stella, Maria Laura; Astegiano, Sara; Corcione, Silvia; Motta, Ilaria; Decastelli, Lucia; Di Perri, Giovanni

    2015-09-01

    Seventeen days after a traumatic open fracture, a Clostridium botulinum wound infection was diagnosed, with self-limiting symptoms. This is the first report of wound botulism in Italy and the authors discuss the possible role of aerosolized contamination of the wound prior to hospital admission. PMID:26397301

  3. 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 ...

  4. Antimicrobial Blue Light Therapy for Multidrug-Resistant Acinetobacter baumannii Infection in a Mouse Burn Model: Implications for Prophylaxis and Treatment of Combat-related Wound Infections

    PubMed Central

    Zhang, Yunsong; Zhu, Yingbo; Gupta, Asheesh; Huang, Yingying; Murray, Clinton K.; Vrahas, Mark S.; Sherwood, Margaret E.; Baer, David G.; Hamblin, Michael R.; Dai, Tianhong

    2014-01-01

    In this study, we investigated the utility of antimicrobial blue light therapy for multidrug-resistant Acinetobacter baumannii infection in a mouse burn model. A bioluminescent clinical isolate of multidrug-resistant A. baumannii was obtained. The susceptibility of A. baumannii to blue light (415 nm)–inactivation was compared in vitro to that of human keratinocytes. Repeated cycles of sublethal inactivation of bacterial by blue light were performed to investigate the potential resistance development of A. baumannii to blue light. A mouse model of third degree burn infected with A. baumannii was developed. A single exposure of blue light was initiated 30 minutes after bacterial inoculation to inactivate A. baumannii in mouse burns. It was found that the multidrug-resistant A. baumannii strain was significantly more susceptible than keratinocytes to blue light inactivation. Transmission electron microscopy revealed blue light–induced ultrastructural damage in A. baumannii cells. Fluorescence spectroscopy suggested that endogenous porphyrins exist in A. baumannii cells. Blue light at an exposure of 55.8 J/cm2 significantly reduced the bacterial burden in mouse burns. No resistance development to blue light inactivation was observed in A. baumannii after 10 cycles of sublethal inactivation of bacteria. No significant DNA damage was detected in mouse skin by means of a skin TUNEL assay after a blue light exposure of 195 J/cm2. PMID:24381206

  5. Simultaneous irrigation and negative pressure wound therapy enhances wound healing and reduces wound bioburden in a porcine model.

    PubMed

    Davis, Kathryn; Bills, Jessica; Barker, Jenny; Kim, Paul; Lavery, Lawrence

    2013-01-01

    Infected foot wounds are one of the most common reasons for hospitalization and amputation among persons with diabetes. The objective of the study was to investigate a new wound therapy system that employs negative pressure wound therapy (NPWT) with simultaneous irrigation therapy. For this study, we used a porcine model with full-thickness excisional wounds, inoculated with Pseudomonas aeruginosa. Wounds were treated for 21 days of therapy with either NPWT, NPWT with simultaneous irrigation therapy using normal saline or polyhexanide biguanide (PHMB) at low or high flow rates, or control. Data show that NPWT with either irrigation condition improved wound healing rates over control-treated wounds, yet did not differ from NPWT alone. NPWT improved bioburden over control-treated wounds. NPWT with simultaneous irrigation further reduced bioburden over control and NPWT-treated wounds; however, flow rate did not affect these outcomes. Together, these data show that NPWT with simultaneous irrigation therapy with either normal saline or PHMB has a positive effect on bioburden in a porcine model, which may translate clinically to improved wound healing outcomes. PMID:24134060

  6. Shiunko promotes epithelization of wounded skin.

    PubMed

    Huang, Kuo-Feng; Hsu, Yao-Chin; Lin, Ching-Nan; Tzeng, Jann-Inn; Chen, Yu-Wen; Wang, Jhi-Joung

    2004-01-01

    Shiunko is a traditional botanic formula (ointment) which is used clinically for the treatment of wounded skin caused by cuts, abrasions, frost or burn. The aim of this study was to evaluate the effect of Shiunko on epithelization of wounded skin. Experimental cutting wounds on the back skin of Sprague-Dawley rats were induced. Different bacterial inoculations (Pseudomonus aeruginosa and Staphylococcus aureus) and treatment (Shiunko, Povidone-iodine and saline) were arranged herein. The incidences of infection and the speed of epithelization were evaluated. We observed that the incidences of wound infection following Pseudomonas aeruginosa inoculation were lower on both the Shiunko-treated group (0%, p < 0.01) and Povidine-iodine-treated group (5%, p < 0.05), than the saline-treated group (40%). The Shiunko-treated group reported higher percentages of complete epithelization not only on the sterilized wounds (100%) but also on the contaminated wounds (90%) when compared to the saline-treated group (60% sterilized wounds, 40% and 50% contaminated wounds) on day 7 (p < 0.01). Povidone-iodine did not promote epithelization of wounded skin, whereas Shiunko did. PMID:15344422

  7. Chronic Wound Biofilms: Pathogenesis and Potential Therapies.

    PubMed

    Clinton, Allie; Carter, Tammy

    2015-01-01

    Chronic wounds are a growing medical problem that cause high rates of morbidity and mortality, costing the healthcare industry in the United States millions of dollars annually. Chronic wound healing is hampered by the presence of bacterial infections that form biofilms, in which the bacteria are encased in exopolysaccharide (EPS) and are less metabolically active than their free-living counterparts. Bacterial biofilms make chronic wounds more refractory to treatment and slow tissue repair by stimulating chronic inflammation at the wound site. Bacterial species communicate through a mechanism known as quorum sensing (QS) to regulate and coordinate the gene expression that is important for virulence-factor production, including biofilm formation. This review focuses on the relationships between chronic wounds, biofilms, and QS in the virulence of chronic-wound pathogens. PMID:26489671

  8. Wound emergencies: the importance of assessment, documentation, and early treatment using a wound electronic medical record.

    PubMed

    Golinko, Michael S; Clark, Sunday; Rennert, Robert; Flattau, Anna; Boulton, Andrew J M; Brem, Harold

    2009-05-01

    Chronic wounds such as diabetic foot ulcers, venous ulcers, and pressure ulcers are a major source of morbidity and mortality. To describe wound characteristics associated with a wound emergency, the Wound Electronic Medical Records (WEMR) of 200 consecutive admissions (139 patients, average number of admissions 1.4) to a dedicated inpatient wound healing unit over a period of 5 months were retrospectively reviewed. Patient mean age was 62 +/- 16 years, 59% were men, 27% had a foot ulcer and diabetes mellitus, and 29% had venous ulcers. Presenting signs and symptoms included wound pain, cellulitis, nonpurulent drainage, and undermining, but few presented with classic local clinical signs of infection. Treatment consisted of sharp debridement with deep tissue culture and pathology from the wound base and/or systemic antibiotics. Twenty-percent (20%) of patients had pathology-confirmed and 38% had pathology- or radiology-confirmed osteomyelitis on admission, supporting that new or increasing wound pain, cellulitis, and/or nonpurulent drainage or presence of significant undermining may be indicative of an invasive infection and that patients presenting with these signs and symptoms require an immediate treatment plan and consideration of hospital admission. Use of an objective documentation system such as the WEMR may help alert clinicians to subtle wound changes that require aggressive treatment; thereby, avoiding emergency room visits and hospital admissions. Future research is needed utilizing the WEMR across multiple medical centers to further define criteria for a chronic wound emergency. PMID:19471049

  9. Negative pressure wound therapy.

    PubMed

    Thompson, James T; Marks, Malcolm W

    2007-10-01

    Negative pressure wound therapy has become an increasingly important part of wound management. Over the last decade, numerous uses for this method of wound management have been reported, ranging from acute and chronic wounds, to closure of open sternal and abdominal wounds, to assistance with skin grafts. The biophysics behind the success of this treatment largely have focused on increased wound blood flow, increased granulation tissue formation, decreased bacterial counts, and stimulation of wound healing pathways through shear stress mechanisms. The overall success of negative pressure wound therapy has led to a multitude of clinical applications, which are discussed in this article. PMID:17967622

  10. The Efficacy of Continuous Negative Pressure and Irrigation Treatment Inside the Wound by a Closed System in Reconstruction of All Layers of the Cranium Accompanying Infection and Cerebrospinal Fluid Leakage.

    PubMed

    Oyama, Mai; Rikimaru, Hideaki; Migita, Hisashi; Sakata, Kensuke; Kiyokawa, Kensuke

    2016-01-01

    There have been many reports to date with respect to treatments on reconstruction of the cranium without accompanying infections following trauma and tumor resection. The morality is, however, high in patients observed with generation of cranial bone defect of all layers accompanying infection and cerebrospinal fluid leakage, and moreover, there are barely any reports on such cases because of the reconstruction thereof being very difficult. In this study, the authors were able to cure such 2 cases by carrying out continuous negative pressure and irrigation treatment inside the wound by a closed system following transplant of free latissimus dorsi muscle flap. This method is believed to be very effective for cranial bone defect of all layers accompanying infection and cerebrospinal fluid leakage, in which treatment was determined to be very difficult. PMID:26674903

  11. [Chronic wounds: differential diagnosis].

    PubMed

    Situm, Mirna; Kolić, 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

  12. 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

  13. High-dose continuous oxacillin infusion results in achievement of pharmacokinetics targets in critically ill patients with deep sternal wound infections following cardiac surgery.

    PubMed

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

    2014-09-01

    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

  14. Comparative In Vitro Activities of ABT-773 against Aerobic and Anaerobic Pathogens Isolated from Skin and Soft-Tissue Animal and Human Bite Wound Infections

    PubMed Central

    Goldstein, Ellie J. C.; Citron, Diane M.; Merriam, C. Vreni; Warren, Yumi; Tyrrell, Kerin

    2000-01-01

    We studied the comparative in vitro activities of ABT-773, a new ketolide, against 268 aerobic and 148 anaerobic recent isolates from clinical bites using an agar dilution method and inocula of 104 CFU/spot for aerobes and 105 CFU for anaerobes. The following are the MIC ranges and MICs at which 90% of isolates are inhibited (MIC90s) of ABT-773 for various isolates, respectively: Pasteurella multocida and Pasteurella septica, 0.125 to 2 and 1 μg/ml; other Pasteurella species, 0.125 to 1 and 0.5 μg/ml; Corynebacterium spp., 0.015 to 0.06 and 0.015 μg/ml; Staphylococcus aureus, 0.03 to 0.06 and 0.06 μg/ml; coagulase-negative staphylococci, 0.015 to >32 and 32 μg/ml; streptococci, 0.015 to 0.03 and 0.03 μg/ml; Eikenella corrodens, 0.25 to 1 and 1 μg/ml; and Bergeyella zoohelcum, 0.03 to 0.25 and 0.06 μg/ml. For anaerobes the MIC ranges and MIC90s of ABT-773 were as follows, respectively: Prevotella heparinolytica, 0.06 to 0.125 and 0.125 μg/ml; Prevotella spp., 0.015 to 0.125 and 0.06 μg/ml; Porphyromonas spp., 0.015 to 0.03 and 0.015 μg/ml; Fusobacterium nucleatum, 0.5 to 8 and 8 μg/ml; other Fusobacterium spp., 0.015 to 8 and 0.5 μg/ml; Bacteroides tectum, 0.015 to 0.5 and 0.06 μg/ml; and Peptostreptococcus spp., 0.015 to 0.25 and 0.03 μg/ml. ABT-773 was more active than all macrolides tested against S. aureus, E. corrodens, and anaerobes, but all compounds were poorly active against F. nucleatum. The activity of ABT-773 was within 1 dilution of that of azithromycin against Pasteurella spp., and ABT-773 was four- to eightfold more active than clarithromycin against Pasteurella spp. ABT-773 may offer a therapeutic alternative for bite wound infections. PMID:10952607

  15. 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

  16. Cold plasma inactivation of chronic wound bacteria.

    PubMed

    Mohd Nasir, N; Lee, B K; Yap, S S; Thong, K L; Yap, S L

    2016-09-01

    Cold plasma is partly ionized non-thermal plasma generated at atmospheric pressure. It has been recognized as an alternative approach in medicine for sterilization of wounds, promotion of wound healing, topical treatment of skin diseases with microbial involvement and treatment of cancer. Cold plasma used in wound therapy inhibits microbes in chronic wound due to its antiseptic effects, while promoting healing by stimulation of cell proliferation and migration of wound relating skin cells. In this study, two types of plasma systems are employed to generate cold plasma: a parallel plate dielectric barrier discharge and a capillary-guided corona discharge. Parameters such as applied voltage, discharge frequency, treatment time and the flow of the carrier gas influence the cold plasma chemistry and therefore change the composition and concentration of plasma species that react with the target sample. Chronic wound that fails to heal often infected by multidrug resistant organisms makes them recalcitrant to healing. Methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (Pseudomonas aeruginosa) are two common bacteria in infected and clinically non-infected wounds. The efficacies of the cold plasma generated by the two designs on the inactivation of three different isolates of MRSA and four isolates of P. aeruginosa are reported here. PMID:27046340

  17. Wound Healing Essentials: Let There Be Oxygen

    PubMed Central

    Sen, Chandan K.

    2009-01-01

    The state of wound oxygenation is a key determinant of healing outcomes. From a diagnostic standpoint, measurements of wound oxygenation are commonly used to guide treatment planning such as amputation decision. In preventive applications, optimizing wound perfusion and providing supplemental O2 in the peri-operative period reduces the incidence of post-operative infections. Correction of wound pO2 may, by itself, trigger some healing responses. Importantly, approaches to correct wound pO2 favorably influence outcomes of other therapies such as responsiveness to growth factors and acceptance of grafts. Chronic ischemic wounds are essentially hypoxic. Primarily based on the tumor literature, hypoxia is generally viewed as being angiogenic. This is true with the condition that hypoxia be acute and mild to modest in magnitude. Extreme near-anoxic hypoxia, as commonly noted in problem wounds, is not compatible with tissue repair. Adequate wound tissue oxygenation is required but may not be sufficient to favorably influence healing outcomes. Success in wound care may be improved by a personalized health care approach. The key lies in our ability to specifically identify the key limitations of a given wound and in developing a multifaceted strategy to specifically address those limitations. In considering approaches to oxygenate the wound tissue it is important to recognize that both too little as well as too much may impede the healing process. Oxygen dosing based on the specific need of a wound therefore seems prudent. Therapeutic approaches targeting the oxygen sensing and redox signaling pathways are promising. PMID:19152646

  18. Delayed Wound Healing in Diabetic (db/db) Mice with Pseudomonas aeruginosa Biofilm Challenge – A Model for the Study of Chronic Wounds

    PubMed Central

    Zhao, Ge; Hochwalt, Phillip C.; Usui, Marcia L.; Underwood, Robert A.; Singh, Pradeep K.; James, Garth A.; Stewart, Philip S.; Fleckman, Philip; Olerud, John E.

    2010-01-01

    Chronic wounds are a major clinical problem that leads to considerable morbidity and mortality. We hypothesized that an important factor in the failure of chronic wounds to heal was the presence of microbial biofilm resistant to antibiotics and protected from host defenses. A major difficulty in studying chronic wounds is the absence of suitable animal models. The goal of this study was to create a reproducible chronic wound model in diabetic mice by application of bacterial biofilm. Six millimeter punch biopsy wounds were created on the dorsal surface of diabetic (db/db) mice, subsequently challenged with Pseudomonas aeruginosa (PAO1) biofilms two days post-wounding, and covered with semi-occlusive dressings for two weeks. Most of the control wounds were epithelialized by 28 days post-wounding. In contrast, none of biofilm challenged wounds were closed. Histological analysis showed extensive inflammatory cell infiltration, tissue necrosis and epidermal hyperplasia adjacent to challenged wounds- all indicators of an inflammatory non-healing wound. Quantitative cultures and transmission electron microscopy demonstrated that the majority of bacteria were in the scab above the wound bed rather than in the wound tissue. The model was reproducible, allowed localized cutaneous wound infections without high mortality and demonstrated delayed wound healing following biofilm challenge. This model may provide an approach to study the role of microbial biofilms in chronic wounds as well as the effect of specific biofilm therapy on wound healing. PMID:20731798

  19. 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

  20. 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

  1. [New directions of research related to chronic wound healing].

    PubMed

    Rusak, Agnieszka; Rybak, Zbigniew

    2013-01-01

    Optimal nutrition, immunological state and psychological condition play an important role in the process of chronic wound healing. Infections caused by pathogens resistant to commonly used antibiotics additionally complicate and disturb regeneration of wounds. As part of the treatment, modern wound dressings are used, for example designed on the basis of alginates, dextranomers, hydrogels, hydrofiber, polyurethanes foams, hydrocolloids and liquids for wound debridement such us 0.9% NaCl, the PWE liquid, Ringer's liquid, octenidine. Owing to their features, treatment in accordance with TIME concept could be realized, because they provide moisture wound bed, protection against contamination, gas exchange, protection of wound edges and infection control. Repairing process in chronic wounds is dependent on blood flow in tissues, which may be insufficient. The result is a permanent hypoxia. Natural occurring antioxidants are becoming more crucial in chronic wound treatment. They decrease oxygen radical concentration, increase angiogenesis, reduce inflammatory response, stimulate fibroblasts and keratinocytes proliferation, possess antibacterial properties against chemotherapeutic resistant strains. There are a lot of antioxidants in honey, papaya fruit (Carrica papaia L.), transgenic flax (Linum usitatissimum), and in orange oil (Citrus sinensis), stem of acanthus (Acanthus ebracteatus), leafs of tea (Camellia sinensis). Application of biologically active, natural derived compounds is nowadays a direction of intense in vitro and in vivo research focused on the chronic wound treatment. Results suggest beneficial influence of antioxidant on wound repairing process. Clinical research are needed to state effective influence of natural compound in the chronic wound treatment. PMID:24377187

  2. [General principles of wound management in emergency departments].

    PubMed

    Zacher, M T; Högele, A M; Hanschen, M; von Matthey, F; Beer, A-K; Gebhardt, F; Biberthaler, P; Kanz, K-G

    2016-04-01

    Wound management is one of the major tasks in emergency departments. The surrounding intact skin but not the wound itself should be disinfected before starting definitive wound treatment. Hair should first be removed by clipping to 1-2 mm above the skin with scissors or clippers as shaving the area with a razor damages the hair follicles and increases the risk of wound infections. Administration of local anesthetics should be performed directly through the exposed edges of the wound. After wound examination, irrigation is performed with Ringer's solution, normal saline or distilled water. The next step is débridement of contaminated and devitalized tissue. There are several wound closure techniques available, including adhesive tapes, staples, tissue adhesives and numerous forms of sutures. Management of specific wounds requires particular strategies. A bleeding control problem frequently occurs with scalp lacerations. Superficial scalp lacerations can be closed by alternative wound closure methods, for example by twisting and fixing hair and the use of tissue adhesives, i.e. hair apposition technique (HAT). For strongly bleeding lacerations of the scalp, the epicranial aponeurosis should be incorporated into the hemostasis. Aftercare varies depending on both the characteristics of the wound and those of the patient and includes adequate analgesia as well as minimizing the risk of infection. Sufficient wound aftercare starts with the treating physician informing the patient about the course of events, potential complications and providing relevant instructions. PMID:27059794

  3. Biofilms and Wounds: An Overview of the Evidence

    PubMed Central

    Percival, Steven L.; McCarty, Sara M.; Lipsky, Benjamin

    2015-01-01

    Significance: Microorganisms can exist both in the planktonic and biofilm state. Each phenotypic state has a role to play in delaying healing and causing infections of both acute and chronic wounds. However, the virulent biofilm state is the fundamental reason that chronic wounds do not heal in a timely manner. We hypothesize that because microorganisms attach to any surface, biofilms can be found in all chronic wounds. However, it is not the biofilm per se that represents the greatest obstacle to the healing of a chronic wound, but its virulence and pathogenicity. Recent Advances: Numerous studies with animals and humans have identified biofilms in wounds. In particular, these studies have highlighted how biofilms impede host fibroblast development, inflammatory responses, and the efficacy of antimicrobial therapy. Despite this, the role biofilms play in affecting the healing of wounds is still vigorously debated. Critical Issues: Clinicians must understand the role that pathogenic biofilms play in impairing the healing of chronic wounds and in increasing the risk for wound infection, with its potentially catastrophic outcomes. The composition of the biofilm, its physiochemical properties, the climaxed indigenous microbiota and their virulence/pathogenicity, microbial numbers and the host's pathophysiology, and immunological fitness will govern the sustainability of a pathogenic biofilm in a wound and its resistance to interventions. Future Directions: Establishing which specific pathogenic biofilms delay wound healing should help guide better wound care practices. PMID:26155379

  4. Evaluation of a new liquid occlusive dressing for excisional wounds.

    PubMed

    Singer, Adam J; Nable, Maria; Cameau, Paul; Singer, Daniel D; McClain, Steve A

    2003-01-01

    We evaluated a novel octylcyanoacrylate-based liquid occlusive dressing for partial-thickness wounds. One hundred and fifteen standardized wounds were created with an electric dermatome set at a depth of 600 micro on the flanks of three pigs and randomly treated with liquid occlusive dressing, a hydrocolloid dressing, or gauze. In one pig, wounds were swabbed with Staphylococcus aureus. Biopsies were taken after 4, 5, 6, and 21 days. Hemostasis was obtained in all wounds treated with the liquid occlusive. The percent reepithelialization of wounds treated with the liquid occlusive and hydrocolloid dressings were significantly greater at days 4 and 5 than control wounds (78% and 82% vs. 40%, p < 0.001 and 99% and 100% vs. 72%, p < 0.001, respectively). None of the liquid occlusive-treated wounds challenged with bacteria became infected. Foreign body reactions were least common in wounds treated with the liquid occlusive (p < 0.001). Scar depth was less for liquid occlusive- and hydrocolloid-treated wounds than controls (285 micro and 303 micro vs. 490 micro, p < 0.001). We conclude that excisional wounds treated with the liquid occlusive dressing reepithelialize as quickly as hydrocolloid-treated wounds. The liquid occlusive dressing is an effective microbial barrier and hemostatic agent resulting in fewer foreign body reactions than hydrocolloid-treated wounds or controls. PMID:12753599

  5. Wound healing and treating wounds: Chronic wound care and management.

    PubMed

    Powers, Jennifer G; Higham, Catherine; Broussard, Karen; Phillips, Tania J

    2016-04-01

    In the United States, chronic ulcers--including decubitus, vascular, inflammatory, and rheumatologic subtypes--affect >6 million people, with increasing numbers anticipated in our growing elderly and diabetic populations. These wounds cause significant morbidity and mortality and lead to significant medical costs. Preventative and treatment measures include disease-specific approaches and the use of moisture retentive dressings and adjunctive topical therapies to promote healing. In this article, we discuss recent advances in wound care technology and current management guidelines for the treatment of wounds and ulcers. PMID:26979353

  6. Surgical wound care - open

    MedlinePlus

    ... around your wound: Use a normal saline solution (salt water) or mild soapy water. Soak the gauze or ... wash out, your wound: Fill a syringe with salt water or soapy water, whichever your doctor recommends. Hold ...

