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Sample records for burn wound infection

  1. Successful treatment of invasive burn wound infection with sepsis in patients with major burns

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective To investigate the clinical characteristics of invasive bum wound infection with sepsis in patients with major burns and to summarize the successful expenences in the treatment of such patients. Methods Eight patients with major bums, complicated by invesive bum wound infection and sepsis were consecutively admitted to our hospital from September 1997 to October 1998. Among them, 6 patients developed multiple organ dysfunction syndrome (MODS) and 2 developed septic shock. The plasma concentrations of IL-6,IL-8,TNFα and lypopolysaccharibe (LPS) were assayed before and after surgical intervention, as well as when the patient' s vital signs became stable. Results The patients' conditions usually deterieorated abruptly when extensive invasive bum wound infection emerged. While multi-microbial infection was usually found, Pseudomonas aeruginosa was the predominant bactena isolated from the subeschar tissue. The plasma concentrations of IL-6, IL-8, TNFα and LPS before surgical intervention wore significantly higher than those after surgical intervention (P<0.05).The lowest levels of the inflammatory mediators were abserved when the patients'conditions became stable,and the values were significantly lower than those before surgical intervention ( P<0.001). Conclusion Since the main cause of burn wound sepsis is the presence of a large area of infected bum wound, they should be excised and covered as early as possible. LPS and pro-inflammatory mediators play an important role in the pathogenesis of burn sepsis. Athough favorable results should be attributed to compmhessive treatment, we believe that early, aggressive and thorough surgical excision of infected burn wounds, followed by sound and complete coverage of the area, play a crucial role.

  2. Experimental substantiation of infected burn wounds of skin in laboratory animals

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    Dobrejkin Е.А.

    2013-06-01

    Full Text Available Objective: To develop a method of simulation of infected area and depth-controlled burn wound through the use of laser radiation. Material and methods: The contact surgical fiber laser at heating mode of 220°C within 2 с has been used in a surgical experiment on 50 white lab rats under the control of a thermal imager, copper laser nozzle on the skin of an animal. Burn wounds have been infected. Results: Controlled single laser effect by the developed method helps speed up the simulation and subsequent infection of burn wounds, all layers of the skin. Conclusion. The infected burn wound model is suitable for the development of effective combined surgical treatment.

  3. Effect of Antioxidants on the Incidence of Wound Infection in Burn Patients

    OpenAIRE

    Sahib, A.S.; Al-Jawad, F.H.; Alkaisy, A.A.

    2010-01-01

    Background. Thermal injury causes the destruction of the physical skin barrier that normally protects the body from invasion by micro-organisms and induces an immunocompromised state that predisposes burn patients to infection, sepsis, and multiple organ failure. Reactive oxygen species contribute to burn-mediated immune suppression, and as the use of antioxidants has a positive effect on immune function, this may reduce the incidence of wound infection and related complications in burn patie...

  4. Thermal injury induces impaired function in polymorphonuclear neutrophil granulocytes and reduced control of burn wound infection

    DEFF Research Database (Denmark)

    Calum, H.; Moser, C.; Jensen, P. O.;

    2009-01-01

    Severe thermal injury induces immunosuppression, involving all parts of the immune system, especially when large fractions of the total body surface area are affected. An animal model was established to characterize the burn-induced immunosuppression. In our novel mouse model a 6% third-degree burn...... of mice with burn wound. The reduction was ascribed to the decline in concentration of polymorphonuclear neutrophil leucocytes and monocytes. When infecting the skin with Pseudomonas aeruginosa, a dissemination of bacteria was observed only in the burn wound group. Histological characterization...

  5. Maggot therapy for repairing serious infective wound in a severely burned patient

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    WU Jun-cheng

    2012-04-01

    Full Text Available 【Abstract】The larvae of musca domestica were put in use to discard the dead tissue of a case of severe burn. A total of 50 000 aseptic maggots were put onto the infective wound surface, and aseptic dressings overlaid the surface. Three days later, another 20 000 maggots were put onto the wound for the second therapy. After twice maggot debridement, most necrotic muscle tissues of the wound were cleaned up, and eventually fresh granulation tissue grew and later the wound was covered and healed by 3 times of skin grafting. The result demonstrates that maggot therapy is safe and effective with no adverse complications except pain. Key words: Biological therapy; Wound infection; Burns; Wound healing; Debridement

