Wound microflora and antibiotic resistance in burn patients

Potapov, A.F.; Shamaeva, S. H.; Иванова, А. А.; Semenova, S. V.

doi:10.34215/1609-1175-2023-1-81-85

Tihookeanskij medicinskij žurnal

2023

DOI: 10.34215/1609-1175-2023-1-81-85

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Wound microflora and antibiotic resistance in burn patients

A.F. Potapov

S. H. Shamaeva²,

А. А. Иванова

et al.

Abstract: Aim. To explore the etiological structure of wound microflora and its antimicrobial susceptibility in burn patients treated in hospital burn departments.Materials and methods. The authors analyzed the microbiology testing results of 2354 wound exudates in samples of 1581 patients with severe burns who underwent treatment in the Burn Unit and Department of Anesthesiology, Resuscitation and Intensive Care of the Center for Emergency Medical Care of the Republic of Sakha (Yakutia) in the period from 2016 to 2020.… Show more

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Cited by 4 publications

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Modern aspects of the monitoring of a burn wound readiness for autodermoplasty

Zurnadzh'yants,

Kchibekov,

Ragimov

et al. 2024

jour

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The leading principle of burned patients’ treatment is to perform free autodermoplasty with split autodermografts. The main criterion for a successful plastic surgery is the percentage of engraftment of skin grafts. The issues of readiness of burn wounds for such surgical interventions continue to be studied and remain open at the present time. The degree of readiness of burn wounds for skin grafting is known to depend on many factors, among which the state of the microbial flora and the level of bacterial contamination of the wound surface play an important role as one of the main criteria for maintaining inflammation in the wound. The method of cytological examination of prints from burn wounds has found wide application, which is associated with the peculiarities of pathomorphological processes in burn wounds. Great importance is attached to studying the state of microcirculation in the wound using laser Doppler flowmetry in order to determine the perfusion and reparative ability of granulation tissue of a burn wound. However, in addition to local criteria, general condition of the body and the state of its immune system in particular should be taken into account. A great number of research works is devoted to the study of immune reactions in response to burn injury. The results of these studies also make it possible to identify certain criteria for predicting the success or chance of unsatisfactory outcomes of autodermoplasty. The levels of hemoglobin and total protein allowing to expect successful surgical treatment have been determined. In spite of the wide range of methods to determe the readiness of a wound for autodermoplasty, many of them are imperfect and nonspecific. The development of complications in the form of lysis or rejection of skin grafts, the maintenance of inflammatory processes, the development of a shortage of donor resources, mortality and the likelihood of developing severe cicatricial deformities in long-term results depend on the quality and timing of surgical treatment. Therefore, the problem of uniform criteria identification for the readiness of a burn wound surface for plastic surgery remains relevant for combustiologists and surgeons.

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Modern aspects of the monitoring of a burn wound readiness for autodermoplasty

Zurnadzh'yants,

Kchibekov,

Ragimov

et al. 2024

jour

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Modern views on the microflora of burn wounds and its antibiotic resistance

Zurnadzh’yants,

Kchibekov,

Mel’nikova

et al. 2024

jour

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Prognosis of outcome of the burn injury depends on recovery speed of damaged layers of derma, therefore execution of the authodermoplasty stays the main principle of the burn injury treatment. However, local infectious complication retard processes of reparation and epithelization of tissues, hinder the engraftment of the donor skin graft, promote the lasting of healing of the donor wounds. But penetration of pathogenic microflora via damaged skin covers leads to infectious generalization with development of multiple organ failure, sepsis, pneumonia, to the increase of lethal outcome quantity. Considering the role of infection in a structure of mortality of burned patients, the significance to study of its etiology, pathogenesis and treatment does not raise doubts. Opportunistic microflora, causing hospital-acquired, or nosocomial, infections, plays a great role in the development of the similar condition in severely burned patients. Among these representatives are Staphylococcus aureus, Enterococcus faecium, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii and Enterobacteriaceae spp. The main clinical significant characteristics of such flora are multiresistance to most antimicrobial drugs, high prevalence in hospitals, and the ability to form biofilms on the surface of burn wounds. It should be noted that with every year the trend of antimicrobial resistance is increasing, and the number of resistant strains is also increasing. Therefore, it is getting more difficult to select adequate antibacterial treatment schemes for severe complicated burn injuries. The prescription of empirical therapy for nosocomial infections in burn patients should be based on the results of monitoring the microbial flora and determining its sensitivity to antibacterial drugs. In addition, methods of local treatment of wounds are constantly being improved using special wound dressings with antiseptic solutions and bacteriophage. To improve treatment rates for such patients, it is necessary to evaluate not only the local state of the wound surface, the degree of bacterial contamination of wounds and systemic inflammation during the entire period of hospitalization, but also the state of the epidemiological situation in burn care hospitals.

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Local Treatment of Infected Wounds Depending on the Phase of the Wound Process

D.V.,

N.G.,

V.B.

2023

Mediko-farmacevtičeskij žurnal "Pulʹs"

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Despite the availability of a large number of funds for the treatment of infected wounds, this issue of clinical medicine does not lose its relevance. In most cases, a combined method of wound treatment is used, which implies both the use of systemic drugs and local treatment, which, taking into account the phase of the wound process, should be aimed at cleansing, reducing inflammation, stimulating regeneration. At the present stage of the development of medicine, dressings used in surgery should meet the principle of wound healing in a humid environment and have certain requirements: to restrain the ingress of microorganisms into the wound, the composition of dressings should not include components that have toxic, allergic, mutagenic and carcinogenic effects. Recently, considerable progress has been made in the development of new methods of treating infected wounds, which are based on the impact of chemical and physical factors on the healing process, taking into account a personalized approach to the patient, based primarily on his general condition and the ability of the body to resist infection. The review, based on modern literature data, presents a generalized analysis of the use of dosage forms and wound coatings in various phases of the wound process, with an emphasis on phase I as the most aggressive for the macroorganism. The criterion for evaluating the correct treatment is to reduce the time of wound healing and prevent the development of complications. An important modern criterion for the effectiveness of wound healing is the aesthetic appearance of the scar, which encourages the search for new ways to treat wounds, a combination of already known drugs and the continuation of research in the field of wound coatings.

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Wound microflora and antibiotic resistance in burn patients

Cited by 4 publications

References 5 publications

Modern aspects of the monitoring of a burn wound readiness for autodermoplasty

Modern aspects of the monitoring of a burn wound readiness for autodermoplasty

Modern views on the microflora of burn wounds and its antibiotic resistance

Local Treatment of Infected Wounds Depending on the Phase of the Wound Process

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