  7. Gunshot wounds -- aftercare

    MedlinePlus

    ... remove pieces of broken or shattered bone To clean the wound Gunshots wounds that pass through the ... mind: Keep the dressing and area around it clean and dry. Take any antibiotics or pain relievers ...

  8. How wounds heal

    MedlinePlus

    ... How puncture wounds heal; How burns heal; How pressure sores heal; How lacerations heal ... bleed. For example, burns, some puncture wounds, and pressure sores don't bleed. Once the scab forms, your ...

  9. 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 ...

  10. Wound care centers

    MedlinePlus

    ... multiple types of dressings as your wound heals. Hyperbaric oxygen therapy Depending on the type of wound, your doctor may recommend hyperbaric oxygen therapy . Oxygen is important for healing. During this treatment, ...

  11. 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 μg/mL can promote the migration of fibroblast L929 cells similar to epidermal growth factor (positive control) at 100 μg/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

  12. The emergency care of traumatic wounds: current recommendations.

    PubMed

    Gfeller, R W; Crowe, D T

    1994-11-01

    Emergency management of wounds involves examination and protection of the wound with a wet dressing (when possible) to prevent further contamination and desiccation. Analgesia (or preferably anesthesia) is provided and the patient and the wound are prepared for surgery. Copious amounts of lavage solution are used under moderate pressure. Proper and thorough debridement under irrigation is tedious and time consuming, but is the most important factor that influences subsequent wound healing. Incomplete removal of devitalized or contaminated tissue and debris are a common cause of wound infection, breakdown, and delayed healing. Wound closure is only accomplished when the veterinarian is certain that all devitalized and contaminated tissue has been removed and there is adequate skin. Covering the wound to heal by second intention or delayed closure should be considered more often in veterinary medicine. All too often, the wound is closed prematurely, resulting in dehiscence and infection a few days later. This provides a source of complications to the pet, as well as a source of dissatisfaction for the client. If, after initial debridement and irrigation, there is any doubt about the advisability of surgical closure, the clinician should cover the wound with a proper dressing and continue daily (or more often) dressing changes with local irrigation and debridement as required. Drainage of wound fluid is critical to healing in contaminated wounds. Wound fluids interfere with healing and increase the likelihood of infection. Passive drains (Penrose) are frequently used, often incorrectly. The exposed end of passive drains should be covered with a sterile, absorbent dressing. Active drainage is more efficient than passive drainage and can be accomplished with minimal additional skill and material. Improper use of drains can cause more problems than no drainage at all. Patients suffering painful traumatic (or surgical) wounds should receive analgesic medications. The

  13. [Prevention and treatment strategy for burn wound sepsis in children].

    PubMed

    Niu, Xihua; Li, Xiaoling

    2016-02-01

    Wound sepsis is one of the main causes of death in patients with severe burn and trauma. The high incidence of burn wound sepsis in children is attributed to their imperfect immune system function, poor resistance against infection, and the weakened skin barrier function after burn. The key to reduce the mortality of pediatric patients with burn wound sepsis is to enhance the understanding of its etiology, epidemiology, pathogenesis, and diagnostic criteria, in order to improve its early diagnosis and treatment. PMID:26902271

  14. [Wound management for cuts and lacerations].

    PubMed

    Kluwe, Wolfram

    2015-02-01

    Skin cuts and lacerations are frequent injuries. A perfect result of the treatment is going without saying for the patient and its relatives. But there are some aspects to note for an adequate wound management. The main aims of wound management are clear: assist in hemostasis, to avoid infection and pain, and to ensure an esthetically pleasing scar. For these we have to treat not only the wound. Taking care for the hole patient and treating the sore pain and preventing painfull manipulations is the goal for the patients satisfaction. The basic aspects of wound healing and wound management will be described. Sutures, tissue adhesives, staples, and skin-closure tapes are options in the outpatient setting. Although suturing is the preferred method for laceration repair, tissue adhesives are similar in patient satisfaction, infection rates, and scarring risk in low skin-tension areas and may be also more cost-effective. Patient education and appropriate procedural coding are important after the repair. Please do not forget in every case to ask for the tetanus immunization and to think about an antibiotic therapy in case of human or animal bites and for wounds in risk areas and with contamination. PMID:26376539

  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. Fluorescence Technology for Point of Care Wound Management.

    PubMed

    Anghel, Ersilia L; Falola, Reuben A; Kim, Paul J

    2016-04-01

    As the prevalence of chronic wounds continues to rise, the need for point of care wound assessment has also increased. While a variety of technologies have been developed to improve diagnostic abilities and monitoring of wounds, none have proven completely effective in all settings. Further, many of the stalwart wound management techniques remain costly, time consuming, and technically challenging. The two key pivotal events of ischemia and infection can lead to limb loss. A relatively new crop of fluorescence-based technologies, including devices that measure pathogenic auto-fluorescence, fluorescence angiography, or map cutaneous oxygenation, are increasingly being utilized for adjunct wound assessment-both clinical and operative settings can address these events. These technologies offer rapid, efficient, visual, and quantitative data that can aid the wound provider in evaluating the viability of tissues, ensuring adequate perfusion, and optimizing wound bed preparation. In the following review, pathogenic auto-fluorescence is compared to gross evaluation of wound infection and culture based diagnostics, indocyanine green fluorescence angiography is compared to various methods of visual and physical assessments of tissue perfusion by the practitioner, and cutaneous oxygenation is compared to clinical signs of ischemia. We focus on the current applications of fluorescence technologies in wound management, with emphasis placed on the evidence for clinical and operative implementation, a safety analyses, procedural limitations, and the future direction of this growing field of wound assessment. PMID:27175815

  17. [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

  18. Advanced Therapeutic Dressings for Effective Wound Healing--A Review.

    PubMed

    Boateng, Joshua; Catanzano, Ovidio

    2015-11-01

    Advanced therapeutic dressings that take active part in wound healing to achieve rapid and complete healing of chronic wounds is of current research interest. There is a desire for novel strategies to achieve expeditious wound healing because of the enormous financial burden worldwide. This paper reviews the current state of wound healing and wound management products, with emphasis on the demand for more advanced forms of wound therapy and some of the current challenges and driving forces behind this demand. The paper reviews information mainly from peer-reviewed literature and other publicly available sources such as the US FDA. A major focus is the treatment of chronic wounds including amputations, diabetic and leg ulcers, pressure sores, and surgical and traumatic wounds (e.g., accidents and burns) where patient immunity is low and the risk of infections and complications are high. The main dressings include medicated moist dressings, tissue-engineered substitutes, biomaterials-based biological dressings, biological and naturally derived dressings, medicated sutures, and various combinations of the above classes. Finally, the review briefly discusses possible prospects of advanced wound healing including some of the emerging physical approaches such as hyperbaric oxygen, negative pressure wound therapy and laser wound healing, in routine clinical care. PMID:26308473

  19. 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...

  20. Involvement of ABA in potato tuber wound-healing

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Rapid suberization of tubers wounded during harvest, handling and seed cutting is crucial in protecting against infections, dehydration and defect development. Research at this laboratory is directed at determining the biological factors that regulate wound-healing and which may facilitate the deve...

  1. DEVELOPMENT OF A NEXT-GENERATION ANTIMICROBIAL WOUND DRESSING.

    PubMed

    Metcalf, Daniel; Parsons, David; Bowler, I Philip

    2016-03-01

    Delayed wound healing due to infection is a burden on healthcare systems, and the patient and caregiver alike. An emerging factor in infection and delayed healing is the presence development of biofilm in wounds. Biofilm is communities of microorganisms, protected by an extracellular matrix of slime in the wound, which can tolerate host defences and applied antimicrobials such as antibiotics or antimicrobial dressings. A growing evidence base exists suggesting that biofilm exists in a majority of chronic wounds, and can be a precursor to infection while causing delayed healing itself. In vivo models have demonstrated that the inflammatory, granulation and epithelialization processes of normal wound healing are impaired by biofilm presence. The challenge in the development of a new antimicrobial wound dressing was to make standard antimicrobial agents more effective against biofilm, and this was answered following extensive biofilm research and testing. A combination of metal chelator, surfactant and pH control displayed highly synergistic anti-biofilm action with 1.2% ionic silver in a carboxymethylcellulose dressing. Its effectiveness was challenged and proven in complex in vitro and in vivo wound biofilm models, followed by clinical safety and performance demonstrations in a 42-patient study and 113 clinical evaluations. Post-market surveillance was conducted on the commercially available dressing, and in a 112-case evaluation, the dressing was shown to effectively manage exudate and suspected biofilm while shifting difficult-to-heal wounds onto healing trajectories, after an average of 4 weeks of new dressing use in otherwise standard wound care protocols. This was accompanied by a low frequency of dressing related adverse events. In a second evaluation, clinical signs of infection and wound dimension data, before and after the evaluations, were also available. Following an average of 5.4 weeks of dressing use, all signs of clinical infection were reduced, from

  2. 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

  3. Assisted closure of fasciotomy wounds

    PubMed Central

    Fowler, J. R.; Kleiner, M. T.; Das, R.; Gaughan, J. P.; Rehman, S.

    2012-01-01

    Introduction Negative pressure wound therapy (NPWT) and vessel loop assisted closure are two common methods used to assist with the closure of fasciotomy wounds. This retrospective review compares these two methods using a primary outcome measurement of skin graft requirement. Methods A retrospective search was performed to identify patients who underwent fasciotomy at our institution. Patient demographics, location of the fasciotomy, type of assisted closure, injury characteristics, need for skin graft, length of stay and evidence of infection within 90 days were recorded. Results A total of 56 patients met the inclusion criteria. Of these, 49 underwent vessel loop closure and seven underwent NPWT assisted closure. Patients who underwent NPWT assisted closure were at higher risk for requiring skin grafting than patients who underwent vessel loop closure, with an odds ratio of 5.9 (95% confidence interval 1.11 to 31.24). There was no difference in the rate of infection or length of stay between the two groups. Demographic factors such as age, gender, fracture mechanism, location of fasciotomy and presence of open fracture were not predictive of the need for skin grafting. Conclusion This retrospective descriptive case series demonstrates an increased risk of skin grafting in patients who underwent fasciotomy and were treated with NPWT assisted wound closure. In our series, vessel loop closure was protective against the need for skin grafting. Due to the small sample size in the NPWT group, caution should be taken when generalising these results. Further research is needed to determine if NPWT assisted closure of fasciotomy wounds truly leads to an increased requirement for skin grafting, or if the vascular injury is the main risk factor. PMID:23610668

  4. 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

  5. Metalloproteinases and Wound Healing

    PubMed Central

    Caley, Matthew P.; Martins, Vera L.C.; O'Toole, Edel A.

    2015-01-01

    Significance: Matrix metalloproteinases (MMPs) are present in both acute and chronic wounds. They play a pivotal role, with their inhibitors, in regulating extracellular matrix degradation and deposition that is essential for wound reepithelialization. The excess protease activity can lead to a chronic nonhealing wound. The timed expression and activation of MMPs in response to wounding are vital for successful wound healing. MMPs are grouped into eight families and display extensive homology within these families. This homology leads in part to the initial failure of MMP inhibitors in clinical trials and the development of alternative methods for modulating the MMP activity. MMP-knockout mouse models display altered wound healing responses, but these are often subtle phenotypic changes indicating the overlapping MMP substrate specificity and inter-MMP compensation. Recent Advances: Recent research has identified several new MMP modulators, including photodynamic therapy, protease-absorbing dressing, microRNA regulation, signaling molecules, and peptides. Critical Issues: Wound healing requires the controlled activity of MMPs at all stages of the wound healing process. The loss of MMP regulation is a characteristic of chronic wounds and contributes to the failure to heal. Future Directions: Further research into how MMPs are regulated should allow the development of novel treatments for wound healing. PMID:25945285

  6. Current concepts in wound management and wound healing products.

    PubMed

    Davidson, Jacqueline R

    2015-05-01

    Current concepts in wound management are summarized. The emphasis is on selection of the contact layer of the bandage to promote a moist wound environment. Selection of an appropriate contact layer is based on the stage of wound healing and the amount of wound exudate. The contact layer can be used to promote autolytic debridement and enhance wound healing. PMID:25744144

  7. New Developments in Smart Bandage Technologies for Wound Diagnostics.

    PubMed

    McLister, Anna; McHugh, Jolene; Cundell, Jill; Davis, James

    2016-07-01

    The pH of wound fluid has long been recognized as an important diagnostic for assessing wound condition, but as yet there are few technological options available to the clinician. The availability of sensors that can measure wound pH, either in the clinic or at home could significantly improve clinical outcome - particularly in the early identification of complications such as infection. New material designs and electrochemical research strategies that are being targeted at wound diagnostics are identified and a critical overview of emerging research that could be pivotal in setting the direction for future devices is provided. PMID:26821765

  8. 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...

  9. Epithelial mechanobiology, skin wound healing, and the stem cell niche.

    PubMed

    Evans, Nicholas D; Oreffo, Richard O C; Healy, Eugene; Thurner, Philipp J; Man, Yu Hin

    2013-12-01

    Skin wound healing is a vital process that is important for re-establishing the epithelial barrier following disease or injury. Aberrant or delayed skin wound healing increases the risk of infection, causes patient morbidity, and may lead to the formation of scar tissue. One of the most important events in wound healing is coverage of the wound with a new epithelial layer. This occurs when keratinocytes at the wound periphery divide and migrate to re-populate the wound bed. Many approaches are under investigation to promote and expedite this process, including the topical application of growth factors and the addition of autologous and allogeneic tissue or cell grafts. The mechanical environment of the wound site is also of fundamental importance for the rate and quality of wound healing. It is known that mechanical stress can influence wound healing by affecting the behaviour of cells within the dermis, but it remains unclear how mechanical forces affect the healing epidermis. Tensile forces are known to affect the behaviour of cells within epithelia, however, and the material properties of extracellular matrices, such as substrate stiffness, have been shown to affect the morphology, proliferation, differentiation and migration of many different cell types. In this review we will introduce the structure of the skin and the process of wound healing. We will then discuss the evidence for the effect of tissue mechanics in re-epithelialisation and, in particular, on stem cell behaviour in the wound microenvironment and in intact skin. We will discuss how the elasticity, mechanical heterogeneity and topography of the wound extracellular matrix impact the rate and quality of wound healing, and how we may exploit this knowledge to expedite wound healing and mitigate scarring. PMID:23746929

  10. Escherichia vulneris in a Danish soccer wound.

    PubMed

    Jepsen, C F; Klebe, T M; Prag, J

    1997-01-01

    Escherichia vulneris was isolated from an infected soccer wound, a finding which has not apparently been described in Europe before, but by questioning Danish clinical microbiological laboratories a further 12 cases were discovered. Treatment with simple debridement and cefuroxime quickly eradicated the bacteria in our case. PMID:9255899

  11. Signals Involved in Tuber Wound-Healing

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The induction and regulation of wound-healing (WH) processes in potato tubers and other vegetables are of great nutritional and economic importance. The rapid accumulation of waxes to restrict water vapor loss and formation of suberin barriers to block infection are crucial components of WH. Recen...

  12. Managing infection: a holistic approach.

    PubMed

    Tayeb, Khaled Abdullah

    2015-05-01

    All wound infection presents risks for the patient, but the risks are multiplied in the presence of a comorbidity such as diabetes, when they can potentially be fatal. Where diabetic foot ulcer (DFU) infection is concerned, early recognition is crucial. Prompt treatment, comprising wound cleansing, debridement of devitalised tissue and use of antimicrobial dressings, can stop locally infected ulcers from deteriorating further. PMID:26079164

  13. 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.

  14. Nanofibre Based Smart Pharmaceutical Scaffolds for Wound Repair and Regenerations.

    PubMed

    Dwivedi, Charu; Pandey, Himanshu; Pandey, Avinash C; Ramteke, Pramod W

    2016-01-01

    Chronic wounds and ulcers are posing a devastating manifestation on the socioeconomic status across the globe along with the patient compliance. It reinforces a need for the development of successful alternative treatments for the chronic wound care and ulcer management practices. This review explores the progressive developments being made in the fabrication of electrospun nanofibrous scaffolds towards elimination of microbial infection from chronic wounds to accelerate the wound healing process. Functional three dimensional nanofibrous scaffolds produced by electrospinning have great potential in a wide spectrum of biomedical practices, such as tissue engineering, drug/gene delivery and wound dressing. Moreover, this review also highlights the materials and post modification methods, such as the functionaliation of electrospun nanofibrous scaffolds using growth factors, so that such smart and bioactive nanofibrous scaffolds could be made suitable for wound healing applications. PMID:26666999

  15. [Debridement of burn wounds using a hydrosurgery system].

    PubMed

    Gong, Chen; Lyu, Kaiyang; Wang, Guangyi; Wang, Guangqing; Zhu, Shihui; Xia, Zhaofan

    2015-12-01

    The healing process of burn wounds is strongly associated with the depth of wounds, and the depth of wounds is dependent to initial temperature and duration of contact with source of heat, infection, and secondary damage in the debridement process. On this basis, some experts present a concept of accurate debridement, which denotes removal of all necrotic tissue and at the same time protecting viable tissue for repair of raw wounds in order to maximally maintain patients' appearance and functions. A new technology of burn wound debridement--hydrosurgery system has been applied clinically. This paper summarizes the characteristics of hydrosurgery in the aspects of its technology, suitable wounds, bacterial load, amount of blood loss, and degree of pain produced during operation, and also the author's opinions regarding its efficacy to realize an accurate debridement for burn injury. PMID:26837254

  16. Wound healing in urology.

    PubMed

    Ninan, Neethu; Thomas, Sabu; Grohens, Yves

    2015-03-01

    Wound healing is a dynamic and complex phenomenon of replacing devitalized tissues in the body. Urethral healing takes place in four phases namely inflammation, proliferation, maturation and remodelling, similar to dermal healing. However, the duration of each phase of wound healing in urology is extended for a longer period when compared to that of dermatology. An ideal wound dressing material removes exudate, creates a moist environment, offers protection from foreign substances and promotes tissue regeneration. A single wound dressing material shall not be sufficient to treat all kinds of wounds as each wound is distinct. This review includes the recent attempts to explore the hidden potential of growth factors, stem cells, siRNA, miRNA and drugs for promoting wound healing in urology. The review also discusses the different technologies used in hospitals to treat wounds in urology, which make use of innovative biomaterials synthesised in regenerative medicines like hydrogels, hydrocolloids, foams, films etc., incorporated with growth factors, drug molecules or nanoparticles. These include surgical zippers, laser tissue welding, negative pressure wound therapy, and hyperbaric oxygen treatment. PMID:25500273

  17. Grand challenge in Biomaterials-wound healing

    PubMed Central

    Salamone, Joseph C.; Salamone, Ann Beal; Swindle-Reilly, Katelyn; Leung, Kelly Xiaoyu-Chen; McMahon, Rebecca E.

    2016-01-01

    Providing improved health care for wound, burn and surgical patients is a major goal for enhancing patient well-being, in addition to reducing the high cost of current health care treatment. The introduction of new and novel biomaterials and biomedical devices is anticipated to have a profound effect on the future improvement of many deleterious health issues. This publication will discuss the development of novel non-stinging liquid adhesive bandages in healthcare applications developed by Rochal Industries. The scientists/engineers at Rochal have participated in commercializing products in the field of ophthalmology, including rigid gas permeable contact lenses, soft hydrogel contact lenses, silicone hydrogel contact lenses, contact lens care solutions and cleaners, intraocular lens materials, intraocular controlled drug delivery, topical/intraocular anesthesia, and in the field of wound care, as non-stinging, spray-on liquid bandages to protect skin from moisture and body fluids and medical adhesive-related skin injuries. Current areas of entrepreneurial activity at Rochal Industries pertain to the development of new classes of biomaterials for wound healing, primarily in regard to microbial infection, chronic wound care, burn injuries and surgical procedures, with emphasis on innovation in product creation, which include cell-compatible substrates/scaffolds for wound healing, antimicrobial materials for opportunistic pathogens and biofilm reduction, necrotic wound debridement, scar remediation, treatment of diabetic ulcers, amelioration of pressure ulcers, amelioration of neuropathic pain and adjuvants for skin tissue substitutes. PMID:27047680

  18. Grand challenge in Biomaterials-wound healing.

    PubMed

    Salamone, Joseph C; Salamone, Ann Beal; Swindle-Reilly, Katelyn; Leung, Kelly Xiaoyu-Chen; McMahon, Rebecca E

    2016-06-01

    Providing improved health care for wound, burn and surgical patients is a major goal for enhancing patient well-being, in addition to reducing the high cost of current health care treatment. The introduction of new and novel biomaterials and biomedical devices is anticipated to have a profound effect on the future improvement of many deleterious health issues. This publication will discuss the development of novel non-stinging liquid adhesive bandages in healthcare applications developed by Rochal Industries. The scientists/engineers at Rochal have participated in commercializing products in the field of ophthalmology, including rigid gas permeable contact lenses, soft hydrogel contact lenses, silicone hydrogel contact lenses, contact lens care solutions and cleaners, intraocular lens materials, intraocular controlled drug delivery, topical/intraocular anesthesia, and in the field of wound care, as non-stinging, spray-on liquid bandages to protect skin from moisture and body fluids and medical adhesive-related skin injuries. Current areas of entrepreneurial activity at Rochal Industries pertain to the development of new classes of biomaterials for wound healing, primarily in regard to microbial infection, chronic wound care, burn injuries and surgical procedures, with emphasis on innovation in product creation, which include cell-compatible substrates/scaffolds for wound healing, antimicrobial materials for opportunistic pathogens and biofilm reduction, necrotic wound debridement, scar remediation, treatment of diabetic ulcers, amelioration of pressure ulcers, amelioration of neuropathic pain and adjuvants for skin tissue substitutes. PMID:27047680

  19. Effect of medicinal plants on wound healing.

    PubMed

    Budovsky, Arie; Yarmolinsky, Ludmila; Ben-Shabat, Shimon

    2015-01-01

    In the United States alone, chronic wounds affect 6.5 million patients. It is expected that the number of chronic wounds will increase worldwide due to the increase in age-related conditions and pathologies such as diabetes, obesity, and cardiovascular diseases. An estimated excess of US$25 billion is spent annually on treatment of chronic wounds, and the burden is rapidly growing due to increasing healthcare costs, an aging population, and a sharp rise in the incidence of diabetes and obesity worldwide. While current therapeutic agents have generally inadequate efficacy and number of serious adverse effects, the medicinal plants have been used in medicine since ancient times and are well known for their abilities to promote wound healing and prevent infection without grave side effects. Thus, herbal therapy may be an alternative strategy for treatment of wounds. The purpose of this review is to provide the verified data on the medicinal plants of the world flora with wound healing activity including the biologically active substances belonging to these herbal preparations and describe in detail the various cellular and molecular mechanisms of their actions. PMID:25703533

  20. Biosurgery in wound healing--the renaissance of maggot therapy.

    PubMed

    Wollina, U; Karte, K; Herold, C; Looks, A

    2000-07-01

    Chronic wounds are a challenge for modern health care. A basic principle of treatment is the removal of sloughy, necrotic, devitalized tissue to prevent wound infection and delayed healing. Biosurgery (syn. maggot or larval therapy) is a promising adjunct to the whole spectrum of topical treatment methods, in particular for debridement. The term 'biosurgery' describes the use of living maggots on wounds to remove devitalized tissue, decrease the risk of infection and improve wound healing. The present paper gives a brief review of history, entomology, biochemistry and medical indications of biosurgery and the practical handling of maggots. We also provide some clinical data from the literature and our own experience in a wound care unit. Biosurgery is an effective and safe treatment option for debridement and disinfection. PMID:11204517

  1. Use of negative pressure wound therapy in burn patients.

    PubMed

    Teng, Shou-Cheng

    2016-09-01

    According to previous research, adjunctive negative pressure wound therapy (NPWT) can help manage infected wounds when applied along with appropriate debridement and antibiotic therapy as deemed clinically relevant. NPWT not only removes fluid, and reduces oedema, but also promotes perfusion around the wounds. In addition, NPWT may lead to improved graft fixation when used as a bolster, especially in patients who are less compliant or have poor graft fixation that result from using traditional methods. NPWT is a good choice to bolster skin grafts in young, active and less-compliant patients. We propose an enhanced segmental compartment-covered technique, which uses NPWT adjunctively as first-line wound treatment to help manage postoperative infection. Moreover, NPWT promotes granulation tissue formation to prepare the wound bed for subsequent skin graft and may be used as a bolster over the graft, which helps to attain skin graft viability. PMID:27547959

  2. Developing a toolbox for analysis of warrior wound biopsies: vibrational spectroscopy

    NASA Astrophysics Data System (ADS)

    Crane, Nicole J.; O'Brien, Frederick P.; Forsberg, Jonathan A.; Potter, Benjamin K.; Elster, Eric A.