  6. Maggot therapy for repairing serious infective wound in a severely burned patient

    OpenAIRE

    WU Jun-cheng; LU Ren-rong; HUO, RAN; FU Hong-bin

    2012-01-01

    【Abstract】The larvae of musca domestica were put in use to discard the dead tissue of a case of severe burn. A total of 50 000 aseptic maggots were put onto the infective wound surface, and aseptic dressings overlaid the surface. Three days later, another 20 000 maggots were put onto the wound for the second therapy. After twice maggot debridement, most necrotic muscle tissues of the wound were cleaned up, and eventually fresh granulation tissue grew and later the woun...

  7. Wound Care in Burn Patients

    OpenAIRE

    Orhan Çizmeci; Samet Vasfi Kuvat

    2011-01-01

    Wound care in one of the most important prognostic factors in burn victims. Open wound carries risks for infection due to hypothermia, protein and fluid losses. In addition, unhealed wounds are the major risk factors for acute-subacute or chronic complications in burn patients. Although no exact algorithm exists for open wound treatment, early escarectomy or debridement together with grafting is the best option. Ointments together with topical epithelizing agents without dressings are generea...

  8. Maggot therapy for repairing serious infective wound in a severely burned patient.

    Science.gov (United States)

    Wu, Jun-Cheng; Lu, Ren-Rong; Huo, Ran; Fu, Hong-Bin

    2012-01-01

    The larvae of musca domestica were put in use to discard the dead tissue of a case of severe burn. A total of 50 000 aseptic maggots were put onto the infective wound surface, and aseptic dressings overlaid the surface. Three days later, another 20 000 maggots were put onto the wound for the second therapy. After twice maggot debridement, most necrotic muscle tissues of the wound were cleaned up, and eventually fresh granulation tissue grew and later the wound was covered and healed by 3 times of skin grafting. The result demonstrates that maggot therapy is safe and effective with no adverse complications except pain. PMID:22480679

  9. Maggot therapy for repairing serious infective wound in a severely burned patient.

    Science.gov (United States)

    Wu, Jun-Cheng; Lu, Ren-Rong; Huo, Ran; Fu, Hong-Bin

    2012-01-01

    The larvae of musca domestica were put in use to discard the dead tissue of a case of severe burn. A total of 50 000 aseptic maggots were put onto the infective wound surface, and aseptic dressings overlaid the surface. Three days later, another 20 000 maggots were put onto the wound for the second therapy. After twice maggot debridement, most necrotic muscle tissues of the wound were cleaned up, and eventually fresh granulation tissue grew and later the wound was covered and healed by 3 times of skin grafting. The result demonstrates that maggot therapy is safe and effective with no adverse complications except pain.

  10. The effect of extensive excision of burn wound with invasive infection on hypermetabolism in burn patients with sepsis

    Institute of Scientific and Technical Information of China (English)

    柴家科; 盛志勇; 刁力

    2000-01-01

    Objective: To evaluate the effect of extensive excision of invasive burn wound infection on hypermetabolic response in burn patients with sepsis. Methods:Eight patients with major burn, complicated by invasive burn wound infection and sepsis were consecutively admitted to our hospital from September 1997 to October 1998. REEs were monitored by means of Cardiorespiratory Diagnostic System (Medical Graphics Corporation, USA) at patients bedside. Plasma concentration of IL-6、IL-8、TNF-α and LPS were assayed before and after surgical intervention and at the time when the patients' vital signs became stable. Correlation analysis between REEs and IL-6、IL-8、TNF-α、LPS was respectively made. Results: A total of 8 patients were treated and all of them survived. Values of REE before surgical intervention were significantly higher than those after surgical intervention(P<0.01), and when patients vital signs became stable the values were significantly lower compared with that after surgical intervention(P<0.01). The plasma concentrations of IL-6、 IL-8、TNF-α and LPS after excision of invasive burn wound infection were significantly lower than those before surgical intervention (P<0.05). The lowest levels of these inflammatory mediators were observed when the conditions of patients became stable, and the values were significantly lower compared with those before surgical intervention (P<0. 001). There was a significant positive correlation between REE level and respective values of plasma IL-6、 IL-8、 TNF-α、 LPS(P <0.01). Conclusions: It is deemed that the extensive excision of invasively infected burn wound in patients with major burn should be performed as early as possible to reduce an increased release of inflammatory mediators, and to control the hypermetabolic response during sepsis.

