Treatment of wounds colonized by multidrug resistant organisms in immune-compromised patients: a retrospective case series

Pignatti, Marco; Gerunda, G.E.; Rompianesi, Gianluca; Ruvo, N. De; Benedetto, Fabrizio Di; Codeluppi, Mauro; Bonucchi, Decenzio; Pacchioni, Lucrezia; Loschi, Pietro; Malaventura, Cristina; G, De Santis

doi:10.1186/1754-9493-7-28

Cited by 3 publications

(3 citation statements)

References 18 publications

(23 reference statements)

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“…The α-SMA, collagen I, and vimentin are EMT makers. The bacterial infection can induce the high expression of EMT makers in the sites of inflammation. − In order to evaluate the efficacy of phototherapy at the molecular level, collagen I, vimentin, α-SMA, and E-cadherin in the wound skin were analyzed by qRT-PCR. As shown in Figure , the relative expression levels of collagen I were higher in groups I and II than in group IV and did not decrease significantly after treatment, indicating that inflammation remained.…”

Section: Resultsmentioning

confidence: 99%

Augmented Graphene Quantum Dot-Light Irradiation Therapy for Bacteria-Infected Wounds

Mei

Gao

Shi

et al. 2020

ACS Appl. Mater. Interfaces

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This paper proposes a highly efficient antibacterial system based on a synergistic combination of photodynamic therapy, photothermal therapy, and chemotherapy. Chitosan oligosaccharide functionalized graphene quantum dots (GQDs-COS) with short-term exposure to 450 nm visible light are used to promote rapid healing in bacteria-infected wounds. The GQDs undergo strong photochemical transformation to rapidly produce radical oxygen species and heat under light illumination, while the COS has an innate antimicrobial ability. Moreover, the positively charged GQDs-COS can easily capture bacteria via electrostatic interactions and kill Gram-positive and Gram-negative bacteria by multivalent interactions and synergistic effects. The antibacterial action of this nanocomposite causes irreversible damage to outer and inner bacterial membranes, resulting in cytoplasm leakage and death. The system has good hemocompatibility and low cytotoxicity and can improve the healing of infected wounds, as demonstrated by the examination of pathological tissue sections and inflammatory markers. These results suggest that GQDs anchored with bioactive molecules are a potential photo-activated antimicrobial strategy for anti-infective therapy.

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Section: Resultsmentioning

confidence: 99%

Augmented Graphene Quantum Dot-Light Irradiation Therapy for Bacteria-Infected Wounds

Mei

Gao

Shi

et al. 2020

ACS Appl. Mater. Interfaces

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“…After debridement, soft tissue reconstruction is safe, even over a contaminated wound. 21 Several surgical techniques have been proposed, including direct closure and skin grafting (rarely indicated) and, more importantly, local, regional, and microsurgical free flaps. 12 , 13 , 18 , 22 , 23 …”

Section: Discussionmentioning

confidence: 99%

“…19,20 After debridement, soft tissue reconstruction is safe, even over a contaminated wound. 21 Several surgical techniques have been proposed, including direct closure and skin grafting (rarely indicated) and, more importantly, local, regional, and microsurgical free flaps. 12,13,18,22,23 Although reconstructive techniques used in the paediatric population do not differ significantly from the ones used in the adult, the different characteristics of soft tissues in children, must be considered.…”

Section: Recurrencesmentioning

confidence: 99%

Surgical treatment of pressure injuries in children: A multicentre experience

Pignatti

D’Arpa

Roche

et al. 2021

Wound Repair Regeneration

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Pressure injuries (PI) are infrequent in paediatric patients, prevalence estimates ranging from 1.4% to 8.2%, and reaching values as high as 43.1% in critical care areas.They can be associated with congenital neurological or metabolic disorders that cause reduced mobility or require the need for medical devices. In children, most pressure injuries heal spontaneously. However, a small percentage of ulcers that is refractory to conservative management or is too severe at presentation (Stage 3 or 4) will be candidates for surgery. We retrospectively reviewed the clinical history of paediatric patients affected by pressure injuries from four European Plastic Surgery Centres. Information was collected from clinical and radiology records, and laboratory reports. An accurate search of the literature revealed only two articles reporting on the surgical treatment of pressure injuries in children. After debridement, we performed surgical coverage of the pressure injuries. We report here our experience with 18 children aged 1-17 years, affected by pressure injury Stages 3 and 4. They were successfully treated with pedicled (17 patients) or free flaps (1 patient). The injuries involved the sacrum (6/18 patients), lower limb (3/18 patients), thoracic spine (2/18 patients), ischium (3/18 patients, bilateral in one patient), temporal area (3/18 patients), hypogastrium (1/18 patients) and were associated to medical devices in three cases. Flaps were followed for a minimum of 19 months and up to 13 years. Only two patients developed true recurrences that were treated again surgically. Pressure injuries are infrequent in children and rarely need surgical treatment. Pedicled flaps have a high success rate. Recurrences, contrary to what is reported in the literature, were rare.

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Vacuum-assisted management of surgical site infections after liver transplantation: 15-year experience in a tertiary hepatobiliary center

et al. 2018

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Immune compromised as well as critically ill patients are at higher risk of surgical wound infection and dehiscence. Wound infections critically influence the outcomes after liver transplantation. In particular, it was shown that they significantly reduce the overall survival rate when compared to patients with uneventful wound healing, and their occurrence is associated with death or graft loss within 1-year post-transplantation. From January 2001 through December 2017, 763 patients underwent liver transplantation in our Institution, the Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, "Policlinico" University Hospital, University of Modena and Reggio Emilia, Modena, Italy. We retrospectively analyzed data from our prospectively maintained database of patients treated with a negative pressure therapy device due to wound or abdominal infections. 13 patients underwent negative pressure treatments for surgical site infection after liver transplantation in our institution. Ten superficial "supra-fascial" applications (SF group) and three deeper abdominal (Ab group) were reported. Mean in-hospital stay for the SF group was 42.6 days, ranging from 8 to 80, while for the Ab group was 62 days (range 23-133), with an overall survival of 34 and 4.6 months, respectively. A multifactorial multidisciplinary approach is needed in the prevention of surgical site infections instead of mere antimicrobial prophylaxis The application of negative pressure wound therapy may help in controlling the diffusion of the infection and preventing sepsis.

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Treatment of wounds colonized by multidrug resistant organisms in immune-compromised patients: a retrospective case series

Cited by 3 publications

References 18 publications

Augmented Graphene Quantum Dot-Light Irradiation Therapy for Bacteria-Infected Wounds

Augmented Graphene Quantum Dot-Light Irradiation Therapy for Bacteria-Infected Wounds

Surgical treatment of pressure injuries in children: A multicentre experience

Vacuum-assisted management of surgical site infections after liver transplantation: 15-year experience in a tertiary hepatobiliary center

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