    2011-03-01

    The management of modern traumatic war wounds remains a significant challenge for clinicians. This is a reflection of the extensive osseous and soft-tissue damage caused by blasts and high-energy projectiles. The ensuing inflammatory response ultimately dictates the pace of wound healing and tissue regeneration. Consequently, the eventual timing of wound closure or definitive coverage is often subjectively based. Some wounds require an extended period of time to close or fail to remain closed, despite the use and application of novel wound-specific treatment modalities. Aside from impaired wound healing, additional wound complications include wound infection, biofilm formation, and heterotopic ossification (the pathological mineralization of soft tissues). An understanding of the molecular environment of acute wounds throughout the debridement process can provide valuable insight into the mechanisms associated with the eventual wound outcome. The analysis of Raman spectra of ex vivo wound biopsy tissue obtained from serial traumatic wound debridements reveals a decreased 1665 cm-1/1445 cm-1 band area ratio in impaired healing wounds, indicative of an impaired remodeling process, in addition to a decreased 1240 cm-1/1270cm-1. The examination of debrided tissue exhibits mineralization during the early development of heterotopic ossification. Finally, preliminary results suggest that Fourier transform infrared (FT-IR) images of wound effluent may be able to provide early microbiological information about the wound.

  3. A Study of Sepsis in Surgical Wounds

    PubMed Central

    Hnatko, S. I.; Macdonald, G. R.; Rodin, A. E.

    1963-01-01

    Published records of the frequency of wound sepsis are often unreliable sources of information on the general frequency of this complication because of unstandardized methods of reporting and because of the various views of different investigators as to what constitutes sepsis. A method of infection reporting, its study and analysis are outlined. A survey of postoperative infections by this method for the years 1959, 1960 and 1961 revealed infection rates of 2.02%, 1.20% and 1.14%, respectively. For the same period the percentages of wound infections caused by Staph. aureus were 83.06%, 69.8% and 51.8%, respectively. The most prevalent phage types were 55/53/54 and 52/80/81/82, although types 80/81/82 and 80 were also involved. Infections with Gram-negative organisms were encountered more often in 1961 than in 1959. The majority of these were of mixed type, and followed abdominal surgery. There is need for more comprehensive study and analysis of postoperative wound sepsis and its complications. It was apparent from this study that, statistically, a relatively low rate of postoperative infections may mask a high rate following a specific surgical procedure. PMID:13954844

  4. Review of recent research on biomedical applications of electrospun polymer nanofibers for improved wound healing.

    PubMed

    Hassiba, Alaa J; El Zowalaty, Mohamed E; Nasrallah, Gheyath K; Webster, Thomas J; Luyt, Adriaan S; Abdullah, Aboubakr M; Elzatahry, Ahmed A

    2016-03-01

    Wound dressings play an important role in a patient's recovery from health problems, as unattended wounds could lead to serious complications such as infections or, ultimately, even death. Therefore, wound dressings since ancient times have been continuously developed, starting from simple dressings from natural materials for covering wounds to modern dressings with functionalized materials to aid in the wound healing process and enhance tissue repair. However, understanding the nature of a wound and the subsequent healing process is vital information upon which dressings can be tailored to ensure a patient's recovery. To date, much progress has been made through the use of nanomedicine in wound healing due to the ability of such materials to mimic the natural dimensions of tissue. This review provides an overview of recent studies on the physiology of wound healing and various wound dressing materials made of nanofibers fabricated using the electrospinning technique. PMID:26744905

  5. Wound healing and cancer progression in Opisthorchis viverrini associated cholangiocarcinoma.

    PubMed

    Botelho, Monica C; Alves, Helena; Richter, Joachim

    2016-07-01

    Infection with the human liver fluke Opisthorchis viverrini induces cancer of the bile ducts, cholangiocarcinoma (CCA). It was shown previously that O. viverrini-secreted proteins accelerate wound resolution in human cholangiocytes. Recombinant Ov-GRN-1 (O. viverrini-derived gene encoding granulin-like growth factor) induced angiogenesis and accelerated mouse wound healing. Given the striking similarities of wound healing and cancer progression, here we discuss the major implications of this finding for an infection-induced cancer of major public health significance in the developing world. PMID:27130317

  6. Evaluation of dense collagen matrices as medicated wound dressing for the treatment of cutaneous chronic wounds.

    PubMed

    Helary, Christophe; Abed, Aicha; Mosser, Gervaise; Louedec, Liliane; Letourneur, Didier; Coradin, Thibaud; Giraud-Guille, Marie Madeleine; Meddahi-Pellé, Anne

    2015-02-01

    Cutaneous chronic wounds are characterized by an impaired wound healing which may lead to infection and amputation. When current treatments are not effective enough, the application of wound dressings is required. To date, no ideal biomaterial is available. In this study, highly dense collagen matrices have been evaluated as novel medicated wound dressings for the treatment of chronic wounds. For this purpose, the structure, mechanical properties, swelling ability and in vivo stability of matrices concentrated from 5 to 40 mg mL(-1) were tested. The matrix stiffness increased with the collagen concentration and was associated with the fibril density and thickness. Increased collagen concentration also enhanced the material resistance against accelerated digestion by collagenase. After subcutaneous implantation in rats, dense collagen matrices exhibited high stability without any degradation after 15 days. The absence of macrophages and neutrophils evidenced their biocompatibility. Subsequently, dense matrices at 40 mg mL(-1) were evaluated as drug delivery system for ampicillin release. More concentrated matrices exhibited the best swelling abilities and could absorb 20 times their dry weight in water, allowing for an efficient antibiotic loading from their dried form. They released efficient doses of antibiotics that inhibited the bacterial growth of Staphylococcus Aureus over 3 days. In parallel, they show no cytotoxicity towards human fibroblasts. These results show that dense collagen matrices are promising materials to develop medicated wound dressings for the treatment of chronic wounds. PMID:26218128

  7. Antibiofilm Efficacy of DispersinB® Wound Spray Used in Combination with a Silver Wound Dressing

    PubMed Central

    Gawande, Purushottam V; Clinton, Allie P; LoVetri, Karen; Yakandawala, Nandadeva; Rumbaugh, Kendra P; Madhyastha, Srinivasa

    2014-01-01

    Chronic wounds including diabetic foot ulcers, pressure ulcers, and venous leg ulcers are a worldwide health problem. As the traditional methods of treatment have proven ineffective against chronic wounds involving biofilms, there is an unmet clinical need for developing products with an antibiofilm component that inhibits and/or disrupts biofilms and thus make the biofilm-embedded bacteria more susceptible to antimicrobial therapy. We developed a DispersinB® antibiofilm enzyme-based wound spray for treating chronic wounds in conjunction with an antimicrobial. Under in vitro conditions, the DispersinB® and Acticoat™ combination performed significantly better (P < 0.05) than Acticoat™ alone, indicating the synergy between the two compounds because of DispersinB® enhancing the antimicrobial activity of Acticoat™. Furthermore, DispersinB® wound spray enhanced the antimicrobial activity of Acticoat™ in a chronic wound mouse model of methicillin-resistant Staphylococcus aureus (MRSA) infection. Thus, this novel combination of DispersinB® and Acticoat™, an antimicrobial dressing, prompts clinical evaluation for potential applications in biofilm-based chronic wound management. PMID:24826078

  8. 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

  9. Modulation of inflammatory response of wounds by antimicrobial photodynamic therapy

    PubMed Central

    Sharma, Mrinalini; Gupta, Pradeep Kumar

    2015-01-01

    Background and aims: Management of infections caused by Pseudomonas aeruginosa is becoming difficult due to the rapid emergence of multi-antibiotic resistant strains. Antimicrobial photodynamic therapy (APDT) has a lot of potential as an alternative approach for inactivation of antibiotic resistant bacteria. In this study we report results of our investigations on the effect of poly-L-lysine conjugate of chlorine p6 (pl-cp6) mediated APDT on the healing of P.aeruginosa infected wounds and the role of Nuclear Factor kappa B (NF-kB) induced inflammatory response in this process. Materials and method: Excisional wounds created in Swiss albino mice were infected with ∼107 colony forming units of P.aeruginosa. Mice with wounds were divided into three groups: 1) Uninfected, 2) Infected, untreated control (no light, no pl-cp6), 3) Infected, APDT. After 24 h of infection (day 1 post wounding), the wounds were subjected to APDT [pl-cp6 applied topically and exposed to red light (660 ± 25 nm) fluence of ∼ 60 J/cm2]. Subsequent to APDT, on day 2 and 5 post wounding (p.w), measurements were made on biochemical parameters of inflammation [toll like receptor-4 (TLR-4), NF-kB, Inteleukin (IL)-[1α, IL-β, and IL-2)] and cell proliferation [(fibroblast growth factor-2 (FGF-2), alkaline phosphatase (ALP)]. Results: In comparison with untreated control, while expression of TLR-4, NF-kB (p105 and p50), and proinflammatory interleukins (IL-1α, IL-1β,IL-2) were reduced in the infected wounds subjected to APDT, the levels of FGF-2 and ALP increased, on day 5 p.w. Conclusion: The measurements made on the inflammatory markers and cell proliferation markers suggest that APDT reduces inflammation caused by P.aeruginosa and promotes cell proliferation in wounds. PMID:26557735

  10. Cuts and puncture wounds

    MedlinePlus

    ... cuts and puncture wounds can be treated at home. Take the following steps. FOR MINOR CUTS Wash your hands with soap or antibacterial ... and scissors safely. Make sure you and your child are up to date on vaccinations . A tetanus vaccine is generally recommended every 10 ... Snake bite Minor cut - first aid Sewing a wound closed - series ...

  11. Saliva and wound healing.

    PubMed

    Brand, Henk S; Veerman, Enno C I

    2013-01-01

    Wounds in the oral cavity heal faster and with less scarring than wounds in other parts of the body. One of the factors implicated in this phenomenon is the presence of saliva, which promotes the healing of oral wounds in several ways. Saliva creates a humid environment, which improves the survival and functioning of inflammatory cells that are crucial for wound healing. Furthermore, saliva contains a variety of proteins that play a role in the various stages of the intraoral wound healing. Tissue factor, present in salivary exosomes, accelerates the clotting of blood dramatically. The subsequent proliferation of epithelial cells is promoted by growth factors in saliva, especially epidermal growth factor. The importance of secretory leucocyte protease inhibitor is demonstrated by the observation that in the absence of this salivary protein, oral wound healing is considerably delayed. Members of the salivary histatin family promote wound closure in vitro by enhancing cell spreading and cell migration. Cell proliferation is not enhanced by histatin. Cyclization of histatin increased its biological activity approximately 1,000-fold compared to linear histatin. These studies suggest that histatins could potentially be used for the development of new wound healing medications. PMID:23878824

  12. Surgical wound care - open

    MedlinePlus

    Surgical incision care; Open wound care ... your wound again with sutures, you need to care for it at home, since it may take ... Your health care provider will tell you how often to change your dressing . To prepare for the dressing change: Clean your ...

  13. Preclinical Evaluation of Tegaderm™ Supported Nanofibrous Wound Matrix Dressing on Porcine Wound Healing Model

    PubMed Central

    Ong, Chee Tian; Zhang, Yanzhong; Lim, Raymond; Samsonraj, Rebekah; Masilamani, Jeyakumar; Phan, Tran Hong Ha; Ramakrishna, Seeram; Lim, Ivor; Kee, Irene; Fahamy, Mohammad; Templonuevo, Vilma; Lim, Chwee Teck; Phan, Toan Thang

    2015-01-01

    Objective: Nanofibers for tissue scaffolding and wound dressings hold great potential in realizing enhanced healing of wounds in comparison with conventional counterparts. Previously, we demonstrated good fibroblast adherence and growth on a newly developed scaffold, Tegaderm™-Nanofiber (TG-NF), made from poly ɛ-caprolactone (PCL)/gelatin nanofibers electrospun onto Tegaderm (TG). The purpose of this study is to evaluate the performance and safety of TG-NF dressings in partial-thickness wound in a pig healing model. Approach: To evaluate the rate of reepithelialization, control TG, human dermal fibroblast-seeded TG-NF(+) and -unseeded TG-NF(−) were randomly dressed onto 80 partial-thickness burns created on four female and four male pigs. Wound inspections and dressings were done after burns on day 7, 14, 21, and 28. On day 28, full-thickness biopsies were taken for histopathological evaluation by Masson-Trichrome staining for collagen and hematoxylin–eosin staining for cell counting. Results: No infection and severe inflammation were recorded. Wounds treated with TG-NF(+) reepithelialized significantly faster than TG-NF(−) and control. Wound site inflammatory responses to study groups were similar as total cell counts on granulation tissues show no significant differences. Most of the wounds completely reepithelialized by day 28, except for two wounds in control and TG-NF(−). A higher collagen coverage was also recorded in the granulation tissues treated with TG-NF(+). Innovation and Conclusion: With better reepithelialization achieved by TG-NF(+) and similar rates of wound closure by TG-NF(−) and control, and the absence of elevated inflammatory responses to TG-NF constructs, TG-NF constructs are safe and demonstrated good healing potentials that are comparable to Tegaderm. PMID:25713753

  14. The prevalence, aetiology and management of wounds in a community care area in Ireland.

    PubMed

    Skerritt, Louise; Moore, Zena

    2014-06-01

    This study aimed to establish the prevalence and aetiology of wounds, allowing an insight into the management of wound care, the use of dressings and the nursing time allocated to the provision of wound care in a community setting in Ireland. A cross-sectional survey was used, with data collected on all clients in the community who received treatment from public health nurses or community registered general nurses for wound care over a 1-week period in April 2013. A 98.9% response rate was realised, and 188 people were identified as having wounds, equating to a crude prevalence of 5% of the active community nursing caseload. A total of 60% (n=112) had leg ulcers, 22% (n=42) had pressure ulcers, 16% (n=30) had an acute wound (surgical or traumatic wounds), 1% (n=2) had a diabetic foot wound and a further 1% (n=2) had wounds of other aetiologies. The mean duration of wounds was 5.41 months. A total of 18% of wounds were identified as infected; however, 60% (n=112) of wounds had antimicrobial products in use as either a primary or secondary dressing. The study established that there is a significant prevalence of wounds in this community care area. There was absence of a clinical diagnosis in many cases, and evidence of inappropriate dressing use, risking an increase in costs and a decrease in good clinical outcomes. It also highlighted the importance of ongoing education and auditing in the provision of wound care. PMID:24912830

  15. 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

  16. 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

  17. Integrins in Wound Healing

    PubMed Central

    Koivisto, Leeni; Heino, Jyrki; Häkkinen, Lari; Larjava, Hannu

    2014-01-01

    Significance: Regulation of cell adhesions during tissue repair is fundamentally important for cell migration, proliferation, and protein production. All cells interact with extracellular matrix proteins with cell surface integrin receptors that convey signals from the environment into the nucleus, regulating gene expression and cell behavior. Integrins also interact with a variety of other proteins, such as growth factors, their receptors, and proteolytic enzymes. Re-epithelialization and granulation tissue formation are crucially dependent on the temporospatial function of multiple integrins. This review explains how integrins function in wound repair. Recent Advances: Certain integrins can activate latent transforming growth factor beta-1 (TGF-β1) that modulates wound inflammation and granulation tissue formation. Dysregulation of TGF-β1 function is associated with scarring and fibrotic disorders. Therefore, these integrins represent targets for therapeutic intervention in fibrosis. Critical Issues: Integrins have multifaceted functions and extensive crosstalk with other cell surface receptors and molecules. Moreover, in aberrant healing, integrins may assume different functions, further increasing the complexity of their functionality. Discovering and understanding the role that integrins play in wound healing provides an opportunity to identify the mechanisms for medical conditions, such as excessive scarring, chronic wounds, and even cancer. Future Directions: Integrin functions in acute and chronic wounds should be further addressed in models better mimicking human wounds. Application of any products in acute or chronic wounds will potentially alter integrin functions that need to be carefully considered in the design. PMID:25493210

  18. Antibiotic concentration in human wound fluid after intravenous administration.

    PubMed Central

    Bagley, D H; Mac Lowry, J; Beazley, R M; Gorschboth, C; Ketcham, A S

    1978-01-01

    Since the wound is the most common focus of infection in the surgical patient, adequate levels of antibiotic within the wound ar essential. This study examines the concentrations of antibiotic achieved in human wounds. Fluid was collected at timed intervals on the first postoperative day from the wounds of 56 patients receiving antibiotics after regional lymph node dissection. Antibiotic concentration was determined by bioassay. Six antibiotics were studied: cephalothin, cefazolin, cephapirin, oxacillin, ampicillin and clindamycin. The cephalosporins and penicillins showed similar patterns of appearance in the wound fluid. The peak level occurred early (1--1 1/2 hours) with subsequent slow decrease. Clindamycin produced nearly constant levels in wound fluid. The concentration of each antibiotic in wound fluid surpassed the serum levels after 2.5 hours. At the dosages studied each antibiotic produced wound fluid concentrations greater than the MIC for most susceptible organisms. Higher doses provided higher wound fluid levels. The rate of appearance and the levels achieved should be considered in the choice of antibiotics in the surgical subject. Images Fig. 1. PMID:686888

  19. [Phlebology and wound healing].

    PubMed

    Hafner, Jürg; Läuchli, Severin; French, Lars E

    2010-04-01

    Venous diseases are highly prevalent and chronic wounds cause high morbidity and costs. Prevalence of severe forms of chronic venous insufficiency is on the decline. This is due to improved diagnosis and treatment of venous thromboembolism, and to improved surgery of varicose veins and their sequelae. The spectrum of chronic wounds has shifted from venous ulcers towards more complex pathologies. At the same time, new treatment options are available. Modern phlebology effectively treats varicose veins, prevents sequelae of varicosis and deep venous thrombosis, and offers help to the great majority of patients with chronic wounds. PMID:20336620

  20. 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

  1. Correction of Hypoxia, a Critical Element for Wound Bed Preparation Guidelines: TIMEO2 Principle of Wound Bed Preparation

    PubMed Central

    Shah, Jayesh B.

