International wound journal
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Negative pressure wound therapy with instillation (NPWTi) is increasingly used as an adjunct therapy for a wide variety of infected wounds. However, the effect of NPWTi on mature biofilm in wounds has not been determined. This study assessed the effects of NPWTi using saline or various antimicrobial solutions on mature Pseudomonas aeruginosa biofilm using an ex vivo porcine skin explant biofilm model. ⋯ Scanning electron micrographs showed disrupted exopolymeric matrix of biofilms and damaged bacterial cells that correlated with CFU levels. Compared with previous studies assessing microbicidal effects of topical antimicrobial dressings on biofilms cultured on porcine skin explants, these ex vivo model data suggest that NPWTi with delivery of active antimicrobial agents enhances the reduction of CFUs by increasing destruction and removal of biofilm bacteria. These results must be confirmed in human studies.
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In this study, the effects of the wound-covering materials, Acticoat(®) and Cutinova Hydro(®) , on wound healing have been studied in rabbit models with open and tissue-lost wounds with full-thickness flank excisions. Rabbits were used as subjects with three groups of four rabbits each, and trial periods of 7, 14 and 21{\uns}days. Four circular wounds, of 1.5 cm diameter were made two on the right (one of them control) and two on the left (one of them control) of the dorsal sides of the abdomen. ⋯ This study has shown the short-term clinical benefits of hydroactive, polyurethane dressings in the management of acute wounds. However, longer periods of wound healing procedure should be planned for reliable and safe results of wound dressing. It has also been concluded that microbiological analyses should be included for more robust and reliable comparisons.
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Randomized Controlled Trial Comparative Study
Comparison of silver nylon wound dressing and silver sulfadiazine in partial burn wound therapy.
The study aims to perform a comparative assessment of two types of burn wound treatment. To do the assessment, patients with partial thickness burn wounds with total body surface area <40% were simple randomised to treat with nanocrystalline silver nylon wound dressing or silver sulfadiazine cream. Efficacy of treatment, use of analgesics, number of wound dressing change, wound infection and final hospitalisation cost were evaluated. The study showed silver nylon wound dressing significantly reduced length of hospital stay, analgesic use, wound infection and inflammation compared with silver sulfadiazine.
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Review Case Reports
Reconstruction of infected and denuded scrotum and penis by combined application of negative pressure wound therapy and split-thickness skin grafting.
Trauma to the genital region and perineum can leave behind lifelong sequelae and pose significant challenges to surgeons in the restoration of functional ability and aesthetic status. Effective methods and techniques are indispensable during the treatment period. Negative pressure wound therapy (NPWT) is a widely accepted technique that is becoming a commonplace treatment in many clinical settings. ⋯ After debridement, we adopted NPWT during the postoperative dressing changes and the application of meshed STSG. The outcomes showed that combination of NPWT and split-thickness skin grafts is safe, well-tolerated and efficient in the reconstruction of penoscrotal defects. This could be a versatile tool for reconstruction after perineal and penoscrotal trauma.
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Randomized Controlled Trial Comparative Study
Clinical outcome and microvascular blood flow in VAC® - and Sorbalgon® -treated peri-vascular infected wounds in the groin after vascular surgery - an early interim analysis.
Vacuum-assisted wound closure (VAC(®)) therapy is considered to be superior to conventional dressings in the treatment of peri-vascular groin infections after vascular surgery at our department. Therefore, we performed an early interim analysis of the clinical outcomes in these seriously ill patients at risk of amputation and death. Patients were randomised to either VAC(®) (n = 5) or Sorbalgon(®) (n = 5; best alternative treatment) therapy after surgical debridement. ⋯ No patient died of the groin infection. Although not statistically proven, fewer wound treatment failures were recorded in the VAC(®) group, justifying this early interim analysis. LDPI studies were feasible.