Use of Ultrasound Debridement as an Adjunctive Tool for Treating Infected Prosthetic Vascular Grafts in the Lower Extremities

Carmo, Michele; Mazzaccaro, Daniela; Barbetta, Iacopo; Settembrini, Alberto M.; Roveri, Sergio; Fumagalli, Miriam; Tassinari, Luca; Settembrini, Piergiorgio

doi:10.1016/j.avsg.2014.11.001

Cited by 7 publications

(3 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For the treatment of patients with infected prosthetic vascular grafts, Michele C performed an ultrasound debridement plus a partial graft removal or no removal instead of the traditional treatment that completes graft removal. They proved that ultrasound debridement was a valuable aid [ 26 ]. M-LFU may be applied in clinical practice and this study proved that M-LFU has distinct potential to facilitate antibiotics and obtain better effect than S-LFU.…”

Section: Discussionmentioning

confidence: 99%

Multiple Low Frequency Ultrasound Enhances Bactericidal Activity of Vancomycin against Methicillin-ResistantStaphylococcus aureusBiofilms

Wang

Wen

Liu

et al. 2018

BioMed Research International

View full text Add to dashboard Cite

Methicillin-resistant Staphylococcus aureus (MRSA) biofilm infections are difficult to treat due to the high antimicrobial resistance of biofilm. Therefore, new treatments are needed for more effective bacteria clearance. This study was to investigate whether low frequency ultrasound (LFU) can enhance the activity of antimicrobial agents against MRSA biofilm infection. Broth microdilution method was used to determine the minimum inhibitory concentration (MIC) of vancomycin (VAN), linezolid (LIN), and levofloxacin (LEV) against three clinical isolated strains, including one methicillin-susceptible Staphylococcus aureus (MSSA) strain and two MRSA strains. Effects of various influencing factors, such as antimicrobial agents, drug concentrations, ultrasonic intensity, and single (S-LFU, 5 or 15 min) or multiple ultrasound (M-LFU, 5 min every 8 h), on the inhibition of biofilms were investigated. The bactericidal effects of S-LFU or M-LFU on MRSA or MSSA biofilms were determined by colony counts. Right after ultrasound, synergistic effects were observed in groups of S-LFU combined with three antimicrobial agents against MSSA biofilm, but for MRSA biofilm, only S-LFU plus VAN had synergistic effect. At the time point of 24 h, M-LFU plus VAN treatment had synergistic bactericidal effect against MRSA and MSSA biofilms, and the synergy showed that VAN is concentration-dependent, but no synergistic effects were observed in all S-LFU combination groups. In conclusion, combination of M-LFU and antimicrobial agents had a better synergistic effect than S-LFU against MRSA or MSSA biofilm. LFU may be useful in treating biofilm infection in the future.

show abstract

Section: Discussionmentioning

confidence: 99%

Multiple Low Frequency Ultrasound Enhances Bactericidal Activity of Vancomycin against Methicillin-ResistantStaphylococcus aureusBiofilms

Wang

Wen

Liu

et al. 2018

BioMed Research International

View full text Add to dashboard Cite

show abstract

“…Currently, ultrasound treatment is often used to promote wound healing, and its advantages have been established [ 1 , 8 ]. The effects of applying ultrasonic waves to biologic tissue are primarily due to cavitation and acoustic streaming [ 9 ]. Notably, cavitation is a vibratory energy that can be applied to remove necrotic material from the wound bed.…”

Section: Discussionmentioning

confidence: 99%

Treatment of prosthetic vascular graft infection in the groin with ultrasound debridement: A case report