    2011-01-01

    Wound bed preparation is an organized approach to create an optimal environment for wound healing by the use of the most cost-effective therapeutic options. It has become an essential part of wound management and seeks to use the latest findings from molecular and cellular research to maximize the benefits of today’s advanced wound care products. The international advisory panel on wound bed preparation met in 2002 to develop a systemic approach to wound management. These principles of this approach are referred to by the mnemonic TIME, which stands for the management of nonviable or deficient tissue (T), infection or inflammation (I), prolonged moisture imbalance (M), and nonadvancing or undermined epidermal edge (E). One critical element of pathophysiology, understanding of the hypoxic nature of the wound and correction of hypoxia as a critical element of wound bed preparation, is not covered. This article proposes to add correction of hypoxia to the TIME principle (TIMEO2 principle) based on the evidence. The evidence that will support the reason and the need for modification of the wound bed preparation protocol is discussed. PMID:24527166

  2. Negative pressure wound therapy with saline instillation: 131 patient case series.

    PubMed

    Brinkert, David; Ali, Mazen; Naud, Magali; Maire, Nicolas; Trial, Chloé; Téot, Luc

    2013-12-01

    Negative pressure wound therapy combined with timed, cyclical instillation (NPWTi) of topical wound solutions has been recently presented as a new adjunctive modality for treating wounds with signs of infection. Normal saline, antiseptics and antimicrobials all have been proposed in scientific and clinical studies as potentially effective when used with NPWTi for treating heavily infected wounds. This is a prospective clinical study of 131 patients with 131 wounds treated with NPWTi using saline between January 2012 and December 2012 in two orthopaedic centres and one surgical wound healing centre in France. Saline was exclusively used. Results were favourable: in 98% of the cases, the wounds could be closed after debridement and following the use of NPWTi. Mean duration of NPWTi was 12·19 days. This does not preclude the need for treating the biofilm appropriately with more active antibacterial products when biofilm has been documented. PMID:24251845

  3. A retrospective review of leg wound complications after coronary artery bypass surgery.

    PubMed

    East, Susan A; Lorenz, Rebecca A; Armbrecht, Eric S

    2013-10-01

    Little research or attention has been paid to finding out whether wound closure with sutures or staples attains the best outcomes after saphenous vein harvest for coronary artery bypass grafting. We undertook a quality improvement project to compare the prevalence of leg wound complications (eg, infection, seroma, hematoma, dehiscence) between two types of skin closure (ie, staples, subcuticular sutures) after conventional open surgery with bridging between incisions and vein harvesting during coronary revascularization to determine the need for practice changes. We found no significant differences between patients with wound complications and those without. However, in this project, the risk for infections was greater for patients with diabetes whose wounds were closed by using subcuticular sutures. These findings have led to practice changes for reducing leg wound complications within our institution: clinicians now assess patients for increased risk of leg wound complications preoperatively and opt to close wounds with staples for patients who have diabetes. PMID:24075335

  4. Slough and biofilm: removal of barriers to wound healing by desloughing.

    PubMed

    Percival, S L; Suleman, L

    2015-11-01

    The presence of non-viable tissue in a chronic wound presents a barrier against effective wound healing, hence removal facilitates healing and reduces areas where microorganisms can attach and form biofilms, effectively reducing the risk of infection. Wound debridement is a necessary process in those wounds that have evidence of cellular debris and non-viable tissue. As slough is a form of non-viable tissue we hypothesise that it will support the attachment and development of biofilms. Biofilms are entities that have serious implications in raising the risk of infection and delaying wound healing. In those wounds that contain only slough, high-risk debridement methods are not considered necessary for its removal. The use of mechanical techniques for removing the slough is regarded as posing a much lower risk to the patient and the wound bed. The process of removing slough from a wound is referred to as 'desloughing'. We propose that mechanical desloughing is a low-risk method of debridement to aid the specific removal of slough. Slough in a wound is a recurrent issue for a large majority of patients. Consequently, desloughing should not be deemed a one-off process but an on-going procedure referred to as 'maintenance desloughing'. Maintenance desloughing will help to achieve and maintain a healthy wound bed and aid the removal of wound biofilms, facilitating wound healing. PMID:26551642

  5. 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

  6. Effectively managing wound exudate.

    PubMed

    Chamanga, Edwin

    2015-09-01

    The management of wound exudate remains a clinical challenge despite technological advances in products with better exudate-handling capacities. This clinical challenge is occasionally encountered when thick exudate (viscous exudate) is present, and when most modern dressings do not possess the capabilities to manage the viscosity while enabling exudate absorption. Maceration to the peri-wound area poses another challenge, irrespective of the number of topical barrier application products on the market and the innovation of dressing products that lock exudate away or those that encourage vertical wicking. In addition to all the above, in clinical practice, the assessment and documentation of wound exudate remains sporadic, leading to the challenges of effective wound exudate dressing selection and cost-effective dressings. PMID:26322408

  7. Cuts and puncture wounds

    MedlinePlus

    ... 2009:chap 39. Simon BC, Hern HG. Wound management principles. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier ...

  8. Wound dressings - a review.

    PubMed

    Dhivya, Selvaraj; Padma, Viswanadha Vijaya; Santhini, Elango

    2015-12-01

    Wound healing is a dynamic and complex process which requires suitable environment to promote healing process. With the advancement in technology, more than 3000 products have been developed to treat different types of wounds by targeting various aspects of healing process. The present review traces the history of dressings from its earliest inception to the current status and also discusses the advantage and limitations of the dressing materials. PMID:26615539

  9. Vitamin E and wound healing: an evidence-based review.

    PubMed

    Hobson, Rachel

    2016-06-01

    Vitamin E has been demonstrated to modulate cellular signalling, gene expression and affect wounds infected with methicillin-resistant Staphylococcus aureus (MRSA), thus influencing wound healing. This evidence-based review aimed to identify and evaluate current research assessing the properties of vitamin E in relation to wound healing, through its role as an antioxidant and its influence on connective tissue growth factor (CTGF), MRSA and gene transcription. Literature dated from 1996 to 2012, published in English, involving either animals or adult humans with an acute or chronic wound were included. The databases that contained relevant articles were narrowed down to four, and a total of 33 identified studies were included. The literature review revealed that there is a significant dearth of robust studies establishing the effects of vitamin E on wound healing, and further research is clearly warranted. PMID:25124164

  10. Phytochemicals in Wound Healing

    PubMed Central

    Thangapazham, Rajesh L.; Sharad, Shashwat; Maheshwari, Radha K.

    2016-01-01

    Significance: Traditional therapies, including the use of dietary components for wound healing and skin regeneration, are very common in Asian countries such as China and India. The increasing evidence of health-protective benefits of phytochemicals, components derived from plants is generating a lot of interest, warranting further scientific evaluation and mechanistic studies. Recent Advances: Phytochemicals are non-nutritive substances present in plants, and some of them have the potential to provide better tissue remodeling when applied on wounds and to also act as proangiogenic agents during wound healing. Critical Issues: In this review, we briefly discuss the current understanding, important molecular targets, and mechanism of action(s) of some of the phytochemicals such as curcumin, picroliv, and arnebin-1. We also broadly review the multiple pathways that these phytochemicals regulate to enhance wound repair and skin regeneration. Future Directions: Recent experimental data on the effects of phytochemicals on wound healing and skin regeneration establish the potential clinical utility of plant-based compounds. Additional research in order to better understand the exact mechanism and potential targets of phytochemicals in skin regeneration is needed. Human studies a2nd clinical trials are pivotal to fully understand the benefits of phytochemicals in wound healing and skin regeneration. PMID:27134766

  11. Nutrition and Chronic Wounds

    PubMed Central

    Molnar, Joseph Andrew; Underdown, Mary Jane; Clark, William Andrew

    2014-01-01

    Significance: Nutrition is one of the most basic of medical issues and is often ignored as a problem in the management of our chronic wound patients. Unfortunately, malnutrition is widespread in our geriatric patients even in nursing homes in developed countries. Attention to basic nutrition and providing appropriate supplements may assist in the healing of our chronic wounds. Recent Advances: Recent research has revealed the epidemiology of malnutrition in developed countries, the similarities to malnutrition in developing countries, and some of the physiologic and sociologic causes for this problem. More information is now available on the biochemical effects of nutrient deficiency and supplementation with macronutrients and micronutrients. In some cases, administration of isolated nutrients beyond recommended amounts for healthy individuals may have a pharmacologic effect to help wounds heal. Critical Issues: Much of the knowledge of the nutritional support of chronic wounds is based on information that has been obtained from trauma management. Due to the demographic differences of the patients and differences in the physiology of acute and chronic wounds, it is not logical to assume that all aspects of nutritional support are identical in these patient groups. Before providing specific nutritional supplements, appropriate assessments of patient general nutritional status and the reasons for malnutrition must be obtained or specific nutrient supplementation will not be utilized. Future Directions: Future research must concentrate on the biochemical and physiologic differences of the acute and chronic wounds and the interaction with specific supplements, such as antioxidants, vitamin A, and vitamin D. PMID:25371850

  12. Arginine metabolism in wounds

    SciTech Connect

    Albina, J.E.; Mills, C.D.; Barbul, A.; Thirkill, C.E.; Henry, W.L. Jr.; Mastrofrancesco, B.; Caldwell, M.D.

    1988-04-01

    Arginine metabolism in wounds was investigated in the rat in 1) lambda-carrageenan-wounded skeletal muscle, 2) Schilling chambers, and 3) subcutaneous polyvinyl alcohol sponges. All showed decreased arginine and elevated ornithine contents and high arginase activity. Arginase could be brought to the wound by macrophages, which were found to contain arginase activity. However, arginase was expressed by macrophages only after cell lysis and no arginase was released by viable macrophages in vitro. Thus the extracellular arginase of wounds may derive from dead macrophages within the injured tissue. Wound and peritoneal macrophages exhibited arginase deiminase activity as demonstrated by the conversion of (guanido-/sup 14/C)arginine to radiolabeled citrulline during culture, the inhibition of this reaction by formamidinium acetate, and the lack of prokaryotic contamination of the cultures. These findings and the known metabolic fates of the products of arginase and arginine deiminase in the cellular populations of the wound suggest the possibility of cooperativity among cells for the production of substrates for collagen synthesis.

  13. Single cell wound repair

    PubMed Central

    Abreu-Blanco, Maria Teresa; Verboon, Jeffrey M

    2011-01-01

    Cell wounding is a common event in the life of many cell types, and the capacity of the cell to repair day-to-day wear-and-tear injuries, as well as traumatic ones, is fundamental for maintaining tissue integrity. Cell wounding is most frequent in tissues exposed to high levels of stress. Survival of such plasma membrane disruptions requires rapid resealing to prevent the loss of cytosolic components, to block Ca2+ influx and to avoid cell death. In addition to patching the torn membrane, plasma membrane and cortical cytoskeleton remodeling are required to restore cell function. Although a general understanding of the cell wound repair process is in place, the underlying mechanisms of each step of this response are not yet known. We have developed a model to study single cell wound repair using the early Drosophila embryo. Our system combines genetics and live imaging tools, allowing us to dissect in vivo the dynamics of the single cell wound response. We have shown that cell wound repair in Drosophila requires the coordinated activities of plasma membrane and cytoskeleton components. Furthermore, we identified an unexpected role for E-cadherin as a link between the contractile actomyosin ring and the newly formed plasma membrane plug. PMID:21922041

  14. Wound healing complications in brain tumor patients on Bevacizumab.

    PubMed

    Ladha, Harshad; Pawar, Tushar; Gilbert, Mark R; Mandel, Jacob; O-Brien, Barbara; Conrad, Charles; Fields, Margaret; Hanna, Teresa; Loch, Carolyn; Armstrong, Terri S

    2015-09-01

    Bevacizumab (BEV) is commonly used for treating recurrent glioblastoma (GBM), and wound healing is a well-established adverse event. Retrospective analysis of GBM patients with and without wound healing complications while on BEV treatment is reported. 287 patients identified, majority were males (60 %) with median age of 52.5 years. 14 cases identified with wound healing problems, related to either craniotomy (n = 8) or other soft tissue wounds (n = 6). Median duration of BEV treatment to complication was 62 days (range 6-559). Majority received 10 mg/kg (n = 11) and nine (64.3 %) were on corticosteroids, with median daily dose of 6 mg (range 1-16 mg) for median of 473 days before starting BEV. For dehisced craniotomy wounds, median time for starting BEV from last surgery was 29 days (range 27-345). Median time from starting BEV to developing wound complication was 47 days (range 16-173). Seven (87.5 %) had infected wounds requiring antibiotics, hospitalization. Four (50 %) required plastic surgery. BEV stopped and safely resumed in 6 (75 %) patients; median delay was 70 days (range 34-346). Soft tissue wounds included decubitus ulcer, dehisced striae, herpes simplex, trauma to hand and back, and abscess. Median time from starting BEV to wound issues was 72 days (range 6-559). Five (83.3 %) were infected, requiring antibiotics. While three (50 %) required hospitalization, none required plastic surgery. Treatment stopped in five (83.3 %) and restarted in two (median delay 48 days, range 26-69). Wound healing complications are uncommon but associated with significant morbidity. Identifying those at risk and contributing factors warrants further investigation. PMID:26298437

  15. Principles of Wound Management and Wound Healing in Exotic Pets.

    PubMed

    Mickelson, Megan A; Mans, Christoph; Colopy, Sara A

    2016-01-01

    The care of wounds in exotic animal species can be a challenging endeavor. Special considerations must be made in regard to the animal's temperament and behavior, unique anatomy and small size, and tendency toward secondary stress-related health problems. It is important to assess the entire patient with adequate systemic evaluation and consideration of proper nutrition and husbandry, which could ultimately affect wound healing. This article summarizes the general phases of wound healing, factors that affect healing, and principles of wound management. Emphasis is placed on novel methods of treating wounds and species differences in wound management and healing. PMID:26611923

  16. Infection.

    PubMed

    Saigal, Gaurav; Nagornaya, Natalya; Post, M Judith D

    2016-01-01

    Imaging is useful in the diagnosis and management of infections of the central nervous system. Typically, imaging findings at the outset of the disease are subtle and nonspecific, but they often evolve to more definite imaging patterns in a few days, with less rapidity than for stroke but faster than for neoplastic lesions. This timing is similar to that of noninfectious inflammatory brain disease, such as multiple sclerosis. Fortunately, imaging patterns help to distinguish the two kinds of processes. Other than for sarcoidosis, the meninges are seldom involved in noninfectious inflammation; in contrast, many infectious processes involve the meninges, which then enhance with contrast on computed tomography (CT) or magnetic resonance imaging (MRI). However, brain infection causes a vast array of imaging patterns. Although CT is useful when hemorrhage or calcification is suspected or bony detail needs to be determined, MRI is the imaging modality of choice in the investigation of intracranial infections. Imaging sequences such as diffusion-weighted imaging help in accurately depicting the location and characterizing pyogenic infections and are particularly useful in differentiating bacterial infections from other etiologies. Susceptibility-weighted imaging is extremely useful for the detection of hemorrhage. Although MR spectroscopy findings can frequently be nonspecific, certain conditions such as bacterial abscesses show a relatively specific spectral pattern and are useful in diagnosing and constituting immediate therapy. In this chapter we review first the imaging patterns associated with involvement of various brain structures, such as the epidural and subdural spaces, the meninges, the brain parenchyma, and the ventricles. Involvement of these regions is illustrated with bacterial infections. Next we illustrate the patterns associated with viral and prion diseases, followed by mycobacterial and fungal infections, to conclude with a review of imaging findings

  17. Optimizing Wound Bed Preparation With Collagenase Enzymatic Debridement

    PubMed Central

    McCallon, Stanley K.; Weir, Dorothy; Lantis, John C.

    2015-01-01

    Difficult-to-heal and chronic wounds affect tens of millions of people worldwide. In the U.S. alone, the direct cost for their treatment exceeds $25 billion. Yet despite advances in wound research and treatment that have markedly improved patient care, wound healing is often delayed for weeks or months. For venous and diabetic ulcers, complete wound closure is achieved in as few as 25%–50% of chronic or hard-to-heal wounds. Wound bed preparation and the consistent application of appropriate and effective debridement techniques are recommended for the optimized treatment of chronic wounds. The TIME paradigm (Tissue, Inflammation/infection, Moisture balance and Edge of wound) provides a model to remove barriers to healing and optimize the healing process. While we often think of debridement as an episodic event that occurs in specific care giver/patient interface. There is the possibility of a maintenance debridement in which the chronic application of a medication can assist in both the macroscopic and microscopic debridement of a wound. We review the various debridement therapies available to clinicians in the United States, and explore the characteristics and capabilities of clostridial collagenase ointment (CCO), a type of enzymatic debridement, that potentially allows for epithelialization while debriding. It appears that in the case of CCO it may exert this influences by removal of the necrotic plug while promoting granulation and sustaining epithelialization. It is also easily combined with other methods of debridement, is selective to necrotic tissue, and has been safely used in various populations. We review the body of evidence has indicated that this concept of maintenance debridement, especially when combined episodic debridement may add a cost an efficacious, safe and cost-effective choice for debridement of cutaneous ulcers and burn wounds and it will likely play an expanding role in all phases of wound bed preparation. PMID:26442207

  18. Antimicrobial peptides and wound healing: biological and therapeutic considerations.

    PubMed

    Mangoni, Maria Luisa; McDermott, Alison M; Zasloff, Michael

    2016-03-01

    Repair of tissue wounds is a fundamental process to re-establish tissue integrity and regular function. Importantly, infection is a major factor that hinders wound healing. Multicellular organisms have evolved an arsenal of host-defense molecules, including antimicrobial peptides (AMPs), aimed at controlling microbial proliferation and at modulating the host's immune response to a variety of biological or physical insults. In this brief review, we provide the evidence for a role of AMPs as endogenous mediators of wound healing and their promising therapeutic potential for the treatment of non-life-threatening skin and other epithelial injuries. PMID:26738772

  19. Activity of antibiotics in contaminated wounds containing clay soil.

    PubMed

    Roberts, A H; Rye, D G; Edgerton, M T; Rodeheaver, G T; Edlich, R F

    1979-03-01

    Most traumatic wounds are contaminated to some degree by soil and run a high risk of infection. The presence of soil in wounds interferes with natural tissue defenses, which include phagocytosis and serum bactericidal capacity. The experimental studies reported herein clearly demonstrate that soil also limits the antibacterial effects of specific antibiotics. This inactivation appears to be the result of a chemical reaction between the charged antibiotics and the soil particles. PMID:434335

  20. Patient perception of wound photography.

    PubMed

    Wang, Sheila C; Anderson, John Ae; Jones, Duncan Vb; Evans, Robyn

    2016-06-01

    The objectives of this study were to provide an assessment of photographic documentation of the wound from the patients' perspective and to evaluate whether this could improve patients' understanding of and involvement in their wound care. Our results revealed that most patients visiting the wound care clinic have difficult-to-see wounds (86%). Only 20% of patients monitor their wounds and instead rely on clinic or nurse visits to track the healing progress. There was a significant association between patients' ability to see their wound and their subsequent memory of the wound's appearance. This was especially true for patients who had recently begun visiting the wound care clinic. This relationship was not present in patients who had visited the clinic for 3  or more years. Patients reported that the inability to see their wounds resulted in feeling a loss of autonomy. The majority of patients reported that photographing their wounds would help them to track the wound progress (81%) and would afford them more involvement in their own care (58%). This study provides a current representation of wound photography from the patients' perspective and reveals that it can motivate patients to become more involved in the management of their wounds - particularly for patients with difficult-to-see wounds. PMID:24872018

  1. A physiologically active polysaccharide hydrogel promotes wound healing.

    PubMed

    Luo, Yi; Diao, Huajia; Xia, Suhua; Dong, Lei; Chen, Jiangning; Zhang, Junfeng

    2010-07-01

    When the skin is injured, the subcutaneous tissues and organs are threatened by pathogens and excessive water loss. Wound dressings are, therefore, needed to protect the wound site from infection and improve the wound closure. Natural polysaccharides have been applied for various biomaterials including wound dressings, which show their advantages in biocompatibility, low toxicity, and pharmaceutical biomedical activity. In this study, a natural polysaccharide Bletilla striata polysaccharide (BSP) hydrogel is prepared by an oxidation and crosslinking methods. This BSP hydrogel represents preferable swelling ability and appropriate water vapor transmission rate. Using a full-thickness trauma mouse model, the hydrogel is applied on the in vivo cutaneous wound healing. Compared with the control groups, the BSP hydrogel achieves the much better healing results. The quantification of the infiltrating inflammatory cells and the level of tumor necrosis factor alpha (TNF-alpha) in the BSP group are attenuated, whereas the secretion of the epidermal growth factor (EGF) is highly elevated. On the 11th day after surgery, the wound area in the BSP hydrogel group is only 1/5-1/3 of those in the control groups. This new BSP hydrogel is proved to control the inflammatory responses and accelerate the wound closure and has potential application in wound healing. (c) 2010 Wiley Periodicals, Inc. J Biomed Mater Res, 2010. PMID:20128009

  2. Extrafloral nectar secretion from wounds of Solanum dulcamara.

    PubMed

    Lortzing, Tobias; Calf, Onno W; Böhlke, Marlene; Schwachtje, Jens; Kopka, Joachim; Geuß, Daniel; Kosanke, Susanne; van Dam, Nicole M; Steppuhn, Anke

    2016-01-01

    Plants usually close wounds rapidly to prevent infections and the loss of valuable resources such as assimilates(1). However, herbivore-inflicted wounds on the bittersweet nightshade Solanum dulcamara appear not to close completely and produce sugary wound secretions visible as droplets. Many plants across the plant kingdom secrete sugary nectar from extrafloral nectaries(2) to attract natural enemies of herbivores for indirect defence(3,4). As ants forage on wound edges of S. dulcamara in the field, we hypothesized that wound secretions are a form of extrafloral nectar (EFN). We show that, unlike EFN from known nectaries, wound secretions are neither associated with any specific structure nor restricted to certain locations. However, similar to EFN, they are jasmonate-inducible and the plant controls their chemical composition. Wound secretions are attractive for ants, and application of wound secretion mimics increases ant attraction and reduces herbivory on S. dulcamara plants in a natural population. In greenhouse experiments, we reveal that ants can defend S. dulcamara from two of its native herbivores, slugs and flea beetle larvae. Since nectar is defined by its ecological function as a sugary secretion involved in interactions with animals(5), such 'plant bleeding' could be a primitive mode of nectar secretion exemplifying an evolutionary origin of structured extrafloral nectaries. PMID:27243650

  3. Clinical and bacteriological assessment of dog-to-dog bite wounds.

    PubMed

    Mouro, S; Vilela, C L; Niza, M M R E

    2010-07-29

    Although dog-to-dog bite wounds are frequent, few studies correlate bacterial involvement to clinical aspects. This work aimed at relating clinical evolution and bacteriological data, with the evolution time (ET), i.e., the period of time elapsed from aggression until presentation. A total of 228 wounds from 83 cases of bitten dogs was evaluated; 48 of the wounds were sampled for bacteriology. Dogs with clinically infected wounds (N=29) were subjected to antimicrobial therapy and local disinfection. Dogs without clinical signs of infection were either subjected to the same treatment (N=43) or only subjected to daily wound saline irrigation (N=11), to evaluate the need for antimicrobial prophylaxis. The majority of wounds were laceration and puncture wounds with dermis penetration (41.2% and 23.2%, respectively). Only 17% of the wounds were clinically infected. The mean ET was 39h 30m and prolonged ET was significantly correlated to infection. None of the wounds from animals not given antibiotics became infected. Bacteriology was positive in 95.8% of the wounds sampled (N=46). A total of 125 isolates was obtained, mostly aerobes. Clinical infection was associated with the presence of strict anaerobes. Excluding antibiotics that should be preserved for life-threatening cases, the higher rates of in vitro antimicrobial susceptibility were observed for sulphamethoxazole-trimethoprim (94.4%) and amoxicillin-clavulanate (91.9%). This study identified the time lag from aggression to presentation as a risk factor for infection development. Further studies are required to evaluate the actual requirement for antimicrobial therapy when only dermis is affected in dog-to-dog bite wounds. PMID:20116941

