Ostomy/wound management
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Ostomy/wound management · Apr 2007
Randomized Controlled Trial Multicenter Study Comparative StudyComparison of wound irrigation and tangential hydrodissection in bacterial clearance of contaminated wounds: results of a randomized, controlled clinical study.
Thorough irrigation of contaminated or infected traumatic and open surgical wounds is considered standard practice. High-power pulse lavage is frequently used to facilitate the removal of surface contaminants and bacteria but studies to compare the results of various irrigation techniques are limited. The purpose of this randomized, controlled clinical study was to compare the ability of a high-pressure parallel waterjet (pressure range 5,025 to 7,360 psi) to pulse lavage (pressure 40 psi) in reducing wound bacterial counts. ⋯ The difference between the two treatment groups was not statistically significant. The results of this study confirm that cleansing contaminated or infected acute wounds using high pressure (at least 15 psi) reduces wound bacterial counts. Studies to compare the clinical outcomes of various irrigation techniques and pressure ranges are warranted and the potential benefit of selective debridement using the high-pressure parallel waterjet should be investigated.
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Ostomy/wound management · Apr 2007
ReviewRecurring and antimicrobial-resistant infections:considering the potential role of biofilms in clinical practice.
Micro-organisms commonly produce biofilm, a polymeric matrix that is adherent to inert or living substances and frequently forms on environmental surfaces, medical devices, and traumatized or compromised living and nonviable necrotic tissues such as wounds. The micro-organisms in a biofilm interact with each other and their environment. They are refractory to conventional therapy and resist conventional methods for culturing; their coordinated activities can lessen the effect of antimicrobials and the host's defenses. ⋯ Micro-organisms in biofilms may remain dormant for weeks or years before causing local or systemic signs and symptoms of infection and are commonly responsible for recurring infections after repeated trials of antibiotics. Most biofilm infection-related research findings have not reached clinical practice yet. However, clinician knowledge about the development of and difficulties culturing micro-organisms in biofilms and their resistance to antibiotics and biocides may lead to improved clinical outcomes in soft tissue and bone infections and the treatment of wounds.