Initial Wound Management of Contaminated and Infected Wounds

2015 ◽  
pp. 11-46
Keyword(s):  
Wound Management ◽  
Infected Wounds

Use of Antibiotic-Impregnated Absorbable Beads and Tissue Coverage of Complex Wounds

2016 ◽  
Vol 82 (11) ◽  
pp. 1068-1072 ◽  
Author(s):  
Terris L. White ◽  
Alfred T. Culliford ◽  
Martin Zomaya ◽  
Gary Freed ◽  
Christopher P. Demas
Keyword(s):  
Wound Management ◽  
Fasciocutaneous Flaps ◽  
Local Antibiotics ◽  
Standard Management ◽  
Systemic Antibiotic Therapy ◽  
Infected Wounds ◽  
Complex Wound ◽  
High Concentrations ◽  
Multicenter Retrospective Review ◽  
Complex Wounds

The treatment of complex wounds is commonplace for plastic surgeons. Standard management is debridement of infected and devitalized tissue and systemic antibiotic therapy. In cases where vital structures are exposed within the wound, coverage is obtained with the use of vascularized tissue using both muscle and fasciocutaneous flaps. The use of nondissolving polymethylmethacrylate and absorbable antibiotic-impregnated beads has been shown to deliver high concentrations of antibiotics with low systemic levels of the same antibiotic. We present a multicenter retrospective review of all cases that used absorbable antibiotic-impregnated beads for complex wound management from 2003 to 2013. A total of 104 cases were investigated, flap coverage was used in 97 cases (93.3%). Overall, 15 patients (14.4%) required reoperation with the highest groups involving orthopedic wounds and sternal wounds. The advantages of using absorbable antibiotic-impregnated beads in complex infected wounds have been demonstrated with minimal disadvantages. The utilization of these beads is expanding to a variety of complex infectious wounds requiring high concentrations of local antibiotics.

scholarly journals Ozonetherapy for wound management in dogs [abstract]

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Susana Gabriela Gayon-Amaro ◽  
Eduardo Flores-Colin
Keyword(s):  
Therapeutic Option ◽  
Local Treatment ◽  
Wound Management ◽  
Ozone Therapy ◽  
Recovery Processes ◽  
Plastic Materials ◽  
Purulent Wounds ◽  
Management Protocol ◽  
Infected Wounds ◽  
Polyethylene Bags

PURPOSE: To demonstrate the bactericide and regenerative capabilities of ozone through the execution of established protocols for infected wounds management. MATERIAL AND METHODS: - Ozone generator - Medical oxygen - Drinking water - Nelaton lead - Gauzes - Polyethylene bags of different sizes - 10 ml syringes - 30G needles Collect information of clinical cases of 5 patients with purulent wounds caused by bite of congener treated with ozone therapy (OP) with bagging technique (1) – injury washing with ozonized water and posterior bagged of affected area with polyethylene for 15 minutes with an ozone concentration of 56 mg/L and infiltration of wound edges with the gas in an anti-inflammatory concentration of 33 mg/L. It was possible to observe short recovery processes of disinfection and regeneration of infected wounds using in only OP as wound management protocol. DISCUSSION: Ozone bactericide property is probably the most studied topic because it was early used in the management of infected wounds (2,3). Later, with the invention of plastic materials, local treatment of septic limbs with gaseous ozone became possible. The regeneration helped with ozone has been intensively described, the acceleration of the process is related with cytokines release and the increase of tisular oxygenation (4). CONCLUSION: Based on that, it is possible to conclude that ozonetherapy could be used as another therapeutic option in the management of infected wounds with bagging technique due to bactericide and regenerative properties of this gas.