  4. Cavity wounds management: a multicentre pilot study.

    PubMed

    Meaume, Sylvie; Facy, Olivier; Munoz-Bongrand, Nicolas; Ribemont, Annie-Claude; Sigal, Michele-Lea; Couffinhal, Jean-Claude; Trial, Chloe; Tacca, Olivier; Bohbot, Serge

    The objective of this study was to assess acceptability (based on pain at removal), efficacy and tolerance of an absorbent and cohesive rope(UrgoClean Rope, Laboratoires Urgo) in the local management of deep cavity wounds. This study was a prospective, multicentre (13), non comparative clinical study. Patients presenting with an acute or chronic non-infected cavity wound were followed up for four weeks and assessed weekly with a physical examination, in addition to volumetric,planimetric and photographic evaluations. Pain at removal was the primary criterion, assessed on a Visual Analogic Scale. The percentage of the wound surface area reduction and volumetric reduction were considered as secondary efficacy criteria. Forty three patients were included in this study. After one week of treatment dressing removal was painless and continued to be so throughout the period of the trial(four weeks). Median surface area at baseline was 7.74 cm2 and was reduced by 54.5% at week 4 (relative area reduction). Median wound volumetric value was noted 12 ml at baseline and was reduced by 72.7% by the end of treatment. The cohesiveness of the new rope was considered very good by health professionals. No residue was observed on the wound bed during the dressing change with the new rope. There were no adverse events related to the tested rope, during this trial.Pain-free removal associated with good efficacy and tolerance were observed with this new cohesive rope in the healing process of deep cavity wounds and could represent a therapeutic alternative to the usual ropes used in such indications. PMID:24180023

  5. The Presence of Oxygen in Wound Healing.

    PubMed

    Kimmel, Howard M; Grant, Anthony; Ditata, James

    2016-08-01

    Oxygen must be tightly governed in all phases of wound healing to produce viable granulation tissue. This idea of tight regulation has yet to be disputed; however, the role of oxygen at the cellular and molecular levels still is not fully understood as it pertains to its place in healing wounds. In an attempt to better understand the dynamics of oxygen on living tissue and its potential role as a therapy in wound healing, a substantial literature review of the role of oxygen in wound healing was performed and the following key points were extrapolated: 1) During energy metabolism, oxygen is needed for mitochondrial cytochrome oxidase as it produces high-energy phosphates that are needed for many cellular functions, 2) oxygen is also involved in the hydroxylation of proline and lysine into procollagen, which leads to collagen maturation, 3) in angiogenesis, hypoxia is required to start the process of wound healing, but it has been shown that if oxygen is administered it can accelerate and sustain vessel growth, 4) the antimicrobial action of oxygen occurs when nicotinamide adenine dinucleotide phosphate (NADPH)-linked oxygenase acts as a catalyst for the production of reactive oxygen species (ROS), a superoxide ion which kills bacteria, and 5) the level of evidence is moderate for the use of hyperbaric oxygen therapy (HBOT) for diabetic foot ulcers, crush injuries, and soft-tissue infections. The authors hypothesized that HBOT would be beneficial to arterial insufficiency wounds and other ailments, but at this time further study is needed before HBOT would be indicated. PMID:27560469

  6. Negative pressure wound therapy with instillation: past, present, and future.

    PubMed

    Kim, Paul J; Attinger, Christopher E; Steinberg, John S; Evans, Karen K

    2015-05-01

    Negative pressure wound therapy with instillation (NPWTi) is a novel treatment option that provides the combination of negative pressure with intermittent instillation of a solution. Standard Negative Pressure Wound Therapy (NPWT) is an established adjunctive treatment option that offers the ability to promote granulation tissue in wounds. However, there is limited evidence for its utility in the environment of active or senescent infection. Wounds that are acutely infected or that contain deleterious biofilm are a challenging problem, which require an intensive multimodal approach including antibiosis, surgical intervention, and local wound care. Adjunctive application of NPWTi can potentially expedite clearance of infection and wound closure. Although this technology has been commercially available for over a decade, its adoption has been limited. Recently, there has been a resurgence of interest in this therapy with emerging evidence from animal models as well as human clinical studies. There are remaining questions regarding NPWTi including the selection of the optimal instillation solution and device settings. This article discusses the past development, current knowledge, and future direction of NPWTi. PMID:26378290

  7. Avascular Necrosis of Acetabulum: The Hidden Culprit of Resistant Deep Wound Infection and Failed Fixation of Fracture Acetabulum – A Case Report

    PubMed Central

    K, Kandhari V; M, Desai M; S, Bava S; N, Wade R

    2015-01-01

    Introduction: Chances of avascular necrosis of acetabulum are rare as it enjoys a rich blood supply. But cases of post - traumatic avascular necrosis of acetabulum following fracture of posterior column have been well documented. Importance of identifying and suspecting the avascular necrosis of acetabulum is essential in cases of failed fixation of fracture acetabulum, previously operated using extensile approach to acetabulum; either extended anterior ilio - femoral or tri - radiate approach. Such patients usually present with repeated deep bone infection or with early failure of fixation with aseptic loosening and migration of its components. We present a similar case. Case Presentation: 40 years female presented with inadequately managed transverse fracture of left acetabulum done by anterior extended ilio-inguinal approach. The fixation failed. She presented 6 months later with painful hip. Cemented total hip replacement was performed with reconstruction of acetabulum by posterior column plating. Six months postoperatively patient presented with dislodgement of cup, pelvic discontinuity and sinus in the thigh. Two stage revision surgery was planned. First implant, removal; debridement and antibiotic spacer surgery was performed. At second stage of revision total hip replacement, patient had Paprosky grade IIIb defect in acetabulum. Spacer was removed through the posterior approach. Anterior approach was taken for anterior plating. Intra-operatively external iliac pulsations were found to be absent so procedure was abandoned after expert opinion. Postoperatively digital subtraction angiography demonstrated a chronic block in the external iliac artery and corona mortis was the only patent vascular channel providing vascular to the left lower limb. Thus, peripheral limb was stealing blood supply from the acetabulum to maintain perfusion. Patient was ultimately left with pelvic discontinuity, excision arthroplasty and pseudoarthrosis of the left hip. Conclusions

  8. Early application of negative pressure wound therapy to acute wounds contaminated with Staphylococcus aureus: An effective approach to preventing biofilm formation

    PubMed Central

    LI, TONGTONG; ZHANG, LIHAI; HAN, LI; WANG, GUOQI; YIN, PENG; LI, ZHIRUI; ZHANG, LICHENG; GUO, QI; LIU, DAOHONG; TANG, PEIFU

    2016-01-01

    Negative pressure wound therapy (NPWT) has been demonstrated to be effective at preventing biofilm-associated infections; however, its role in biofilm prevention is unknown. The present study evaluated the effect of NPWT on biofilm prevention when rapidly initiated following wound contamination. Full-thickness dermal wounds (8 mm) were created in rabbit ears and inoculated with green fluorescent protein-labeled Staphylococcus aureus (S. aureus). At 6 h following inoculation, continuous NPWT at −125 mmHg was initiated, with the wounds on the contralateral ear left untreated in order to serve as self-controls. S. aureus rapidly formed mature biofilms in the wound beds post-inoculation, with a persistent bacterial burden of ~105−107 colony-forming units (CFUs)/wound and impaired wound healing. Compared with the untreated group, NPWT resulted in a significant reduction in biofilm matrix, which was verified by scanning electron microscopy and epifluorescence. A reduction in bacterial counts followed (P<0.05) with ~103 CFUs/wound on postoperative day 13 and improvement in all healing parameters (P<0.05) relative to control wounds. The results of the present investigation suggest that NPWT is an effective strategy to impeding the formation of S. aureus wound biofilms when initiated rapidly following bacterial contamination. The early application of NPWT, aimed at biofilm prevention, may improve wound care. PMID:26997991

  9. Radiotherapy and wound healing.

    PubMed

    Devalia, Haresh L; Mansfield, Lucy

    2008-03-01

    This review article discusses basic radiation physics and effects of radiation on wounds. It examines various postulated hypothesis on the role of circulatory decrease and radiation-induced direct cellular damage. The new concept related to the radiation pathogenesis proposes that there is a cascade of cytokines initiated immediately after the radiation. Sustained activation of myofibroblasts in the wound accounts for its chronicity. Recent advances highlight that transforming growth factor beta1 is the master switch in pathogenesis of radiation fibrosis. This articles overviews its role and summarises the available evidences related to radiation damage. The goal of this article was to provide its modern understanding, as future research will concentrate on antagonising the effects of cytokines to promote wound healing. PMID:18081782

  10. 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

  11. The wound/burn guidelines - 1: Wounds in general.

    PubMed

    Inoue, Yuji; Hasegawa, Minoru; Maekawa, Takeo; Le Pavoux, Andres; Asano, Yoshihide; Abe, Masatoshi; Ishii, Takayuki; Ito, Takaaki; Isei, Taiki; Imafuku, Shinichi; Irisawa, Ryokichi; Ohtsuka, Masaki; Ohtsuka, Mikio; Ogawa, Fumihide; Kadono, Takafumi; Kodera, Masanari; Kawakami, Tamihiro; Kawaguchi, Masakazu; Kukino, Ryuichi; Kono, Takeshi; Sakai, Keisuke; Takahara, Masakazu; Tanioka, Miki; Nakanishi, Takeshi; Nakamura, Yasuhiro; Hashimoto, Akira; Hayashi, Masahiro; Fujimoto, Manabu; Fujiwara, Hiroshi; Matsuo, Koma; Madokoro, Naoki; Yamasaki, Osamu; Yoshino, Yuichiro; Tachibana, Takao; Ihn, Hironobu

    2016-04-01

    The Japanese Dermatological Association determined to prepare the Wound/Burn Guidelines focusing on treatments, catering to needs for the clinical practice of dermatology. Among these guidelines, "Wounds in General" was intended to explain knowledge necessary "to heal wounds" without specifying particular disorders. PMID:26972819

  12. 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

  13. [Dressing and wound care pain].

    PubMed

    Chin, Yen-Fan

    2006-12-01

    Wound care is an important step for promoting wound healing. Nevertheless it is also a major source of pain for patients with wounds. The results of a survey showed that not only burn patients but also non-burn ones suffered from wound care pain which occurred in inpatients and outpatients. One of the significant factors causing wound care pain was that the dressing adhered to the wound bed. Although some agencies claimed that particular dressings with low adhesion can result in painless removal, the actual effects needed to be verified. Results of clinical trials revealed that for relieving wound care pain of certain kinds of wound, it was recommended to use particular dressings, such as banana leaf dressing, boiled potato peel bandage, Acticoat, Mepital or Mefix. PMID:17160873

  14. Wound Healing Devices Brief Vignettes

    PubMed Central

    Anderson, Caesar A.; Hare, Marc A.; Perdrizet, George A.

    2016-01-01

    Significance: The demand for wound care therapies is increasing. New wound care products and devices are marketed at a dizzying rate. Practitioners must make informed decisions about the use of medical devices for wound healing therapy. This paper provides updated evidence and recommendations based on a review of recent publications. Recent Advances: The published literature on the use of medical devices for wound healing continues to support the use of hyperbaric oxygen therapy, negative pressure wound therapy, and most recently electrical stimulation. Critical Issue: To inform wound healing practitioners of the evidence for or against the use of medical devices for wound healing. This information will aid the practitioner in deciding which technology should be accepted or rejected for clinical use. Future Directions: To produce high quality, randomized controlled trials or acquire outcome-based registry databases to further test and improve the knowledge base as it relates to the use of medical devices in wound care. PMID:27076996

  15. Therapeutic utility of antibacterial peptides in wound healing.

    PubMed

    Otvos, Laszlo; Ostorhazi, Eszter

    2015-07-01

    Cationic antimicrobial peptides were first thought to fight infection in animal models by disintegrating bacterial peptides and later by inhibiting bacteria-specific intracellular processes. However, ever increasing evidences indicate that cationic peptides accumulate around and modulate the immune system both systemically and in cutaneous and mucosal surfaces where injuries and infections occur. Native and designer antibacterial peptides as well as cationic peptides, never considered as antibiotics, promote wound healing at every step of cutaneous tissue regeneration. This article provides an introductory list of examples of how cationic peptides are involved in immunostimulation and epithelial tissue repair, eliminating wound infections and promoting wound healing in potential therapeutic utility in sight. Although a few antimicrobial peptides reached the Phase II clinical trial stage, toxicity concerns limit the potential administration routes. Resistance induction to both microbiology actions and the integrity of the innate immune system has to be carefully monitored. PMID:25835521

  16. Injuring mechanisms of gunshot wounds.

    PubMed

    White, K M

    1989-03-01

    The severity of injury in a gunshot wound is dependent on many factors, including the type of firearm; the velocity, mass, and construction of the bullet; and the structural properties of the tissues that are wounded. Knowledge of ballistics and an appreciation of the wounding potential of certain firearms and their ammunition can help clinicians anticipate the severity of a wound and raise the index of suspicion for occult but severe internal trauma. PMID:2679792

  17. The use of urinary bladder matrix in the treatment of trauma and combat casualty wound care.

    PubMed

    Valerio, Ian L; Campbell, Paul; Sabino, Jennifer; Dearth, Christopher L; Fleming, Mark

    2015-01-01

    Treatment of combat injuries and resulting wounds can be difficult to treat due to compromised and evolving tissue necrosis, environmental contaminants, multidrug resistant microbacterial and/or fungal infections, coupled with microvascular damage and/or hypovascularized exposed vital structures. Our group has developed surgical care algorithms with identifiable salvage techniques to achieve stable, definitive wound coverage often with the aid of certain regenerative medicine biologic scaffold materials and advanced wound care to facilitate tissue coverage and healing. This case series reports on the role of urinary bladder matrix scaffolds in the wound care and reconstruction of traumatic and combat wounds. Urinary bladder matrix was found to facilitate definitive soft tissue reconstruction by establishing a neovascularized soft tissue base acceptable for second stage wound and skin coverage options within traumatic and combat-related wounds. PMID:26237704

  18. Use of an Acellular Regenerative Tissue Matrix Over Chronic Wounds

    PubMed Central

    Stacey, D. Heath

    2013-01-01

    Objectives: Bioengineered skin grafts, including acellular dermal matrices, may be effective in treating lower extremity and trunk wounds that are not responsive to traditional wound management. Acellular dermal wound matrix is derived from human acellular dermal wound matrix (HADWM) tissue and provides a scaffold that supports cellular repopulation and revascularization. The major structural components of the dermis are retained during processing, and a single application has been shown to help achieve wound closure. Methods: This patient case series examined the use of HADWM on lower extremity and trunk wounds in 11 patients (6 male and 5 female) with a mean age of 55 years (range: 31–83 years). Wounds were debrided 1 to 2 times, followed by placement of HADWM (range: 4–330 cm2) on wounds that varied from the dorsal surface of the foot, lower abdomen, and lower extremity to the Achilles flap. A nonadherent layer in conjunction with bacitracin was placed over HADWM. Negative pressure wound therapy (NPWT) was placed over the HADWM and initiated continuously at −125 mm Hg for 1 to 2 weeks. After the application of NPWT, HADWM was covered with various gauze dressings using mineral oil. Results: All patients completed their treatment successfully, and follow-up ranged from 1 week to 6 months. One patient experienced an infection, which resulted in partial graft loss that required replacement with HADWM and NPWT. No additional complications occurred in the other patients. Conclusions: This patient case series demonstrated successful use of HADWM and NPWT, which further supports published studies documenting HADWM success in chronic wounds. PMID:24324850

  19. Topical Naltrexone as Treatment for Type 2 Diabetic Cutaneous Wounds

    PubMed Central

    Immonen, Jessica A.; Zagon, Ian S.; McLaughlin, Patricia J.

    2014-01-01

    Objective: Type 2 diabetes (T2D) is associated with impaired cutaneous wound healing and can result in ulceration, infection, and/or amputation. More than 25 million people in the United States have T2D and are vulnerable to epithelial-related complications. Current therapies are limited in their efficacy. New treatments for full-thickness cutaneous wounds that focus on underlying diabetic pathways are needed. Approach: Topical application of the opioid receptor antagonist naltrexone (NTX) dissolved in cream reverses delayed wound closure in type 1 diabetic rat by the acceleration of reepithelialization and enhancement of angiogenesis and remodeling. NTX blocks the opioid growth factor (OGF)–OGF receptor (OGFr) axis and upregulates DNA synthesis and cell proliferation. To investigate whether NTX is an effective therapy for T2D wound closure, genetically obese mice (db/db) and normal C57Bl/6J mice received full-thickness cutaneous wounds. Wounds (5 mm in diameter) were treated topically three times daily with 10−5 M NTX or sterile saline dissolved in cream and photographed every 2 days. Results: Wounds in db/db mice treated with saline were 11–92% larger than those in normal mice throughout the 2-week observation. Topical NTX therapy in T2D mice reduced the residual wound size by 13–30% between days 8 and 14 relative to diabetic mice receiving saline. Reepithelialization and DNA synthesis, as analyzed by epithelial thickness and BrdU labeling indexes, respectively, were accelerated in NTX-treated wounds. Innovation and Conclusion: These data suggest that the OGF-OGFr axis plays a role in epithelial-related complications of T2D and that blockade of this pathway by NTX may be an effective treatment for wound repair. PMID:24940556

  20. Biofilms and Wounds: An Identification Algorithm and Potential Treatment Options

    PubMed Central

    Percival, Steven L.; Vuotto, Claudia; Donelli, Gianfranco; Lipsky, Benjamin A.

    2015-01-01

    Significance: The presence of a “pathogenic” or “highly virulent” biofilm is a fundamental risk factor that prevents a chronic wound from healing and increases the risk of the wound becoming clinically infected. There is presently no unequivocal gold standard method available for clinicians to confirm the presence of biofilms in a wound. Thus, to help support clinician practice, we devised an algorithm intended to demonstrate evidence of the presence of a biofilm in a wound to assist with wound management. Recent Advances: A variety of histological and microscopic methods applied to tissue biopsies are currently the most informative techniques available for demonstrating the presence of generic (not classified as pathogenic or commensal) biofilms and the effect they are having in promoting inflammation and downregulating cellular functions. Critical Issues: Even as we rely on microscopic techniques to visualize biofilms, they are entities which are patchy and dispersed rather than confluent, particularly on biotic surfaces. Consequently, detection of biofilms by microscopic techniques alone can lead to frequent false-negative results. Furthermore, visual identification using the naked eye of a pathogenic biofilm on a macroscopic level on the wound will not be possible, unlike with biofilms on abiotic surfaces. Future Direction: Lacking specific biomarkers to demonstrate microscopic, nonconfluent, virulent biofilms in wounds, the present focus on biofilm research should be placed on changing clinical practice. This is best done by utilizing an anti-biofilm toolbox approach, rather than speculating on unscientific approaches to identifying biofilms, with or without staining, in wounds with the naked eye. The approach to controlling biofilm should include initial wound cleansing, periodic debridement, followed by the application of appropriate antimicrobial wound dressings. This approach appears to be effective in removing pathogenic biofilms. PMID:26155381

  1. Chemical Composition and Anti-Candidiasis Mediated Wound Healing Property of Cymbopogon nardus Essential Oil on Chronic Diabetic Wounds

    PubMed Central

    Kandimalla, Raghuram; Kalita, Sanjeeb; Choudhury, Bhaswati; Dash, Suvakanta; Kalita, Kasturi; Kotoky, Jibon

    2016-01-01

    Poor wound healing is one of the major complication of diabetic patients which arises due to different factors like hyperglycemia, oxidative stress, vascular insufficiency and microbial infections. Candidiasis of diabetic wounds is a difficult to treat condition and potentially can lead to organ amputation. There are a few number of medications available in market to treat this chronic condition; which demands for alternative treatment options. In traditional system of medicine like Ayurveda, essential oil extracted from leaves of Cymbopogon nardus L. (Poaceae) has been using for the treatment of microbial infections, inflammation and pain. In this regard, we have evaluated anti-Candida and anti-inflammatory activity mediated wound healing property of C. nardus essential oil (EO-CN) on candidiasis of diabetic wounds. EO-CN was obtained through hydro-distillation and subjected to Gas chromatography–mass spectroscopy (GC–MS) analysis for chemical profiling. Anti-Candida activity of EO-CN was tested against Candida albicans, C. glabrata and C. tropicalis by in vitro zone of inhibition and minimum inhibitory concentration (MIC) assays. Anti-candidiasis ability of EO-CN was evaluated on C. albicans infected diabetic wounds of mice through measuring candida load on the 7th, 14th, and 21st day of treatment. Further progression in wound healing was confirmed by measuring the inflammatory marker levels and histopathology of wounded tissues on last day of EO-CN treatment. A total of 95 compounds were identified through GC–MS analysis, with major compounds like citral, 2,6-octadienal-, 3,7-dimethyl-, geranyl acetate, citronellal, geraniol, and citronellol. In vitro test results demonstrated strong anti-Candida activity of EO-CN with a MIC value of 25 μg/ml against C. albicans, 50 μg/ml against C. glabrata and C. tropicalis. EO-CN treatment resulted in significant reduction of candida load on diabetic wounds. Acceleration in wound healing was indicated by declined

  2. Chemical Composition and Anti-Candidiasis Mediated Wound Healing Property of Cymbopogon nardus Essential Oil on Chronic Diabetic Wounds.

