Defying hard-to-heal wounds with an early antibiofilm intervention strategy: wound hygiene

Murphy, Christine; Atkin, Leanne; Swanson, Terry; Tachi, Masahiro; Tan, Yih Kai; de Ceniga, Melina Vega; Weir, Dot; Wolcott, Randall; Ĉernohorská, Júlia; Ciprandi, Guido; Dissemond, Joachim; James, Garth A; Hurlow, Jenny; Lázaro MartÍnez, José Luis; Mrozikiewicz-Rakowska, Beata; Wilson, Pauline

doi:10.12968/jowc.2020.29.sup3b.s1

Cited by 71 publications

(44 citation statements)

References 57 publications

(13 reference statements)

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“…41 The importance of surgical debridement in wound bed preparation and its role in disrupting biofilms has been highlighted in the recent international consensus studies. 42,43 In our study, 28.15% of patients underwent conservative management alone, which consisted of debridements, dressings, and antimicrobials, when needed.…”

Section: Discussionmentioning

confidence: 76%

A Current Overview of Chronic Wounds Presenting to a Plastic Surgery Unit in Central India

Khan¹,

Cheruvu²,

Krishna³

et al. 2020

CWCMR

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Purpose: To analyze the demographic, clinical, and microbiological profile of patients presenting to our unit with chronic wounds of various etiologies with an intent to give a current overview of chronic wounds. Patients and Methods: We performed a prospective observational study of patients presenting with chronic wounds from October 2018 to September 2019. The study was conducted at the Department of Burns and Plastic Surgery of a tertiary care institute in a nonmetropolitan city in Central India. A total of 103 patients were included in the study. Data collected from the patients included demographic details, history, clinical features, and relevant laboratory reports. Wound swabs obtained by Levine's technique were sent for culture and sensitivity studies. Treatment was instituted according to the clinical picture and modified if necessary. Progress was monitored until the wound healed, either by conservative management or by surgical intervention. Patients were followed up for six months thereafter. Results: Most of the patients presented with lower limb wounds (n=81, 78.64%). Swab specimens from 103 wounds were cultured. Among the isolates, gram-negative organisms were more common than gram-positive organisms. Staphylococcus aureus was the most common species isolated, followed by Pseudomonas aeruginosa. The frequency of infections caused by other gram-negative organisms like Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis was on the rise. There were significant differences in the patterns of antimicrobial resistance in our patients. Sharp debridements were required in almost all cases for wound preparation. Most of the patients (n=74, 71.84%) underwent surgical intervention for achieving wound closure. Split-thickness skin grafting (STSG) was the most common surgical intervention performed (n=45, 43.68% patients), followed by local and distant flaps. Conclusion: Our study gives a current overview of the causes, clinical presentation, prevalent microbial flora, and their antibiotic susceptibilities prevalent in chronic wounds presenting to our unit. Treatments administered are discussed with emphasis on the different reconstructions performed.

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Section: Discussionmentioning

confidence: 76%

A Current Overview of Chronic Wounds Presenting to a Plastic Surgery Unit in Central India

Khan¹,

Cheruvu²,

Krishna³

et al. 2020

CWCMR

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“…An indication for the use of antiseptic wound therapy is the presence of a local infection. 3 However, the challenge is to diagnose local wound infection at an early stage and to distinguish it from systemic infection and other differential diagnoses. 4 For this reason, the TILI score should be used in daily clinical practice.…”

Section: Discussionmentioning

confidence: 99%

“…1 Local wound infections can also impair physiological wound healing. 2,3 Therefore, early detection of local wound infections is an interdisciplinary challenge in daily practice, especially in the treatment antiseptics • hard-to-heal wounds • local wound infection • TILI score • validation • wound therapy • wounds of patients with acute and hard-to-heal wounds. 4 The nomenclature used to define uncomplicated contamination (i.e., the bacterial contamination is not pathological), from critical colonisation to local or systemic infection, is not uniform worldwide.…”

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confidence: 99%

Therapeutic Index for Local Infections score validity: a retrospective European analysis