Wounds, fractures, orthopaedics

2012 ◽  
pp. 401-502
Author(s):  
Jonathan P. Wyatt ◽  
Robin N. Illingworth ◽  
Colin A. Graham ◽  
Kerstin Hogg ◽  
Michael J. Clancy ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Needlestick Injury ◽  
Wound Management ◽  
Skin Wounds ◽  
Infected Wounds ◽  
Bites And Stings ◽  
Bite Wounds

The approach to wounds 402 Further assessment of skin wounds 404 Wound management 406 Tetanus prophylaxis 410 Antibiotic prophylaxis 411 Wound aftercare 412 Infected wounds and cellulitis 413 Bite wounds 414 Specific bites and stings 416 Needlestick injury 418 Puncture wounds 419 How to describe a fracture ...

scholarly journals TERAPI LARVA PADA LUKA KRONIS TERBUKA

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Sunny Wangko
Keyword(s):  
Wound Healing ◽  
Growth Factors ◽  
Chronic Wound ◽  
Healing Process ◽  
Bioactive Molecules ◽  
Wound Management ◽  
Wound Healing Process ◽  
Beneficial Effects ◽  
Infected Wounds ◽  
Larval Therapy

Abstract: The usage of larvae in wound treatment has been known across the centuries in different countries. However, larval therapy is offered when the conventional therapy has failed in the management of chronic, infected wounds. Concerning the larval therapy, it was presumed that the wound healing was due to the mechanical debridement effect of the larval movement and of their hooks. To date, a variety of study reports reveals that there are several beneficial effects of the larval therapy, inter alia: secretion/excretion of larvae contains enzymes, growth factors, and cytokines that collaborate in the wound healing process. The bioactive molecules in the secretion/excretion of the larvae has to be further studied and to be developed, therefore, they can be applied in the wound management efficiently and economically. Keywords: larval therapy, chronic wound, healing process.     Abstrak: Walaupun pemanfaatan larva pada luka kronis telah sangat lama dikenal di berbagai negara, terapi larva umumnya digunakan bila terapi konvensional telah gagal. Awalnya diduga bahwa efek debridemen mekanis oleh gerakan larva dan kaitnya yang paling berperan. Dewasa ini, laporan berbagi studi telah mengungkapkan bahwa larva menyekresi dan menyintesis berbagai bahan baik berupa enzim, sitokin, dan growth factors yang turut berperan dalam proses penyembuhan luka. Adanya molekul bioaktif dalam ekskresi dan sekresi larva perlu diteliti dan dikembangkan agar dapat diaplikasikan dengan lebih efisien dan ekonomis. Kata kunci: terapi larva, luka kronis, penyembuhan luka.

scholarly journals Acetic acid dressings: Finding the Holy Grail for infected wound management

2017 ◽  
Vol 50 (03) ◽  
pp. 273-280 ◽  
Author(s):  
Kapil S. Agrawal ◽  
Anup Vidyadhar Sarda ◽  
Raghav Shrotriya ◽  
Manoj Bachhav ◽  
Vinita Puri ◽  
...  
Keyword(s):  
Wound Healing ◽  
Acetic Acid ◽  
Topical Application ◽  
Donor Site ◽  
Wound Management ◽  
Venous Ulcers ◽  
Health Care Burden ◽  
Wide Range ◽  
Infected Wounds ◽  
Graft Donor