    PubMed

    Kandimalla, Raghuram; Kalita, Sanjeeb; Choudhury, Bhaswati; Dash, Suvakanta; Kalita, Kasturi; Kotoky, Jibon

    2016-01-01

    Poor wound healing is one of the major complication of diabetic patients which arises due to different factors like hyperglycemia, oxidative stress, vascular insufficiency and microbial infections. Candidiasis of diabetic wounds is a difficult to treat condition and potentially can lead to organ amputation. There are a few number of medications available in market to treat this chronic condition; which demands for alternative treatment options. In traditional system of medicine like Ayurveda, essential oil extracted from leaves of Cymbopogon nardus L. (Poaceae) has been using for the treatment of microbial infections, inflammation and pain. In this regard, we have evaluated anti-Candida and anti-inflammatory activity mediated wound healing property of C. nardus essential oil (EO-CN) on candidiasis of diabetic wounds. EO-CN was obtained through hydro-distillation and subjected to Gas chromatography-mass spectroscopy (GC-MS) analysis for chemical profiling. Anti-Candida activity of EO-CN was tested against Candida albicans, C. glabrata and C. tropicalis by in vitro zone of inhibition and minimum inhibitory concentration (MIC) assays. Anti-candidiasis ability of EO-CN was evaluated on C. albicans infected diabetic wounds of mice through measuring candida load on the 7th, 14th, and 21st day of treatment. Further progression in wound healing was confirmed by measuring the inflammatory marker levels and histopathology of wounded tissues on last day of EO-CN treatment. A total of 95 compounds were identified through GC-MS analysis, with major compounds like citral, 2,6-octadienal-, 3,7-dimethyl-, geranyl acetate, citronellal, geraniol, and citronellol. In vitro test results demonstrated strong anti-Candida activity of EO-CN with a MIC value of 25 μg/ml against C. albicans, 50 μg/ml against C. glabrata and C. tropicalis. EO-CN treatment resulted in significant reduction of candida load on diabetic wounds. Acceleration in wound healing was indicated by declined levels of

  3. Effect of Human Burn Wound Exudate on Pseudomonas aeruginosa Virulence.

    PubMed

    Gonzalez, Manuel R; Fleuchot, Betty; Lauciello, Leonardo; Jafari, Paris; Applegate, Lee Ann; Raffoul, Wassim; Que, Yok-Ai; Perron, Karl

    2016-01-01

    Burn wound sepsis is currently the main cause of morbidity and mortality after burn trauma. Infections by notorious pathogens such as Pseudomonas aeruginosa, Staphylococcus aureus, and Acinetobacter baumannii impair patient recovery and can even lead to fatality. In this study, we investigated the effect of burn wound exudates (BWEs) on the virulence of those pathogens. BWEs were collected within 7 days after burn trauma from 5 burn patients. We first monitored their effect on pathogen growth. In contrast to A. baumannii and S. aureus, P. aeruginosa was the only pathogen able to grow within these human fluids. Expression of typical virulence factors such as pyocyanin and pyoverdine was even enhanced compared the levels seen with standard laboratory medium. A detailed chemical composition analysis of BWE was performed, which enabled us to determine the major components of BWE and underline the metabolic modifications induced by burn trauma. These data are essential for the development of an artificial medium mimicking the burn wound environment and the establishment of an in vitro system to analyze the initial steps of burn wound infections. IMPORTANCE Microbial infection of severe burn wounds is currently a major medical challenge. Of the infections by bacteria able to colonize such injuries, those by Pseudomonas aeruginosa are among the most severe, causing major delays in burn patient recovery or leading to fatal issues. In this study, we investigated the growth properties of several burn wound pathogens in biological fluids secreted from human burn wounds. We found that P. aeruginosa strains were able to proliferate but not those of the other pathogens tested. In addition, burn wound exudates (BWEs) stimulate the expression of virulence factors in P. aeruginosa. The chemical composition analysis of BWEs enabled us to determine the major components of these fluids. These data are essential for the development of an artificial medium mimicking the burn wound

  4. Effect of Human Burn Wound Exudate on Pseudomonas aeruginosa Virulence

    PubMed Central

    Gonzalez, Manuel R.; Fleuchot, Betty; Lauciello, Leonardo; Jafari, Paris; Applegate, Lee Ann; Raffoul, Wassim; Que, Yok-Ai

    2016-01-01

    ABSTRACT Burn wound sepsis is currently the main cause of morbidity and mortality after burn trauma. Infections by notorious pathogens such as Pseudomonas aeruginosa, Staphylococcus aureus, and Acinetobacter baumannii impair patient recovery and can even lead to fatality. In this study, we investigated the effect of burn wound exudates (BWEs) on the virulence of those pathogens. BWEs were collected within 7 days after burn trauma from 5 burn patients. We first monitored their effect on pathogen growth. In contrast to A. baumannii and S. aureus, P. aeruginosa was the only pathogen able to grow within these human fluids. Expression of typical virulence factors such as pyocyanin and pyoverdine was even enhanced compared the levels seen with standard laboratory medium. A detailed chemical composition analysis of BWE was performed, which enabled us to determine the major components of BWE and underline the metabolic modifications induced by burn trauma. These data are essential for the development of an artificial medium mimicking the burn wound environment and the establishment of an in vitro system to analyze the initial steps of burn wound infections. IMPORTANCE Microbial infection of severe burn wounds is currently a major medical challenge. Of the infections by bacteria able to colonize such injuries, those by Pseudomonas aeruginosa are among the most severe, causing major delays in burn patient recovery or leading to fatal issues. In this study, we investigated the growth properties of several burn wound pathogens in biological fluids secreted from human burn wounds. We found that P. aeruginosa strains were able to proliferate but not those of the other pathogens tested. In addition, burn wound exudates (BWEs) stimulate the expression of virulence factors in P. aeruginosa. The chemical composition analysis of BWEs enabled us to determine the major components of these fluids. These data are essential for the development of an artificial medium mimicking the

  5. Nutritional aspects of wound healing.

    PubMed

    Ayello, E A; Thomas, D R; Litchford, M A

    1999-01-01

    Proper nutrition is essential to prevent the development of pressure ulcers and to support adequate and timely wound healing. Additionally, research and clinical observation suggest nutrients play a major role in wound healing. How the nutrients Vitamin A, Vitamin C, zinc, calories, protein, and fluids are used in wound healing and recommendations regarding use of supplements are discussed in this article. PMID:10855131

  6. Wound Drainage Culture (For Parents)

    MedlinePlus

    ... Things to Know About Zika & Pregnancy Wound Drainage Culture KidsHealth > For Parents > Wound Drainage Culture Print A A A Text Size What's in ... de heridas What It Is A wound drainage culture is a test to detect germs such as ...

  7. 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

  8. [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

  9. The Wounded Spirit.

    ERIC Educational Resources Information Center

    Peretti, Frank

    2001-01-01

    This article offers a glimpse into the life of Frank Peretti, who as a child suffered abuse because of his physical disfigurement. He was bullied and physically assaulted by peers and sometimes adults. Now well known for his novels, Peretti suggests that people who cause others to suffer also suffer from a wounded spirit. (Author)

  10. Diabetic Wound Care

    MedlinePlus

    ... Feet Footwear & Products Products by Company Products by Type Foot Health Awareness Diabetes Awareness What is a Podiatrist? Today's Podiatrist Print Share RSS Home » Learn About Feet » Foot Health Information Diabetic Wound Care What is a Diabetic Foot Ulcer? ...

  11. Spiral wound extraction cartridge

    DOEpatents

    Wisted, Eric E.; Lundquist, Susan H.

    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.

  12. 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.

  13. Healing Invisible Wounds

    ERIC Educational Resources Information Center

    Adams, Erica J.

    2010-01-01

    As many as 9 in 10 justice-involved youth are affected by traumatic childhood experiences. According to "Healing Invisible Wounds: Why Investing in Trauma-Informed Care for Children Makes Sense," between 75 and 93 percent of youth currently incarcerated in the justice system have had at least one traumatic experience, including sexual abuse, war,…

  14. 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

  15. 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

  16. The application of new biosynthetic artificial skin for long-term temporary wound coverage.

    PubMed

    Wang, Hsian-Jenn; Chou, Trong-Duo; Tsou, Tai-Li; Chen, Tim-Mo; Chen, Shao-Liang; Chen, Shyi-Gen; Wei, Lin-Gwei; Yeh, Kuan-Jeh; Ko, Yao-Huang; Wang, Chi-Shyran; Lee, Wei-Hwa

    2005-12-01

    Temporary dressings protect wounds from desiccation and infection. In our previous study, we used meshed acellular porcine dermis (APD) to enhance wound healing and decrease wound contraction; however, the wounds showed meshed scar. In this study, we produced an artificial skin composed of a cross-linked silicon sheet on the surface of APD which we have called silicone acellular porcine dermis (SAPD). This new artificial skin can protect the wound long enough to promote wound healing either by second intention or covered long enough until cultured epithelium autograft (CEA) or autologous skin graft can be harvested for permanent coverage. We delivered 4 cm x 5 cm full-thickness wound on the back of 350 g Sprague-Dawley rats. Thirty-six rats were divided into two groups. Eighteen rats had SAPD and the other 18 were covered with Biobrane. The wounds were first examined 2 weeks after grafting and followed weekly for an additional 4 weeks to evaluate the wound and study pathological changes by using H.E. and Masson's stains. Wound size was calculated by ruler and analyzed by Student's t-test. At the 2-week inspection, both SAPD and Biobrane showed tight adherence to the wound with no change of wound size. Both the SAPD and Biobrane dermal templates were pink. In the Biobrane-covered group, the wounds contracted soon after the tie-over dressing was removed. Its dermal layer is a layer of thin porcine dermal substance, which was promptly digested by tissue hyaluronidase and provides no real dermal template. In the SAPD-covered group however, the wound size was maintained significantly from third to sixth week after grafting (p<0.001). SAPD was designed with thick epidermal silicone and a well-organized porcine dermis so that it incorporates into the recipient wound. Clinically the silicone layer of SAPD dislodged from APD about 6-7 weeks after grafting and was followed by dermal matrix exposure and infection. In pathological examination, much like a human skin graft, new

  17. Combating Superbug Without Antibiotic on a Postamputation Wound in a Patient with Diabetic Foot.

    PubMed

    Sun, Shuyao; Wang, Chun; Chen, Dawei; Cen, Shiqiang; Lv, Xiaoju; Wen, Xiaorong; Liu, Min; Lu, Wusheng; Zhao, Jichun; Ran, Xingwu

    2016-03-01

    Diabetic foot is a kind of limb- and life-threatening complication that is difficult to treat with conventional therapy, especially when accompanied with peripheral arterial insufficiency and severe infection. We present a diabetic patient with a postamputation wound infected by multidrug-resistant Acinetobacter baumannii/haemolyticus, which was resistant to almost all antibiotics. As the clinical response to antimicrobial therapy was poor, antibiotic was discontinued. Autologous platelet-rich gel with anticoagulation, negative pressure wound therapy, and improvement of microcirculation were used successfully to eradicate infection of the superbug and achieve final wound closure. PMID:26238676

  18. Effects of Topically Applied Vitamin D during Corneal Wound Healing

    PubMed Central

    Reins, Rose Y.; Hanlon, Samuel D.; Magadi, Sri; McDermott, Alison M.

    2016-01-01

    Vitamin D is an important regulator of immune function and largely acts to dampen chronic inflammatory events in a variety of tissues. There is also accumulating evidence that vitamin D acts to enhance initial inflammation, beneficial during both infection and wound healing, and then promotes resolution and prevention of chronic, damaging inflammation. The current study examines the effect of topical vitamin D in a mouse of model of corneal epithelial wound healing, where acute inflammation is necessary for efficient wound closure. At 12 and 18 hours post-wounding, vitamin D treatment significantly delayed wound closure by ~17% and increased infiltration of neutrophils into the central cornea. Basal epithelial cell division, corneal nerve density, and levels of VEGF, TGFβ, IL-1β, and TNFα were unchanged. However, vitamin D increased the production of the anti-microbial peptide CRAMP 12 hours after wounding. These data suggest a possible role for vitamin D in modulating corneal wound healing and have important implications for therapeutic use of vitamin D at the ocular surface. PMID:27035345

  19. Biofilms in wounds: a review of present knowledge.

    PubMed

    Cooper, R A; Bjarnsholt, T; Alhede, M

    2014-11-01

    Following confirmation of the presence of biofilms in chronic wounds, the term biofilm became a buzzword within the wound healing community. For more than a century pathogens have been successfully isolated and identified from wound specimens using techniques that were devised in the nineteenth century by Louis Pasteur and Robert Koch. Although this approach still provides valuable information with which to help diagnose acute infections and to select appropriate antibiotic therapies, it is evident that those organisms isolated from clinical specimens with the conditions normally used in diagnostic laboratories are mainly in a planktonic form that is unrepresentative of the way in which most microbial species exist naturally. Usually microbial species adhere to each other, as well as to living and non-living surfaces, where they form complex communities surrounded by collectively secreted extracellular polymeric substances (EPS). Cells within such aggregations (or biofilms) display varying physiological and metabolic properties that are distinct from those of planktonic cells, and which contribute to their persistence. There are many factors that influence healing in wounds and the discovery of biofilms in chronic wounds has provided new insight into the reasons why. Increased tolerance of biofilms to antimicrobial agents explains the limited efficacy of antimicrobial agents in chronic wounds and illustrates the need to develop new management strategies. This review aims to explain the nature of biofilms, with a view to explaining their impact on wounds. PMID:25375405

  20. Nonhealing Wound Due to Rhodococcus equi in an Apparently Immunocompetent Patient, Revealing CD8+ T-Lymphocyte Deficiency ▿

    PubMed Central

    Denes, Eric; Peignon-Orsoni, Dominique; Terrade, François-Xavier

    2010-01-01

    We describe a case of a nonhealing wound due to Rhodococcus equi. Failure of the wound to heal led to immunological investigations and the discovery of a previously unknown CD8+ T-lymphocyte deficit responsible for the chronic infection. The infection was cured after a 3-month course of a combination of antibiotics. PMID:20881171

  1. Tissue Engineering and Regenerative Repair in Wound Healing

    PubMed Central

    Hu, Michael S.; Maan, Zeshaan N.; Wu, Jen-Chieh; Rennert, Robert C.; Hong, Wan Xing; Lai, Tiffany S.; Cheung, Alexander T. M.; Walmsley, Graham G.; Chung, Michael T.; McArdle, Adrian; Longaker, Michael T.; Lorenz, H. Peter

    2014-01-01

    Wound healing is a highly evolved defense mechanism against infection and further injury. It is a complex process involving multiple cell types and biological pathways. Mammalian adult cutaneous wound healing is mediated by a fibroproliferative response leading to scar formation. In contrast, early to mid-gestational fetal cutaneous wound healing is more akin to regeneration and occurs without scar formation. This early observation has led to extensive research seeking to unlock the mechanism underlying fetal scarless regenerative repair. Building upon recent advances in biomaterials and stem cell applications, tissue engineering approaches are working towards a recapitulation of this phenomenon. In this review, we describe the elements that distinguish fetal scarless and adult scarring wound healing, and discuss current trends in tissue engineering aimed at achieving scarless tissue regeneration. PMID:24788648

  2. Nutritional support for wound healing.

    PubMed

    MacKay, Douglas; Miller, Alan L

    2003-11-01

    Healing of wounds, whether from accidental injury or surgical intervention, involves the activity of an intricate network of blood cells, tissue types, cytokines, and growth factors. This results in increased cellular activity, which causes an intensified metabolic demand for nutrients. Nutritional deficiencies can impede wound healing, and several nutritional factors required for wound repair may improve healing time and wound outcome. Vitamin A is required for epithelial and bone formation, cellular differentiation, and immune function. Vitamin C is necessary for collagen formation, proper immune function, and as a tissue antioxidant. Vitamin E is the major lipid-soluble antioxidant in the skin; however, the effect of vitamin E on surgical wounds is inconclusive. Bromelain reduces edema, bruising, pain, and healing time following trauma and surgical procedures. Glucosamine appears to be the rate-limiting substrate for hyaluronic acid production in the wound. Adequate dietary protein is absolutely essential for proper wound healing, and tissue levels of the amino acids arginine and glutamine may influence wound repair and immune function. The botanical medicines Centella asiatica and Aloe vera have been used for decades, both topically and internally, to enhance wound repair, and scientific studies are now beginning to validate efficacy and explore mechanisms of action for these botanicals. To promote wound healing in the shortest time possible, with minimal pain, discomfort, and scarring to the patient, it is important to explore nutritional and botanical influences on wound outcome. PMID:14653765

  3. Filament wound structure and method

    DOEpatents

    Dritt, William S.; Gerth, Howard L.; Knight, Jr., Charles E.; Pardue, Robert M.

    1977-01-01

    The present invention relates to a filament wound spherical structure comprising a plurality of filament band sets disposed about the surface of a mandrel with each band of each set formed of a continuous filament circumferentially wound about the mandrel a selected number of circuits and with each circuit of filament being wound parallel to and contiguous with an immediate previously wound circuit. Each filament band in each band set is wound at the same helix angle from the axis of revolution of the mandrel and all of the bands of each set are uniformly distributed about the mandrel circumference. The pole-to-equator wall thickness taper associated with each band set, as several contiguous band sets are wound about the mandrel starting at the poles, is accumulative as the band sets are nested to provide a complete filament wound sphere of essentially uniform thickness.

  4. Antibiofilm Efficacy of DispersinB(®) Wound Spray Used in Combination with a Silver Wound Dressing.

    PubMed

    Gawande, Purushottam V; Clinton, Allie P; LoVetri, Karen; Yakandawala, Nandadeva; Rumbaugh, Kendra P; Madhyastha, Srinivasa

    2014-01-01

    Chronic wounds including diabetic foot ulcers, pressure ulcers, and venous leg ulcers are a worldwide health problem. As the traditional methods of treatment have proven ineffective against chronic wounds involving biofilms, there is an unmet clinical need for developing products with an antibiofilm component that inhibits and/or disrupts biofilms and thus make the biofilm-embedded bacteria more susceptible to antimicrobial therapy. We developed a DispersinB® antibiofilm enzyme-based wound spray for treating chronic wounds in conjunction with an antimicrobial. Under in vitro conditions, the DispersinB® and Acticoat™ combination performed significantly better (P < 0.05) than Acticoat™ alone, indicating the synergy between the two compounds because of DispersinB® enhancing the antimicrobial activity of Acticoat™. Furthermore, DispersinB® wound spray enhanced the antimicrobial activity of Acticoat™ in a chronic wound mouse model of methicillin-resistant Staphylococcus aureus (MRSA) infection. Thus, this novel combination of DispersinB® and Acticoat™, an antimicrobial dressing, prompts clinical evaluation for potential applications in biofilm-based chronic wound management. PMID:24826078

  5. Post-surgical wound management of pilonidal cysts with a haemoglobin spray: a case series.

    PubMed

    Mustafi, N; Engels, P

    2016-04-01

    Painful acute cysts in the natal cleft or lower back, known as pilonidal sinus disease, are a severe burden to many younger patients. Although surgical intervention is the preferred first line treatment, postsurgical wound healing disturbances are frequently reported due to infection or other complications. Different treatment options of pilonidal cysts have been discussed in the literature, however, no standardised guideline for the postsurgical wound treatment is available. After surgery, a common recommended treatment to patients is rinsing the wound with clean water and dressing with a sterile compress. We present a case series of seven patients with wounds healing by secondary intention after surgical intervention of a pilonidal cyst. The average age of the patients was 40 years old. Of the seven patients, three had developed a wound healing disturbance, one wound had started to develop a fibrin coating and three were in a good condition. The applied wound care regimens comprised appropriate mechanical or autolytic debridement, rinsing with an antimicrobial solution, haemoglobin application, and primary and secondary dressings. In all seven cases a complete wound closure was achieved within an average of 76 days with six out of seven wounds achieving wound closure within 23-98 days. Aesthetic appearance was deemed excellent in five out of seven cases excellent and acceptable in one. Treatment of one case with a sustained healing disturbance did result in wound closure but with a poor aesthetic outcome and an extensive cicatrisation of the new tissue. Based on these results we recommend that to avoid healing disturbances of wounds healing by secondary intention after surgical pilonidal cyst intervention, an adequate wound care regime comprising appropriate wound debridement, rinsing, topically applied haemoglobin and adequate wound dressing is recommendable as early as possible after surgery. PMID:27064368

  6. Thiolated Carboxymethyl-Hyaluronic-Acid-Based Biomaterials Enhance Wound Healing in Rats, Dogs, and Horses

    PubMed Central

    Yang, Guanghui; Prestwich, Glenn D.; Mann, Brenda K.

    2011-01-01

    The progression of wound healing is a complicated but well-known process involving many factors, yet there are few products on the market that enhance and accelerate wound healing. This is particularly problematic in veterinary medicine where multiple species must be treated and large animals heal slower, oftentimes with complicating factors such as the development of exuberant granulation tissue. In this study a crosslinked-hyaluronic-acid (HA-) based biomaterial was used to treat wounds on multiple species: rats, dogs, and horses. The base molecule, thiolated carboxymethyl HA, was first found to increase keratinocyte proliferation in vitro. Crosslinked gels and films were then both found to enhance the rate of wound healing in rats and resulted in thicker epidermis than untreated controls. Crosslinked films were used to treat wounds on forelimbs of dogs and horses. Although wounds healed slower compared to rats, the films again enhanced wound healing compared to untreated controls, both in terms of wound closure and quality of tissue. This study indicates that these crosslinked HA-based biomaterials enhance wound healing across multiple species and therefore may prove particularly useful in veterinary medicine. Reduced wound closure times and better quality of healed tissue would decrease risk of infection and pain associated with open wounds. PMID:23738117

  7. The Use of Biologic Scaffolds in the Treatment of Chronic Nonhealing Wounds

    PubMed Central

    Turner, Neill J.; Badylak, Stephen F.

    2015-01-01

    Significance: Injuries to the skin as a result of illness or injury, particularly chronic nonhealing wounds, present a major healthcare problem. Traditional wound care approaches attempt to control the underlying causes, such as infection and ischemia, while the application of wound dressings aims to modify a poorly healing wound environment into a microenvironment more closely resembling an acute wound allowing the body to heal the wound naturally. Recent Advances: Regenerative medicine approaches, such as the use of biologic scaffold materials comprising an intact extracellular matrix (ECM) or individual components of the ECM, are providing new therapeutic options that focus upon the provision of biochemical cues that alter the wound microenvironment to facilitate rapid restoration of normal skin architecture. Critical Issues: The incidence of chronic nonhealing wounds continues to increase. For example, between 15% and 20% of diabetics are likely to develop chronic, nonhealing foot wounds creating an increasing burden on healthcare systems worldwide. Future Directions: Developing a thorough understanding of wound microenvironment and the mechanisms by which biologic scaffolds work in vivo has the potential to markedly improve outcomes in the clinical translation for the treatment of chronic wounds. PMID:26244105

  8. Clinical Biofilms: A Challenging Frontier in Wound Care

    PubMed Central

    Hurlow, Jennifer; Couch, Kara; Laforet, Karen; Bolton, Laura; Metcalf, Daniel; Bowler, Phil

    2015-01-01

    Significance: Biofilms have been implicated in a variety of wound complications. Recent Advances: Research has confirmed that biofilms form in wounds of patients experiencing delayed healing and may be a precursor to infection. Critical Issues: Research into the strength of this association is still in its infancy. Is biofilm formation a cause of these complications, a step toward them, or a signal that unresolved factors injuring tissue or delaying healing are setting the stage for biofilm formation, infection, and healing delay? To qualify biofilms for use in informing clinical practice decisions, biofilm characteristics supporting those decisions need standardized definitions and valid evidence that they predict or diagnose healing or infection outcomes. Literature searches of relevant terms reviewed biofilm definitions and validation of their role in predicting and diagnosing delayed wound healing or infection. Future Directions: Further research is needed to provide a rapid accurate technique to identify and characterize biofilms in ways that optimize their validity in diagnosing or screening patient risk of infection or delayed healing and to inform clinical decisions. This research will help validate biofilm's capacity to support wound care clinical practice decisions and establish their importance in guiding clinical practice. PMID:26005595

  9. 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

  10. 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

  11. The wound hormone jasmonate

    PubMed Central

    Koo, Abraham J.K.; Howe, Gregg A.

