A 2000 patient retrospective assessment of a new strategy for burn wound management in view of infection prevention and treatment

Abstract

Infections in burn patients are still the principal cause of complications in burn injuries. The aim of this study is to assess a new strategy for burn wound management in view of infection prevention and treatment in the experience of the Burn Treatment Center in Siemianowice Śląskie. The applied methodology involved the analysis of patient records describing the hospital's epidemiological situation between 2014 and 2016. The analysis also included the use and cost of antibiotics, silver-containing dressings, and other antiseptics relative to the number of sepsis cases, including those caused by Pseudomonas aeruginosa, as well as the mortality ratio. The total costs of prevention and treatment of infections were reduced, while the use of silver-containing dressings and antiseptics increased. The number of patients with sepsis decreased, including cases caused by P. aeruginosa, and the mortality ratio was reduced. Introducing a strategy for burn wound-oriented infection prevention and treatment in burn patients provides a number of benefits. It is also cost-effective. Using locally applied active dressings and antiseptics can be a welcome choice for often-unnecessary antibiotic therapy of a suspected or existing burn wound infection.

Appropriate use of dressings containing nanocrystalline silver to support antimicrobial stewardship in wounds

“…Tonkin and Wood reported a 50% reduction in antibiotic use ( P = 0.016) with NCS dressings compared with SSD, in addition to a significant reduction in hospital length of stay (15.1 and 8.8 days for SSD and ACTICOAT, respectively, P = 0.045). Antibiotic usage was reduced with NCS (5.2%) compared with silvazine (57%) in the audit performed by Fong et al More recently, observations of a substantial increase in antibiotic resistance in a Polish burns unit led to the introduction of a new infection management protocol incorporating antiseptic cleansers and NCS dressings . This new intervention resulted in a marked reduction in sepsis cases, particularly those caused by P. aeruginosa .…”

“…Concurrently, the authors mention increased sensitivity to most antibiotics used to treat P. aeruginosa infections following the protocol modification. In addition, the reported increase in expenditure for antiseptic solutions and dressings (USD 34, 554) was more than offset by the USD 106, 055 decrease in expenditure for antibiotics and antimycotics, resulting in a total reduction in cost of USD 71, 501 …”

“…Antibiotic usage was reduced with NCS (5.2%) compared with silvazine (57%) in the audit performed by Fong et al 74 More recently, observations of a substantial increase in antibiotic resistance in a Polish burns unit led to the introduction of a new infection management protocol incorporating antiseptic cleansers and NCS dressings. 76 This new intervention resulted in a marked reduction in sepsis cases, particularly those caused by P. aeruginosa. Concurrently, the authors mention increased sensitivity to most antibiotics used to treat P. aeruginosa infections following the protocol modification.…”

“…In addition, the reported increase in expenditure for antiseptic solutions and dressings (USD 34, 554) was more than offset by the USD 106, 055 decrease in expenditure for antibiotics and antimycotics, resulting in a total reduction in cost of USD 71, 501. 76 Furthermore, improved wound assessment has been highlighted in the most recent CQUIN targets. 77 Technologies that supplement clinician judgement, particularly from a microbial load perspective, will aid more targeted approach to wound infection.…”

Synthesis of imidazolidine‐2,4‐dione and 2‐thioxoimidazolidin‐4‐one derivatives as inhibitors of virulence factors production in Pseudomonas aeruginosa

“…The opportunistic Gram‐negative Pseudomonas aeruginosa bacterium is associated with high morbidity rate of many chronic and acute infections including pneumonia, [ 1 ] cystic fibrosis, [ 2 ] chronic otitis, [ 3 ] burn injuries, [ 4 ] and urinary tract infections. [ 5 ] Additionally, it displays an intrinsic resistance to several antibiotics due to its restricted cell permeability as well as expression of efflux systems that expel antibiotics out of the cell.…”