Haga

Inoue

Shindo

2020

Annals of Medicine and Surgery

View full text Add to dashboard Cite

Introduction Prosthetic graft infection (PGI) is associated with low patient survival rates. The effectiveness of ultrasound debridement in chronic wound healing has been previously reported; however, data on the use of ultrasound technology and its effect on the treatment of PGI are still lacking. We report a case in which PGI in the groin was managed by graft removal using ultrasound debridement. Presentation of case A 70-year-old man was diagnosed with chronic limb-threatening ischemia and underwent a femoral-femoral bypass with a polytetrafluoroethylene graft. Eight months postoperatively, he developed an infection at the femoral incision site. Graft removal was performed using ultrasound debridement. The estimated blood loss was 10 mL. The wound healed, and the patient has remained in good health for 2 years postoperatively. Discussion When the ultrasonic probe is applied to the wound, ultrasonic energy penetrates into the tissue, and a fibrinolytic action removes necrotic or infected tissue without removing healthy tissue, thereby minimizing bleeding. Using this technique, we were able to perform effective debridement at not only the wound but also the anastomosis. Conclusion It is our opinion that this technique can be used to achieve adequate debridement with little bleeding during graft removal and may provide a new option for the treatment of PGI.

show abstract

“…LFCUD devices incorporate potentially beneficial ultrasound energy to precisely remove debris . Promising results have been reported in previous case series where LFCUD was used to prepare wounds for skin grafts and promote closure of wounds in patients with prosthetic vascular graft infection and infected sterno‐cutaneous fistulae . A similar form of LFCUD is in common use in dentistry to remove plaque biofilm while causing minimal disturbance of viable tissue· We recently completed a feasibility study using LFCUD treatments of 10 patients with vasculopathy.…”

Section: Physiological Effects On Healingmentioning

confidence: 99%

The effect of 22.5 kHz low‐frequency contact ultrasound debridement (LFCUD) on lower extremity wound healing for a vascular surgery population: A randomised controlled trial

Murphy

Houghton

Brandys

et al. 2018

International Wound Journal

View full text Add to dashboard Cite

The aim of this study was to compare changes in wound size and appearance and health complication rates in patients with vasculopathy and lower-extremity wounds treated with or without low-frequency contact ultrasound debridement (LFCUD) This study was a randomised controlled trial. The study was conducted in a vascular surgery service, including outpatient wound clinic and inpatient ward, in a tertiary care academic centre. In total, 70 patients with vasculopathy and lower-extremity wounds of mixed aetiology were enrolled in the trial; 68 completed the study. Patients were randomised to receive LFCUD plus usual care (n = 33) or usual care (n = 37) at 4 weekly visits, and were followed thereafter for up to 12 wk. The main outcome measures included closed wounds, change in wound surface area (WSA), and wound appearance by the revised Photographic Wound Assessment Tool (revPWAT). After 4 weekly LFCUD treatments, patients in the LFCUD group had significantly better wound appearance (total revPWAT score) compared with the control group treated only with usual care (P = <0.05). LFCUD-treated wounds also had a significant reduction in WSA over 4 wk that was not found in the UC group. LFCUD treatment was also associated with a greater number of healed wounds, odds ratio 5.00 (95% CI 1.24-20.25), and fewer instances of wound deterioration. Weekly LFCUD applications to patients with significant vasculopathy resulted in superior healing outcomes when compared with current usual wound care practice.

show abstract

Use of Ultrasound Debridement as an Adjunctive Tool for Treating Infected Prosthetic Vascular Grafts in the Lower Extremities

Cited by 7 publications

References 17 publications

Multiple Low Frequency Ultrasound Enhances Bactericidal Activity of Vancomycin against Methicillin-ResistantStaphylococcus aureusBiofilms

Multiple Low Frequency Ultrasound Enhances Bactericidal Activity of Vancomycin against Methicillin-ResistantStaphylococcus aureusBiofilms

Treatment of prosthetic vascular graft infection in the groin with ultrasound debridement: A case report

The effect of 22.5 kHz low‐frequency contact ultrasound debridement (LFCUD) on lower extremity wound healing for a vascular surgery population: A randomised controlled trial

Contact Info

Product

Resources

About