    2009-01-01

    Plant tissues are highly vulnerable to injury by herbivores, pathogens, mechanical stress, and other environmental insults. Optimal plant fitness in the face of these threats relies on complex signal transduction networks that link damage-associated signals to appropriate changes in metabolism, growth, and development. Many of these wound-induced adaptive responses are triggered by de novo synthesis of the plant hormone jasmonate (JA). Recent studies provide evidence that JA mediates systemic wound responses through distinct cell autonomous and nonautonomous pathways. In both pathways, bioactive JAs are recognized by an F-box protein-based receptor system that couples hormone binding to ubiquitin-dependent degradation of transcriptional repressor proteins. These results provide a new framework for understanding how plants recognize and respond to tissue injury. PMID:19695649

  12. Postoperative Spine Infections.

    PubMed

    Pawar, Abhijit Yuvaraj; Biswas, Samar Kumar

    2016-02-01

    Postoperative spinal wound infection increases the morbidity of the patient and the cost of healthcare. Despite the development of prophylactic antibiotics and advances in surgical technique and postoperative care, wound infection continues to compromise patient outcome after spinal surgery. Spinal instrumentation also has an important role in the development of postoperative infections. This review analyses the risk factors that influence the development of postoperative infection. Classification and diagnosis of postoperative spinal infection is also discussed to facilitate the choice of treatment on the basis of infection severity. Preventive measures to avoid surgical site (SS) infection in spine surgery and methods for reduction of all the changeable risk factors are discussed in brief. Management protocols to manage SS infections in spine surgery are also reviewed. PMID:26949475

  13. Postoperative Spine Infections

    PubMed Central

    Biswas, Samar Kumar

    2016-01-01

    Postoperative spinal wound infection increases the morbidity of the patient and the cost of healthcare. Despite the development of prophylactic antibiotics and advances in surgical technique and postoperative care, wound infection continues to compromise patient outcome after spinal surgery. Spinal instrumentation also has an important role in the development of postoperative infections. This review analyses the risk factors that influence the development of postoperative infection. Classification and diagnosis of postoperative spinal infection is also discussed to facilitate the choice of treatment on the basis of infection severity. Preventive measures to avoid surgical site (SS) infection in spine surgery and methods for reduction of all the changeable risk factors are discussed in brief. Management protocols to manage SS infections in spine surgery are also reviewed. PMID:26949475

  14. The Burn Wound Microenvironment

    PubMed Central

    Rose, Lloyd F.; Chan, Rodney K.

    2016-01-01

    Significance: While the survival rate of the severely burned patient has improved significantly, relatively little progress has been made in treatment or prevention of burn-induced long-term sequelae, such as contraction and fibrosis. Recent Advances: Our knowledge of the molecular pathways involved in burn wounds has increased dramatically, and technological advances now allow large-scale genomic studies, providing a global view of wound healing processes. Critical Issues: Translating findings from a large number of in vitro and preclinical animal studies into clinical practice represents a gap in our understanding, and the failures of a number of clinical trials suggest that targeting single pathways or cytokines may not be the best approach. Significant opportunities for improvement exist. Future Directions: Study of the underlying molecular influences of burn wound healing progression will undoubtedly continue as an active research focus. Increasing our knowledge of these processes will identify additional therapeutic targets, supporting informed clinical studies that translate into clinical relevance and practice. PMID:26989577

  15. 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

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

    ClinicalTrials.gov

    2016-05-11

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

  17. The effect of a silver-containing Hydrofiber dressing on superficial wound bed and bacterial balance of chronic wounds.

    PubMed

    Coutts, Pat; Sibbald, R Gary

    2005-12-01

    The treatment of chronic wounds represents a major cost to society and has a profound effect on the participant's quality of life. Chronic wounds may have an increased bacterial burden that can impair healing without all the clinical signs of infection. Silver dressings may provide an alternative topical method to control bacterial burden. The primary aim of this study was to evaluate the clinical improvement in chronic wounds through the effect on wound size, maceration, resolution of surface slough and conversion to healthy granulation during a 4-week application of the silver-containing Hydrofiber dressing. This was a single centre, open-label case series study which included a total of 30 evaluable participants: four with diabetic neuropathic foot ulcers, 13 venous stasis ulcers, four pressure ulcers and nine miscellaneous wounds that did not fit any of the previous categories. All participants had adequate vascular supply, indicating the potential to heal. The wounds were stalled or had the signs and symptoms consistent with critical colonisation. The underlying cause of the ulceration was identified and corrected, or the symptoms and signs were treated. This was followed by the application of silver-containing Hydrofiber dressings for a period of 4 weeks. The majority of wounds treated decreased in size (70%) with decreased exudate, decreased purulence and resolution of surface slough (75%). There was an increased quality and quantity of healthy granulation tissue. Unlike some silver dressings, the Hydrofiber and silver combination dressing was unlikely to cause burning and stinging on application. Peri-wound maceration was present in 54% of participants at baseline, and 85% of these resolved with this dressing. A desloughing action was seen in those patients with pre-existing slough at baseline and its removal will lower the bacterial burden of the wound. PMID:16618321

  18. Prototype Development of the Intelligent Hydrogel Wound Dressing and Its Efficacy in the Detection of Model Pathogenic Wound Biofilms.

    PubMed

    Thet, N T; Alves, D R; Bean, J E; Booth, S; Nzakizwanayo, J; Young, A E R; Jones, B V; Jenkins, A Toby A

    2016-06-22

    The early detection of wound infection in situ can dramatically improve patient care pathways and clinical outcomes. There is increasing evidence that within an infected wound the main bacterial mode of living is a biofilm: a confluent community of adherent bacteria encased in an extracellular polymeric matrix. Here we have reported the development of a prototype wound dressing, which switches on a fluorescent color when in contact with pathogenic wound biofilms. The dressing is made of a hydrated agarose film in which the fluorescent dye containing vesicles were mixed with agarose and dispersed within the hydrogel matrix. The static and dynamic models of wound biofilms, from clinical strains of Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and Enterococcus faecalis, were established on nanoporous polycarbonate membrane for 24, 48, and 72 h, and the dressing response to the biofilms on the prototype dressing evaluated. The dressing indicated a clear fluorescent/color response within 4 h, only observed when in contact with biofilms produced by a pathogenic strain. The sensitivity of the dressing to biofilms was dependent on the species and strain types of the bacterial pathogens involved, but a relatively higher response was observed in strains considered good biofilm formers. There was a clear difference in the levels of dressing response, when dressings were tested on bacteria grown in biofilm or in planktonic cultures, suggesting that the level of expression of virulence factors is different depending of the growth mode. Colorimetric detection on wound biofilms of prevalent pathogens (S. aureus, P. aeruginosa, and E. faecalis) is also demonstrated using an ex vivo porcine skin model of burn wound infection. PMID:26492095

  19. 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

  20. [Treatment of surgical wound dehiscence by topical negative pressure therapy: Clinical case].

    PubMed

    Fresno-García, Carmen; Alconero-Camarero, Ana Rosa; Fernández-Carro, Belén

    2015-01-01

    Topical negative pressure therapy is an alternative treatment for complex wounds that consists of the direct application of sub-atmospheric pressure, obtaining a number of effects that are beneficial for tissues, promoting the healing of both acute and chronic wounds and complementing surgical procedures. We report the case of a 75 year old man diagnosed with surgical wound dehiscence after a femorotibial bypass graft, who was hospitalized again with the aim to perform the implantation of a topical negative pressure therapy in the infected wound. We designed a care plan for this patient following the steps of the scientific method and basing ourselves on the NANDA, NIC, and NOC taxonomies. PMID:26183760

  1. Epidermal Grafting for Chronic Complex Wounds in India: A Case Series

    PubMed Central

    Chaudhary, Dr. Ajay; Purushothaman, Shyam; K.V., Smitha; Arvind K., Varada

    2016-01-01

    Background  In India, the high cost of medical treatments and limited resources can deter patients from receiving available care, leading to the development of chronic wounds. We evaluated the use of epidermal grafting in patients with complex, long-term chronic wounds. Methods Eighteen patients with complex wounds were treated with epidermal micrografts between September 2014 and March 2015 at a state-run, community health center in Mahe, Puducherry, India. Wound re-epithelialization was monitored for up to 14 weeks. Results  Comorbidities in the patient group (nine females and nine males; mean age 54.1 ± 10.8 years, range 32–70 years) included diabetes mellitus, hypertension, obesity (body mass index (BMI) >30 kg/m2), and peripheral vascular disease. The wound types included diabetic and nondiabetic foot, pressure, and venous leg ulcers. The average wound age prior to treatment was 36.8 ± 48.5 months (range 2–180 months) in the majority of patients. All wounds measured less than 7 cm × 7 cm. The mean time to wound epithelialization was 3.7 ± 1.8 weeks (range 2–9 weeks). The majority of wounds healed following epidermal grafting (n=16, 88.9%). One patient developed infection following removal of the dressing under non-sterile conditions against the advice of the healthcare providers. Another patient developed wound hypergranulation after grafting. Both wounds healed completely after treatment with antibiotic therapy and tissue resection, respectively. All donor sites healed without complications. Conclusion  In patients with small- to medium-sized chronic wounds, epidermal grafting offered a viable wound closure option for wounds requiring only the epidermal layer. Additionally, epidermal grafting was performed in the clinic without anesthesia or a surgeon, making the procedure more accessible in resource-challenged regions. PMID:27054051

  2. [Stab wounds in emergency department].

    PubMed

    Bège, T; Berdah, S V; Brunet, C

    2013-12-01

    Stab wounds represent the most common cause of penetrating wounds, occurring mainly in case of aggression or suicide attempt. Clinical severity depends on the superficial or penetrating aspect of the wound, its location and damaged organs. Medical management must be known because the vital risk is involved in penetrating wounds. Hemodynamically unstable patients should be operated without delay after performing a chest X-ray and ultrasound Focus assisted sonography for trauma (FAST) to guide the surgery. In the stable patients, the general clinical examination, exploration of the wound and medical imaging detect injuries requiring surgical management. Stab penetrating wounds require close and rapid collaboration between medical teams, tailored to the institution's resources. PMID:24176734

  3. Chemokines and diabetic wound healing.

    PubMed

    Ochoa, Oscar; Torres, Francis M; Shireman, Paula K

    2007-01-01

    Chemokines are critical for white blood cell recruitment to injured tissues and play an important role in normal wound healing processes. In contrast, impaired wound healing in diabetic patients is accompanied by decreased early inflammatory cell infiltration but persistence of neutrophils and macrophages in the chronic, nonhealing wounds. These changes in inflammatory cell recruitment occur in conjunction with alterations in chemokine and growth factor expression. In addition to leukocyte trafficking, many different cell types, including endothelial cells, fibroblasts, and keratinocytes, produce and respond to chemokines, and these interactions are altered in diabetic wounds. Thus, the chemokine system may have both direct and inflammatory-mediated effects on many different aspects of diabetic wound healing. The potential roles of chemokines and inflammatory or immune cells in nonhealing diabetic wounds, including impairments in growth factor expression, angiogenesis, extracellular matrix formation, and reepithelialization, are examined. PMID:18053419

  4. Studies on Wound Healing Activity of Heliotropium indicum Linn. Leaves on Rats

    PubMed Central

    Dash, G. K.; Murthy, P. N.

    2011-01-01

    The petroleum ether, chloroform, methanol, and aqueous extracts of Heliotropium indicum Linn. (Family: Boraginaceae) were separately evaluated for their wound healing activity in rats using excision (normal and infected), incision, and dead space wound models. The effects of test samples on the rate of wound healing were assessed by the rate of wound closure, period of epithelialisation, wound breaking strength, weights of the granulation tissue, determination of hydroxyproline, super oxide dismutase (SOD), catalase, and histopathology of the granulation tissues. Nitrofurazone (0.2% w/w) in simple ointment I. P. was used as reference standard for the activity comparison. The results revealed significant promotion of wound healing with both methanol and aqueous extracts with more promising activity with the methanol extract compared to other extracts under study. In the wound infection model (with S. aureus and P. aeruginosa), the methanol extract showed significant healing activity similar to the reference standard nitrofurazone. Significant increase in the granulation tissue weight, increased hydroxyproline content, and increased activity of SOD and catalase level with the animals treated with methanol extract in dead space wound model further augmented the wound healing potential of H. indicum. The present work substantiates its validity of the folklore use. PMID:22084720

  5. The role of endogenous and exogenous enzymes in chronic wounds: a focus on the implications of aberrant levels of both host and bacterial proteases in wound healing.

    PubMed

    McCarty, Sara M; Cochrane, Christine A; Clegg, Peter D; Percival, Steven L

    2012-01-01

    Cutaneous wound healing is orchestrated by a number of physiological pathways that ultimately lead to reformation of skin integrity and the production of functional scar tissue. The remodeling of a wound is significantly affected by matrix metalloproteinases (MMPs), which act to control the degradation of the extracellular matrix (ECM). Regulation of MMPs is imperative for wound healing as excessive levels of MMPs can lead to disproportionate destruction of the wound ECM compared to ECM deposition. In addition to human MMPs, bacterial proteases have been found to be influential in tissue breakdown and, as such, have a role to play in the healing of infected wounds. For example, the zinc-metalloproteinase, elastase, produced by Pseudomonas aeruginosa, induces degradation of fibroblast proteins and proteoglycans in chronic wounds and has also been shown to degrade host immune cell mediators. Microbial extracellular enzymes have also been shown to degrade human wound fluid and inhibit fibroblast cell growth. It is now being acknowledged that host and bacterial MMPs may act synergistically to cause tissue breakdown within the wound bed. Several studies have suggested that bacterial-derived secreted proteases may act to up-regulate the levels of MMPs produced by the host cells. Together, these findings indicate that bacterial phenotype in terms of protease producing potential of bacteria should be taken into consideration during diagnostic and clinical intervention of infected wound management. Furthermore, both host MMPs and those derived from infecting bacteria need to be targeted in order to increase the healing capacity of the injured tissue. The aim of this review is to investigate the evidence suggestive of a relationship between unregulated levels of both host and bacterial proteases and delayed wound healing. PMID:22380687

  6. 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

  7. Wound Healing Activity of Rubus sanctus Schreber (Rosaceae): Preclinical Study in Animal Models

    PubMed Central

    Süntar, Ipek; Koca, Ufuk; Keleş, Hikmet; Akkol, Esra Küpeli

    2011-01-01

    Young shoots of Rubus species have been used for healing of wounds, infected insect bites and pimples in folk medicine for ages. In order to evaluate the wound healing activity of Rubus sanctus, four different extracts were prepared from the whole aerial parts of the plant by using n-hexane, chloroform, ethyl acetate and methanol, respectively. Incision wound healing model by using tensiometer on rats and excision model on mice were employed to assess the activity. Remarkable wound healing activity was observed with the ointment formulation of the methanol extract at 1% concentration on the mentioned models. The results of histopathological examination also supported the outcome of both incision and excision wound models. The wound healing effect was comparatively evaluated with a reference ointment Madecassol. The experimental data confirmed the ethnobotanical usage of R. sanctus. PMID:19755505

  8. Electrospun PCL membranes incorporated with biosynthesized silver nanoparticles as antibacterial wound dressings

    NASA Astrophysics Data System (ADS)

    Augustine, Robin; Kalarikkal, Nandakumar; Thomas, Sabu

    2016-03-01

    An open wound is highly prone to bacterial colonization and infection. Bacterial barrier property is an important factor that determines the success of a wound coverage material. Apart from the bacterial barrier property, presence of antibacterial agents can successfully eliminate the invasion and colonization of pathogen in the wound. Silver nanoparticles are well-known antimicrobial agents against a wide range of microorganisms. Biosynthesized silver nanoparticles are more acceptable for medical applications due to superior biocompatibility than chemically synthesized ones. Presence of biomolecules on biosynthesized silver nanoparticles enhances its therapeutic efficiency. Polycaprolactone (PCL) is a well-known material for biomedical applications including wound dressings. Electrospinning is an excellent technique for the fabrication of thin membranes for wound coverage applications with barrier property against microbes. In this paper, we report the fabrication and characterization of electrospun PCL membranes incorporated with biosynthesized silver nanoparticles for wound dressing applications.

  9. The effect of incisional negative pressure therapy on wound complications after acetabular fracture surgery.

    PubMed

    Reddix, Robert N; Leng, Xiaoyan Iris'; Woodall, James; Jackson, Benjamin; Dedmond, Barnaby; Webb, Lawrence X

    2010-01-01

    The purpose of the study was to determine if the use of incisional negative pressure therapy affected the rate of wound complications after acetabular fracture surgery. Between August 1996 to April 2005, 301 patients were found to have had an operatively treated acetabular fracture. There were 235 patients who had placement of incisional vacuum-assisted closure (VAC) who had three (1.27%) deep wound infections and one (0.426%) wound dehiscence. There were 66 consecutive patients who were available in the 5 years preceding the usage of the incisional VAC who had four (6.06%) deep wound infections and two (3.03%) wound dehiscences. This is less than the published infection rate of 4% for patients undergoing operative treatment of acetabular fractures and less than the authors' rate of 6.15% in the time period before the use of the incisional negative pressure wound therapy (p=.0414). The use of incisional negative pressure wound therapy significantly decreases perioperative wound complications after acetabular fracture surgery. PMID:20727304

  10. Healing in the irradiated wound

    SciTech Connect

    Miller, S.H.; Rudolph, R. )

    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.

  11. 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

  12. Honey: A Biologic Wound Dressing.

    PubMed

    Molan, Peter; Rhodes, Tanya

    2015-06-01

    Honey has been used as a wound dressing for thousands of years, but only in more recent times has a scientific explanation become available for its effectiveness. It is now realized that honey is a biologic wound dressing with multiple bioactivities that work in concert to expedite the healing process. The physical properties of honey also expedite the healing process: its acidity increases the release of oxygen from hemoglobin thereby making the wound environment less favorable for the activity of destructive proteases, and the high osmolarity of honey draws fluid out of the wound bed to create an outflow of lymph as occurs with negative pressure wound therapy. Honey has a broad-spectrum antibacterial activity, but there is much variation in potency between different honeys. There are 2 types of antibacterial activity. In most honeys the activity is due to hydrogen peroxide, but much of this is inactivated by the enzyme catalase that is present in blood, serum, and wound tissues. In manuka honey, the activity is due to methylglyoxal which is not inactivated. The manuka honey used in wound-care products can withstand dilution with substantial amounts of wound exudate and still maintain enough activity to inhibit the growth of bacteria. There is good evidence for honey also having bioactivities that stimulate the immune response (thus promoting the growth of tissues for wound repair), suppress inflammation, and bring about rapid autolytic debridement. There is clinical evidence for these actions, and research is providing scientific explanations for them. PMID:26061489

  13. Gallic Acid Promotes Wound Healing in Normal and Hyperglucidic Conditions.

    PubMed

    Yang, Dong Joo; Moh, Sang Hyun; Son, Dong Hwee; You, Seunghoon; Kinyua, Ann W; Ko, Chang Mann; Song, Miyoung; Yeo, Jinhee; Choi, Yun-Hee; Kim, Ki Woo

    2016-01-01

    Skin is the outermost layer of the human body that is constantly exposed to environmental stressors, such as UV radiation and toxic chemicals, and is susceptible to mechanical wounding and injury. The ability of the skin to repair injuries is paramount for survival and it is disrupted in a spectrum of disorders leading to skin pathologies. Diabetic patients often suffer from chronic, impaired wound healing, which facilitate bacterial infections and necessitate amputation. Here, we studied the effects of gallic acid (GA, 3,4,5-trihydroxybenzoic acid; a plant-derived polyphenolic compound) on would healing in normal and hyperglucidic conditions, to mimic diabetes, in human keratinocytes and fibroblasts. Our study reveals that GA is a potential antioxidant that directly upregulates the expression of antioxidant genes. In addition, GA accelerated cell migration of keratinocytes and fibroblasts in both normal and hyperglucidic conditions. Further, GA treatment activated factors known to be hallmarks of wound healing, such as focal adhesion kinases (FAK), c-Jun N-terminal kinases (JNK), and extracellular signal-regulated kinases (Erk), underpinning the beneficial role of GA in wound repair. Therefore, our results demonstrate that GA might be a viable wound healing agent and a potential intervention to treat wounds resulting from metabolic complications. PMID:27399667

  14. 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.

  15. Current Microbial Isolates from Wound Swabs, Their Culture and Sensitivity Pattern at the Niger Delta University Teaching Hospital, Okolobiri, Nigeria

    PubMed Central

    Pondei, Kemebradikumo; Fente, Beleudanyo G.; Oladapo, Oluwatoyosi

    2013-01-01

    Background: Wound infections continue to be problematic in clinical practice where empiric treatment of infections is routine. Objectives: A retrospective cross-sectional study to determine the current causative organisms of wound infections and their antibiotic susceptibility patterns in the Niger Delta University Teaching Hospital (NDUTH), Okolobiri, Bayelsa State of Nigeria. Methods: Records of wound swabs collected from 101 patients with high suspicion of wound infection were analysed. Smears from the wound swabs were inoculated on appropriate media and cultured. Bacterial colonies were Gram stained and microscopically examined. Biochemical tests were done to identify pathogen species. The Kirby-Bauer disk diffusion method was used for antibiotic testing. Results: Prevalence of wound infection was 86.13% (CI: 79.41–92.85). Most bacteria were Gram negative bacilli with Pseudomonas aeruginosa being the most prevalent pathogen isolated. The bacterial isolates exhibited a high degree of resistance to the antibiotics tested (42.8% to 100% resistance). All isolates were resistant to cloxacillin. Age group and sex did not exert any effect on prevalence, aetiological agent or antimicrobial resistance pattern. Conclusion: We suggest a multidisciplinary approach to wound management, routine microbiological surveillance of wounds, rational drug use and the institution of strong infection control policies. PMID:23874138

  16. 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...