ABSTRACT Background: Wounds have since long, contributed majorly to the health-care burden. Infected long-standing non-healing wounds place many demands on the treating surgeon and are devastating for the patients physically, nutritionally, vocationally, financially, psychologically and socially. Acetic acid has long been included among agents used in the treatment of infected wounds. In this study, we have evaluated the use of acetic acid for topical application in the treatment of infected wounds. Materials and Methods: A total of 100 patients with infected wounds were treated with topical application of 1% acetic acid as dressing material after appropriate cleaning. A specimen of wound swab was collected before first application and further on days 3, 7, 10 and 14. Daily dressings of wounds were done similarly. Minimum inhibitory concentration (MIC) of acetic acid against various organisms isolated was determined. Results: The patients treated ranged between 9 and 60 years, with the mean age 33 years. Nearly 70% of patients were male. Aetiologies of wounds: infective 35, diabetic 25, trauma 20, burns 10, venous ulcers 5 and infected graft donor site 5. Various microorganisms isolated include Pseudomonas aeruginosa (40%), Staphylococcus aureus (2%), Acinetobacter (12%), Escherichia Coli (5%), Proteus mirabilis (3%), Klebsiella (18%), methicillin-resistant S. aureus (10%), Streptococcus (2%) and Enterococcus (1%), Citrobacter (1%). Few wounds (6%) also isolated fungi. About 28%, 64% and 8% of patients isolated no growth on culture after 7, 14 and 21 days, respectively. MIC of all isolated organisms was ≤0.5%. Conclusion: pH of the wound environment plays a pivotal role in wound healing. Acetic acid with concentration of 1% has shown to be efficacious against wide range of bacteria as well as fungi, simultaneously accelerating wound healing. Acetic acid is non-toxic, inexpensive, easily available and efficient topical agent for effective elimination of wound infections caused due to multi-drug resistant, large variety of bacteria and fungus.

scholarly journals Vipareeta Malla Taila in the management of diabetic ulcer: A case report

2016 ◽  
Vol 7 (3) ◽  
Author(s):  
Dhyan Surendranath ◽  
Prasanna N Rao ◽  
Gopikrishna BJ ◽  
Avnish Pathak
Keyword(s):  
Wound Management ◽  
Diabetic Ulcer ◽  
Incision And Drainage ◽  
Medical Practitioners ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Optimal Intervention ◽  
Wide Range ◽  
Infected Wounds ◽  
History Of

Wound management is a common problem, encountered by medical practitioners all over the globe. The development and progression of a diabetic ulcer is made complex by a wide-range of diabetic complications. Without early and optimal intervention, the wound can rapidly deteriorate, leading to amputation of the affected limb. Vipareeta Malla Taila is an oil used in the management of chronic infected wounds mentioned in Ayurveda. A 46 year old Indian man presented with a boil over his left foot with a history of diabetes. After routine examination he underwent incision and drainage followed by daily dressing with gauze impregnated with Vipareeta Malla Taila for 28 days during which his wound healed completely. Sushruta (500BC) was the first to elaborately explain the management of wounds, wherein he explained the use of medicated oils in the management of chronic infected ulcers. Vipareeta Malla Taila helped in wound healing inspite of raised blood glucose levels throughout the treatment duration. Healing of a diabetic ulcer is a long process requiring constant vigil. With the application of Vipareeta Malla Taila, the wound responded by clearance of slough, promotion of healthy granulation and eventual epithelialization in a very short duration 

scholarly journals A comparative study of vacuum assisted closure dressing with conventional dressings in the management of infected wounds

2020 ◽  
Vol 8 (1) ◽  
pp. 97
Author(s):  
Karanvir Singh ◽  
Gurlal Singh Puar ◽  
Vikas Kakkar ◽  
Rana Ranjit Singh
Keyword(s):  
Hospital Stay ◽  
Wound Management ◽  
Vacuum Assisted Closure ◽  
Average Hospital ◽  
Total Hospital Stay ◽  
Significant Difference ◽  
Infected Wounds ◽  
Group A ◽  
Group B ◽  
Day By Day

Background: In the whole world including India, incidence of infected wounds is increasing day by day. Trauma is the most common cause of wounds and number of other factors contribute to wound infection there on. Wound management and care thus carry an important role for such patients in the form of dressings, debridement etc. Many conventional dressings are being used these days, but vacuum assisted closure (VAC) dressing as widely gained acceptance now.Methods: Our study was conducted on 60 patients divided in 2 groups of 30 each to compare VAC dressing with conventional dressings.Results: There was significant difference in total hospital stay, no. of debridement done, granulation tissue fill up and graft take up in both groups, for example, the average hospital stay in group A was 21.8±7.61 and in group B was 26.47±9.55.Conclusions: So, VAC dressing was found to be more beneficial and patient friendly with lesser hospital stay and thus lesser cost than conventional dressings.