et al. 2020

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Objective: A score to identify local wound infections was developed by a panel of experts from seven European countries. The Therapeutic Index for Local Infections (TILI) score was designed for health professionals who are not specialised in wound care. This study was carried out to test the validity of the TILI score in everyday practice. Method: Content validity was analysed by means of evaluation by a panel of experts, individually and face-to-face, followed by a European multicentred, retrospective, observational study. Participating clinicians sent anonymised copies of completed TILI scores for patients with leg ulcers along with a photograph of the wound for analysis by two blinded reviewers. Concordance (Kappa index) and convergent criterion validity (sensitivity, specificity, accuracy, Youden's J Index and receiver operator characteristic (ROC) or area under the curve (AUC) curve) were calculated to construct validity and reliability. Results: A total of 307 patients with leg ulcers from seven institutions in five European countries were included in this retrospective analysis. It was shown that the diagnosis of local wound infection could be documented well with five of the six clinical criteria included in the TILI score. By summing up these facultative criteria in comparison with any direct criteria that may be present, there would have been an indication for local antiseptic wound therapy in 22% of patients examined. Conclusions: The results show that the TILI score is concordant with the expert assessment of patients and with good diagnostic characteristics. Thus, the easy-to-use TILI score can now be used in the daily routine practice of health professionals to diagnose local wound infections.

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“…La gestione delle ferite ha un sostanziale impatto sul Sistema sanitario a livello globale, imponendo costi notevoli alla società: si stima che negli USA si spendano annualmente 25 miliardi dollari per la gestione delle ferite croniche (11,13). Analogamente, la gestione delle lesioni acute, soprattutto post-chirurgiche, impegna sempre maggiori risorse: nel Regno Unito (UK) è stato stimato che la spesa annuale totale, necessaria per la gestione delle ferite e delle comorbilità associate, sia pari a 5,3 miliardi di sterline, di cui 2,1 destinati alle ferite che vanno incontro a risoluzione e 3,2 miliardi alle ferite che cronicizzano (9), con il 25-50% dei posti-letto occupati da pazienti con lesioni cutanee in UK e fino al 66% delle infermiere dedicate al wound care nella Repubblica d'Irlanda (13). In Europa è stato stimato che il costo medio per episodio sia di 6650 euro per le ulcere alle gambe e 10.000 euro per le ulcere ai piedi, con un costo complessivo che corrisponde al 2-4% della spesa sanitaria complessiva.…”

Section: Le Lesioni Cutanee Infette: Cenni DI Epidemiologia E Farmacounclassified

“…La scelta dell'antisettico dipende dalle sue caratteristiche fisico-chimiche peculiari e dalle sue indicazioni specifiche (13). Come illustrato dalla Tabella III (17), un antisettico come la soluzione elettrolitica di sodio ipoclorito allo 0,05%, per il quale in letteratura non sono mai stati evidenziati fenomeni di resistenza e che nella forma di soluzione isotonica alla concentrazione di 0,05% mostra un'ottima tollerabilità sul tessuto cutaneo leso, può essere considerato un ottimo alleato nella gestione delle ferite infette, risultando il composto di prima o di seconda scelta per tutte le indicazioni (12).…”

Section: Ruolo Degli Antisettici Topici Nella Gestione Delle Lesioni unclassified

The new formulation of the 0,05% sodium hypochlorite electrolytic solution for cutaneous use: reasons and advantages

Scalise

2021

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Superinfection of skin lesions is quite common, and often delays wound recovery. Infection control plays therefore a key role in the management of skin lesions, requiring the use of specific antimicrobials. Among available agents, topic antiseptic drugs are currently recommended as a first-choice option, to be preferred to antibiotics, given the growing resistance to these drugs. Compared to antibiotics, antiseptic drugs have a wider spectrum of action, including bacteria, fungi, virus, protozoa, and prions. The ideal antiseptic for the management of an infected skin lesion is expected to be both highly effective and well tolerated, in order to promote the physiologic process of tissue restoration. Among available antiseptics, the 0,05% sodium hypochlorite electrolytic solution meets these criteria: the product proved to be effective in vitro and in animal experimental models against a wide range of microorganisms, besides exerting an anti-inflammatory action in the absence of any irritating, cytotoxic or carcinogenic adverse effect, and being useful in biofilm removal. Similarly, in several clinical trials, the 0,05% sodium hypochlorite electrolytic solution was demonstrated to be very effective and safe in the management of infected skin wounds: based on these results, this product should be strongly considered among the first-choice options for the disinfection of skin wounds. The new formulation, developed according to the latest reference standards for wound healing and in agreement with current guidelines, is qualitatively improved, with an expected positive impact in every field of clinical application and a subsequent benefit for treated patients.

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Defying hard-to-heal wounds with an early antibiofilm intervention strategy: wound hygiene

Cited by 71 publications

References 57 publications

<p>A Current Overview of Chronic Wounds Presenting to a Plastic Surgery Unit in Central India</p>

<p>A Current Overview of Chronic Wounds Presenting to a Plastic Surgery Unit in Central India</p>

Therapeutic Index for Local Infections score validity: a retrospective European analysis

The new formulation of the 0,05% sodium hypochlorite electrolytic solution for cutaneous use: reasons and advantages

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