  17. The fluid dynamics of simultaneous irrigation with negative pressure wound therapy.

    PubMed

    Davis, Kathryn E; Moquin, Kenneth J; Lavery, Lawrence A

    2016-08-01

    Saline irrigation has been shown to be both experimentally and clinically efficacious in decreasing bacterial contamination as well as decreasing infection rates. The dynamics of irrigation delivery fall into two primary categories: simultaneous and intermittent irrigation. An important component to irrigation therapy is distribution of irrigation solution to hard-to-reach areas of a wound bed, including undermining and fissure-like structures. Here we test the effectiveness of simultaneous irrigation to fill the irregular structures of a wound bed. In order to visualise the dynamic movement of irrigation solution, three-dimensional wound models were constructed using clear synthetic ballistic gel. Wounds with the aforementioned characteristics were carved into the ballistic gel with varying area, depth and volume. All three wounds were dressed as per manufacturer's instructions. Data demonstrate that simultaneous irrigation is effective in reaching all parts of a wound bed in wound models that have both undermining and tunnelling, and irrigation effectively saturates bridged wounds. Finally, this study shows that there is constant turnover of irrigation solution in the wound that is driven more by administration volume and less by flow rate. These data show that simultaneous irrigation is an effective technique for delivering irrigation solution to both simple and complex wounds. PMID:25968404

  18. Nitric oxide-releasing nanoparticles accelerate wound healing by promoting fibroblast migration and collagen deposition.

    PubMed

    Han, George; Nguyen, Long N; Macherla, Chitralekha; Chi, Yuling; Friedman, Joel M; Nosanchuk, Joshua D; Martinez, Luis R

    2012-04-01

    Wound healing is a complex process that involves coordinated interactions between diverse immunological and biological systems. Long-term wounds remain a challenging clinical problem, affecting approximately 6 million patients per year, with a high economic impact. To exacerbate the problem, these wounds render the individual susceptible to life-threatening microbial infections. Because current therapeutic strategies have proved suboptimal, it is imperative to focus on new therapeutic approaches and the development of technologies for both short- and long-term wound management. In recent years, nitric oxide (NO) has emerged as a critical molecule in wound healing, with NO levels increasing rapidly after skin damage and gradually decreasing as the healing process progresses. In this study, we examined the effects of a novel NO-releasing nanoparticle technology on wound healing in mice. The results show that the NO nanoparticles (NO-np) significantly accelerated wound healing. NO-np modified leukocyte migration and increased tumor growth factor-β production in the wound area, which subsequently promoted angiogenesis to enhance the healing process. By using human dermal fibroblasts, we demonstrate that NO-np increased fibroblast migration and collagen deposition in wounded tissue. Together, these data show that NO-releasing nanoparticles have the ability to modulate and accelerate wound healing in a pleiotropic manner. PMID:22306734

  19. Wound tube heat exchanger

    DOEpatents

    Ecker, Amir L.

    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.

  20. 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

  1. Neurolaena lobata L. promotes wound healing in Sprague Dawley rats

    PubMed Central

    Nayak, Bijoor Shivananda; Ramlogan, Surrin; Chalapathi Rao, AV; Maharaj, Sandeep

    2014-01-01

    Background: The leaves of the Neurolaena lobata (Asteraceae) plant are used to control diabetes and heal wounds and infections. Aim: The ethanolic extract of N. lobata leaf was evaluated for its ability to heal inflicted wounds in rats using the excision wound model. Materials and Methods: Animals were divided into three groups of six each. Test group animals were treated topically with an ethanolic extract of N. lobata (1:1 with petroleum jelly, 100 mg/kg/day). Standard and control group animals were treated with mupirocin and petroleum jelly, respectively. Treatment was given for 13 days and the wound area was measured on alternate days. Parameters of healing assessed were the rate of wound contraction, period of epithelialization and hydroxyproline content. Antimicrobial activity of the extract was observed against Pseudomonas aeruginosa, Staphylococcus aureus and Escherichia coli. Results: Phytochemical analysis of the extract showed the presence of saponins, tannins, alkaloids and flavanoids. Extract-treated animals exhibited 87% reduction in the wound area over 13 days when compared with the control (78%) and standard (83%) groups (P < 0.05). A significant decrease in the epithelialization period was noticed with the extract-treated test group animals compared with the controls and the standard group animals (P < 0.008). The hydroxyproline content of the extract-treated animals was higher (230.5 ± 42.1) when evaluated against the control and (79.0 ± 32.2) and the standard (115.0 ± 44.5) groups (P < 0.05). Conclusion: Increase in the rate of wound contraction and hydroxyproline content with decrease in epithelialization time in extract-treated animals support further evaluation of N. lobata as a pharmacotherapy for wound healing. PMID:25143886

  2. Platelet gel for healing cutaneous chronic wounds.

    PubMed

    Crovetti, Giovanni; Martinelli, Giovanna; Issi, Marwan; Barone, Marilde; Guizzardi, Marco; Campanati, Barbara; Moroni, Marco; Carabelli, Angelo

    2004-04-01

    Wound healing is a specific host immune response for restoration of tissue integrity. Experimental studies demonstrated an alteration of growth factors activity due to their reduced synthesis, increased degradation and inactivation. In wound healing platelets play an essential role since they are rich of alpha-granules growth factors (platelet derived growth factor--PDGF; transforming growth factor-beta--TGF-beta; vascular endothelial growth factor--VEGF). Topical use of platelet gel (PG), hemocomponent obtained from mix of activated platelets and cryoprecipitate, gives the exogenous and in situ adding of growth factors (GF). The hemocomponents are of autologous or homologous origin. We performed a technique based on: multicomponent apheretic procedure to obtain plasma rich platelet and cryoprecipitate; manual processing in an open system, in sterile environment, for gel activation. Every step of the gel synthesis was checked by a quality control programme. The therapeutic protocol consists of the once-weekly application of PG. Progressive reduction of the wound size, granulation tissue forming, wound bed detersion, regression and absence of infective processes were considered for evaluating clinical response to hemotherapy. 24 patients were enrolled. They had single or multiple cutaneous ulcers with different ethiopathogenesis. Only 3 patients could perform autologous withdrawal; in the others homologous hemocomponent were used, always considering suitability and traceability criteria for transfusional use of blood. Complete response was observed in 9 patients, 2 were subjected to cutaneous graft, 4 stopped treatment, 9 had partial response and are still receiving the treatment. In each case granulation tissue forming increased following to the first PG applications, while complete re-epithelization was obtained later. Pain was reduced in every treated patient. Topical haemotherapy with PG may be considered as an adjuvant treatment of a multidisciplinary process

  3. Negative pressure wound therapy combined with skin grafting improves surgical wound healing in the perianal area.

    PubMed

    Jia-Zi, Shi; Xiao, Zhai; Jun-Hui, Li; Chun-Yu, Xue; Hong-da, Bi

    2016-08-01

    Management of large tissue defects resulting from local wide resection of perianal is a clinical challenge for surgeons. The aim of the present study was to investigate the efficacy of negative pressure wound therapy (NPWT) following skin grafting on perianal surgical wound healing.Included in this study were 12 patients with perianal tumors who received skin grafting after perianal tumor resection between December 2012 and December 2014. A self-designed negative pressure drainage device was then applied to maintain a standard negative pressure at -150 mm Hg and removed on day 8 postoperation. The outcome was recorded immediately after NPWT and at 6-month follow-up.All skin grafts survived without infection, hematoma, and necrosis in all 12 patients. No tumor recurrence was detected during 6-month follow-up. Natural folds were observed around the anus. All patients showed normal bowel movements.NPWT following skin grafting was effective for perianal surgical wound healing and infection prevention, thus benefiting anatomical and functional recovery of the anus. PMID:27583890

  4. Negative pressure wound therapy combined with skin grafting improves surgical wound healing in the perianal area

    PubMed Central

    Jia-zi, Shi; Xiao, Zhai; Jun-hui, Li; Chun-yu, Xue; Hong-da, Bi

    2016-01-01

    Abstract Management of large tissue defects resulting from local wide resection of perianal is a clinical challenge for surgeons. The aim of the present study was to investigate the efficacy of negative pressure wound therapy (NPWT) following skin grafting on perianal surgical wound healing. Included in this study were 12 patients with perianal tumors who received skin grafting after perianal tumor resection between December 2012 and December 2014. A self-designed negative pressure drainage device was then applied to maintain a standard negative pressure at −150 mm Hg and removed on day 8 postoperation. The outcome was recorded immediately after NPWT and at 6-month follow-up. All skin grafts survived without infection, hematoma, and necrosis in all 12 patients. No tumor recurrence was detected during 6-month follow-up. Natural folds were observed around the anus. All patients showed normal bowel movements. NPWT following skin grafting was effective for perianal surgical wound healing and infection prevention, thus benefiting anatomical and functional recovery of the anus. PMID:27583890

  5. 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

  6. 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

  7. 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

  8. Difficult wounds: an update.

    PubMed

    Edlich, Richard F; Winters, Kathryne L; Britt, L D; Long, William B; Gubler, K Dean; Drake, David B

    2005-01-01

    The purpose of this collective review is to describe revolutionary advances in the treatment of Gardner's syndrome (GS), pseudofolliculitis barbae, nasal septal perforation, factitious wounds, and hidradenitis suppurativa (HS). Gardner's syndrome or familial polyposis has various manifestations that appear to be controlled by a single genetic locus. Apart from the large bowel adenomas, which are always present, a common extracolonic symptom of Gardner's syndrome is the occurrence of epidermal cysts. These cysts can be seen before the intestinal polyps are evident. Because epidermal cysts in patients with Gardner's syndrome are always benign, we excise these cysts using incisions that are commonly used for rhytidectomy. Pseudofolliculitis barbae, a pseudofolliculitis caused by ingrown hairs, effects 85% of blacks who shave their beards. When this disease is allowed to progress to keloid formation, we use a surgical approach that includes excision of the keloidal scar, meticulous debridement of all residual ingrown hairs in the underlying wound, and coverage of the defect with a split-thickness skin graft. More recently, laser therapy has revolutionized the treatment of pseudofolliculitis barbae and has enabled a cure for the first time for those plagued with this disorder and for whom a beardless face is acceptable. Nasal septal perforation is a well recognized complication of septal surgery. Other iatrogenic causes of perforation include cryosurgery, electrocoagulation for epitaxis, nasotracheal intubation, or nose packing. In recent years drugs such as cocaine account for an increasing number of perforations. It has only been with the use of an external approach for the repair of the nasal septal defect that surgical closure has become easier and more reliable. The external approach allows for greater surgical closure and enables the surgeon to use both hands with the aid of binocular vision to mobilize and suture local mucosal advancement flaps and the

  9. Keratinocyte-Secreted Heat Shock Protein-90alpha: Leading Wound Reepithelialization and Closure

    PubMed Central

    Bhatia, Ayesha; O'Brien, Kathryn; Chen, Mei; Woodley, David T.; Li, Wei

    2016-01-01

    Significance: Delayed and nonhealing wounds pose a health, economic, and social problem worldwide. For decades, the conventional wisdom pointed to growth factors as the driving force of wound healing and granted them a center stage for therapeutic development. To date, few have obtained US FDA approvals or shown clinical effectiveness and safety. Critical Issue: Wound closure is the initial and most critical step during wound healing. Closing chronic wounds to shut down continued infection is the primary and likely the only achievable goal at the clinic in the foreseeable future. The critical question here is to identify the factor(s) in wounded tissues that drives the initial wound closure. Recent Advances: We made an unexpected discovery of the secreted form of heat shock protein-90alpha (Hsp90α) for promoting skin cell motility, reepithelialization, and wound closure. Secreted Hsp90α possesses unique properties to remain functional under the hostile wound environment that compromises conventional growth factors' effectiveness. Through the common lipoprotein receptor-related protein-1 cell surface receptor and activation of the Akt signaling pathway, topical application of human recombinant Hsp90α protein greatly accelerates excision, burn, and diabetic skin wound closure in rodent and porcine models. Future Directions: In almost all cells, the 2–3% of their total proteins (∼7,000 per cell) are Hsp90 (α and β), a long unraveled puzzle. Our new finding of Hsp90 secretion in wounded tissues suggests that the stockpile of Hsp90α by all cells is to rapidly supply the need for extracellular Hsp90α to repair damaged tissues. We propose that keratinocytes at the wound edge secrete Hsp90α that leads the reepithelialization process to close the wound. PMID:27076995

  10. Multimodal imaging of ischemic wounds

    NASA Astrophysics Data System (ADS)

    Zhang, Shiwu; Gnyawali, Surya; Huang, Jiwei; Liu, Peng; Gordillo, Gayle; Sen, Chandan K.; Xu, Ronald

    2012-12-01

    The wound healing process involves the reparative phases of inflammation, proliferation, and remodeling. Interrupting any of these phases may result in chronically unhealed wounds, amputation, or even patient death. Quantitative assessment of wound tissue ischemia, perfusion, and inflammation provides critical information for appropriate detection, staging, and treatment of chronic wounds. However, no method is available for noninvasive, simultaneous, and quantitative imaging of these tissue parameters. We integrated hyperspectral, laser speckle, and thermographic imaging modalities into a single setup for multimodal assessment of tissue oxygenation, perfusion, and inflammation characteristics. Advanced algorithms were developed for accurate reconstruction of wound oxygenation and appropriate co-registration between different imaging modalities. The multimodal wound imaging system was validated by an ongoing clinical trials approved by OSU IRB. In the clinical trial, a wound of 3mm in diameter was introduced on a healthy subject's lower extremity and the healing process was serially monitored by the multimodal imaging setup. Our experiments demonstrated the clinical usability of multimodal wound imaging.

  11. Kinetics of healing of grafted and nongrafted wounds on the distal portion of the forelimbs of horses.

    PubMed

    Schumacher, J; Brumbaugh, G W; Honnas, C M; Tarpley, R J

    1992-09-01

    Full-thickness, circular, cutaneous wounds (5 cm in diameter) were created on the distal portion of the forelimbs of 6 horses. One wound on each horse was treated with 6 full-thickness punch grafts that were obtained from the horse's neck with a 6-mm skin biopsy punch and inserted in the graft sites on day 14 after wounding. The wound on the contralateral limb was not grafted. A combination of ticarcillin disodium and clavulanate potassium was applied to the wounds when bandages were changed to control bacterial infection. Areas of each wound were measured on days 1, 7, 9, 11, 13 through 15, 17 through 22, 24, 26, 29, and 32 after wounding. Three distinguishable phases of healing were observed (expansion, contraction, and epithelialization), and the time course of each phase was evaluated, using formulas of first-order processes. Rate constants of each phase were not significantly (P less than 0.05) affected by punch grafts. PMID:1416356

  12. Mixed-species Biofilm Compromises Wound Healing by Disrupting Epidermal Barrier Function

    PubMed Central

    Sinha, Mithun; Ganesh, Kasturi; Chaney, Sarah; Mann, Ethan; Miller, Christina; Khanna, Savita; Bergdall, Valerie K.; Powell, Heather M.; Cook, Charles H.; Gordillo, Gayle M.; Wozniak, Daniel J.; Sen, Chandan K.

    2015-01-01

    In chronic wounds, biofilm infects host tissue for extended periods of time. This work establishes the first chronic pre-clinical model of wound biofilm infection aimed at addressing long-term host response. Although biofilm infected wounds did not show marked differences in wound closure, the repaired skin demonstrated compromised barrier function. This observation is clinically significant because it leads to the notion that even if a biofilm infected wound is closed as observed visually, it may be complicated by the presence of failed skin which is likely to be infected and or further complicated post-closure. Study of underlying mechanisms recognized for the first time biofilm-inducible miR-146a and miR-106b in the host skin wound-edge tissue. These miRs silenced ZO-1 and ZO-2 to compromise tight junction function resulting in leaky skin as measured by transepidermal water loss. Intervention strategies aimed at inhibiting biofilm-inducible miRNAs may be productive in restoring barrier function of host skin. PMID:24771509

  13. 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

  14. Clinical Relevance of Mold Culture Positivity With and Without Recurrent Wound Necrosis Following Combat-Related Injuries

    PubMed Central

    Rodriguez, Carlos; Weintrob, Amy C.; Dunne, James R.; Weisbrod, Allison B.; Lloyd, Bradley; Warkentien, Tyler; Malone, Debra; Wells, Justin; Murray, Clinton K.; Bradley, William; Shaikh, Faraz; Shah, Jinesh; Carson, M. Leigh; Aggarwal, Deepak; Tribble, David R.

    2014-01-01

    Background Invasive fungal wound infections (IFI) are a recognized threat for personnel who sustain combat-related blast trauma in Afghanistan. Blast trauma, particularly when dismounted, has wounds contaminated with organic debris and potential for mold infection. Trauma-associated IFI is characterized by recurrent wound necrosis on serial debridement with histologic evidence of invasive molds and/or fungal culture growth. Wounds with mold growth, but lacking corresponding recurrent necrosis present a clinical dilemma of whether to initiate antifungal treatment. Our objective was to assess the clinical significance of fungal culture growth without recurrent wound necrosis. Methods United States military personnel wounded during combat in Afghanistan (June 2009 - August 2011) were assessed for growth of mold from wound cultures and/or histopathological evidence of IFI. Identified patients were stratified based upon clinical wound appearance (with/without recurrent necrosis) and the resultant groups were compared for injury characteristics, clinical management, and outcomes. Results A total of 96 patients were identified: 77 with fungal elements on histopathology and/or fungal growth plus recurrent wound necrosis and 19 with fungal growth on culture but no wound necrosis after initial debridements. Injury patterns and severity were similar between the groups. Patients with recurrent necrosis had more frequent fevers and leukocytosis during the first two weeks post-injury, and the majority received antifungal therapy compared to only three (16%) patients without recurrently necrotic wounds. Overall, patients without recurrent wound necrosis had significantly less operative procedures (p=0.02), shorter length of stay in the intensive care unit (p<0.01), and lower rates of high-level amputations (5% versus 20%) and deaths (none versus 8%) despite no or infrequent antifungal use. Conclusions The finding of molds on wound culture among patients with blast trauma in the

  15. Wound repair in Pocillopora.

    PubMed

    Rodríguez-Villalobos, Jenny Carolina; Work, Thierry Martin; Calderon-Aguilera, Luis Eduardo

    2016-09-01

    Corals routinely lose tissue due to causes ranging from predation to disease. Tissue healing and regeneration are fundamental to the normal functioning of corals, yet we know little about this process. We described the microscopic morphology of wound repair in Pocillopora damicornis. Tissue was removed by airbrushing fragments from three healthy colonies, and these were monitored daily at the gross and microscopic level for 40days. Grossly, corals healed by Day 30, but repigmentation was not evident at the end of the study (40d). On histology, from Day 8 onwards, tissues at the lesion site were microscopically indistinguishable from adjacent normal tissues with evidence of zooxanthellae in gastrodermis. Inflammation was not evident. P. damicornis manifested a unique mode of regeneration involving projections of cell-covered mesoglea from the surface body wall that anastomosed to form gastrovascular canals. PMID:27397755

  16. Wound repair in Pocillopora

    USGS Publications Warehouse

    Rodríguez-Villalobos, Jenny Carolina; Work, Thierry M.; Calderon-Aguileraa, Luis Eduardo

    2016-01-01

    Corals routinely lose tissue due to causes ranging from predation to disease. Tissue healing and regeneration are fundamental to the normal functioning of corals, yet we know little about this process. We described the microscopic morphology of wound repair in Pocillopora damicornis. Tissue was removed by airbrushing fragments from three healthy colonies, and these were monitored daily at the gross and microscopic level for 40 days. Grossly, corals healed by Day 30, but repigmentation was not evident at the end of the study (40 d). On histology, from Day 8 onwards, tissues at the lesion site were microscopically indistinguishable from adjacent normal tissues with evidence of zooxanthellae in gastrodermis. Inflammation was not evident. P. damicornis manifested a unique mode of regeneration involving projections of cell-covered mesoglea from the surface body wall that anastomosed to form gastrovascular canals.

  17. Wound healing in plants

    PubMed Central

    Tisi, Alessandra; Angelini, Riccardo

    2008-01-01

    Copper amine oxidases (CuAO) and flavin-containing amine oxidases (PAO) are hydrogen peroxide (H2O2)-producing enzymes responsible for the oxidative de-amination of polyamines. Currently, a key role has been ascribed to apoplastic amine oxidases in plants, i.e., to behave as H2O2-delivering systems in the cell wall during cell growth and differentiation as well as in the context of host-pathogen interactions. Indeed, H2O2 is the co-substrate for the peroxidase-driven reactions during cell-wall maturation and a key signalling molecule in defence mechanisms. We recently demonstrated the involvement of an apoplastic PAO in the wound-healing process of the Zea mays mesocotyl. Experimental evidence indicated a similar role for an apoplastic PAO in Nicotiana tabacum. In this addendum we suggest that a CuAO activity is also involved in this healing event. PMID:19704660

  18. Image-guided cold atmosphere plasma (CAP) therapy for cutaneous wound

    NASA Astrophysics Data System (ADS)

    Yu, Zelin; Ren, Wenqi; Gan, Qi; Li, Jiahong; Li, XiangXiang; Zhang, Shiwu; Jin, Fan; Cheng, Cheng; Ting, Yue; Xu, Ronald X.

    2016-03-01

    Bacterial infection is one of the major factors contributing to the compromised healing in chronic wounds. Sometimes bacteria biofilms formed on the wound are more resistant than adherent bacteria. Cold atmosphere plasma (CAP) has already shown its potential in contact-free disinfection, blood coagulation, and wound healing. In this study, we integrated a multimodal imaging system with a portable CAP device for image-guided treatment of infected wound in vivo and evaluated the antimicrobial effect on Pseudomonas aeruginosa sample in vitro.15 ICR mice were divided into three groups for therapeutic experiments:(1) control group with no infection nor treatment (2) infection group without treatment (3) infection group with treatment. For each mouse, a three millimeters punch biopsy was created on the dorsal skin. Infection was induced by Staphylococcus aureus inoculation one day post-wounding. The treated group was subjected to CAP for 2 min daily till day 13. For each group, five fixed wounds' oxygenation and blood perfusion were evaluated daily till day 13 by a multimodal imaging system that integrates a multispectral imaging module and a laser speckle imaging module. In the research of relationship between therapeutic depth and sterilization effect on P.aeruginosa in agarose, we found that the CAP-generated reactive species reached the depth of 26.7μm at 30s and 41.6μm at 60s for anti-bacterial effects. Image-guided CAP therapy can be potentially used to control infection and facilitate the healing process of infected wounds.

  19. Evaluation of the antiba