scholarly journals Therapy of infected wounds: overcoming clinical challenges by advanced drug delivery systems

2021 ◽  
Author(s):  
Pia Kaiser ◽  
Jana Wächter ◽  
Maike Windbergs
Keyword(s):  
Drug Delivery ◽  
Drug Delivery Systems ◽  
Healing Process ◽  
Delivery Systems ◽  
Wound Dressings ◽  
Wound Management ◽  
Future Perspective ◽  
Special Focus ◽  
Comprehensive Overview ◽  
Infected Wounds

AbstractIn recent years, the incidence of infected wounds is steadily increasing, and so is the clinical as well as economic interest in effective therapies. These combine reduction of pathogen load in the wound with general wound management to facilitate the healing process. The success of current therapies is challenged by harsh conditions in the wound microenvironment, chronicity, and biofilm formation, thus impeding adequate concentrations of active antimicrobials at the site of infection. Inadequate dosing accuracy of systemically and topically applied antibiotics is prone to promote development of antibiotic resistance, while in the case of antiseptics, cytotoxicity is a major problem. Advanced drug delivery systems have the potential to enable the tailor-made application of antimicrobials to the side of action, resulting in an effective treatment with negligible side effects. This review provides a comprehensive overview of the current state of treatment options for the therapy of infected wounds. In this context, a special focus is set on delivery systems for antimicrobials ranging from semi-solid and liquid formulations over wound dressings to more advanced carriers such as nano-sized particulate systems, vesicular systems, electrospun fibers, and microneedles, which are discussed regarding their potential for effective therapy of wound infections. Further, established and novel models and analytical techniques for preclinical testing are introduced and a future perspective is provided. Graphical abstract

scholarly journals Profile and Antimicrobial Susceptibility Pattern of Bacterial Isolates from Infected Wounds of Patients Attending Berekum Holy Family Hospital in Ghana

2019 ◽  
pp. 1-8
Author(s):  
Isaac Dadzie ◽  
Nicholas Quansah ◽  
Emmanuel Kingsley Dadzie
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antimicrobial Susceptibility ◽  
Financial Burden ◽  
Wound Management ◽  
Wound Infections ◽  
Susceptibility Pattern ◽  
Gram Negative ◽  
Antimicrobial Susceptibility Pattern ◽  
Infected Wounds ◽  
Predominant Pathogen

Background: Wound management and care after an infection has been known to present a major concern to healthcare professionals. Its association with increased trauma, discomfort and financial burden to patients bring to bear the need for aggressive intervention. This study sought to investigate the bacterial profile and their antimicrobial susceptibility pattern of infected wounds in patients who reported to Berekum Holy Family Municipal Hospital in Ghana. Methodology: A total of 150 consenting patients with wound infections of diverse aetiologies were recruited. Wound swabs were aseptically obtained, macroscopically analyzed, gram stained and cultured on differential media. Antibiotic susceptibility testing was performed by Kirby-Bauer disk diffusion technique. Results: The prevalence of wound infection was 84.67% with cellulitis (35.43%) accounting for the most cause. Gram-negative bacilli (84.5%) were the most isolated bacteria with Pseudomonas aeruginosa (28%) being the most predominant pathogen isolated. Polymicrobial infections were identified in 33 (19.64%) of the infected wounds with Pseudomonas aeruginosa/Proteus mirabilis being the most common association (36.4%). The isolated gram-negative organisms were absolutely susceptible (97%-100%) to amikacin. Gentamicin, Ciprofloxacin and Levofloxacin exhibited moderate to higher susceptibility. Gentamicin exhibited maximal susceptibility against the gram-positive organisms with tetracycline being the most resistant antibiotic against the isolated organisms. Conclusion: With the increased detection of bacterial pathogens causing wound infections and their susceptibility to the tested antibiotics, we recommend that patients with wound infections should immediately report cases to health facilities for early intervention.

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