  11. Effect of interferon-gamma treatment on the course of a burn wound infection.

    Science.gov (United States)

    Hershman, M J; Sonnenfeld, G; Logan, W A; Pietsch, J D; Wellhausen, S R; Polk, H C

    1988-06-01

    Interferon-gamma (IFN-gamma) has been shown to have immunoregulatory properties and is able to modulate resistance to several microbial infections. This study was designed to determine the efficacy of IFN-gamma treatment in a murine burn wound infection model. Bacterial challenge consisted of Klebsiella pneumoniae (10(8) organisms/ml) or Pseudomonas aeruginosa (10(8) organisms/ml), applied topically immediately after burning. Groups of CBA/J mice received either IFN-gamma or RPMI-1640 medium (controls) subcutaneously. IFN-gamma was administered daily at a dose of 7,500 units for 5 days prior to bacterial challenge. Burn without bacterial challenge produced no mortality. Mice treated with IFN-gamma survived significantly longer than controls when the bacterial challenge was K. pneumoniae. There was no difference in survival when bacterial challenge was P. aeruginosa. The Ia antigen expression of peripheral blood mononuclear cells was severely reduced for 3 days post-burn. This drop was prevented on day 3 post-burn in mice treated with IFN-gamma. These data indicate that interferon was effective treatment in a murine model of Klebsiella burn wound infection and was associated with maintenance of Ia antigen expression that may have contributed to the action of the IFN-gamma. PMID:3137276

  12. Negative Pressure Wound Therapy Decreases Mortality in a Murine Model of Burn-Wound Sepsis Involving Pseudomonas aeruginosa Infection

    OpenAIRE

    Yang Liu; Qin Zhou; Yunchuan Wang; Zhengcai Liu; Maolong Dong; Yaojun Wang; Xiao Li; Dahai Hu

    2014-01-01

    BACKGROUND: The colonization of burn wounds by Pseudomonas aeruginosa can lead to septic shock, organ injuries, and high mortality rates. We hypothesized that negative pressure wound therapy (NPWT) would decrease invasion and proliferation of P. aeruginosa within the burn wound and reduce mortality. METHODS: Thermal injuries were induced in anesthetized mice, and P. aeruginosa was applied to the wound surface for 24 h. After removing the burn eschar and debridement, the animals were subjected...

  13. Contribution of Quorum Sensing to the Virulence of Pseudomonas aeruginosa in Burn Wound Infections

    OpenAIRE

    Rumbaugh, Kendra P.; Griswold, John A.; Iglewski, Barbara H.; Hamood, Abdul N.

    1999-01-01

    The Pseudomonas aeruginosa quorum-sensing systems, las and rhl, control the production of numerous virulence factors. In this study, we have used the burned-mouse model to examine the contribution of quorum-sensing systems to the pathogenesis of P. aeruginosa infections in burn wounds. Different quorum-sensing mutants of P. aeruginosa PAO1 that were defective in the lasR, lasI, or rhlI gene or both the lasI and rhlI genes were utilized. The following parameters of the P. aeruginosa infection ...

  14. Requirements for Pseudomonas aeruginosa acute burn and chronic surgical wound infection.

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    Keith H Turner

    2014-07-01

    Full Text Available Opportunistic infections caused by Pseudomonas aeruginosa can be acute or chronic. While acute infections often spread rapidly and can cause tissue damage and sepsis with high mortality rates, chronic infections can persist for weeks, months, or years in the face of intensive clinical intervention. Remarkably, this diverse infectious capability is not accompanied by extensive variation in genomic content, suggesting that the genetic capacity to be an acute or a chronic pathogen is present in most P. aeruginosa strains. To investigate the genetic requirements for acute and chronic pathogenesis in P. aeruginosa infections, we combined high-throughput sequencing-mediated transcriptome profiling (RNA-seq and genome-wide insertion mutant fitness profiling (Tn-seq to characterize gene expression and fitness determinants in murine models of burn and non-diabetic chronic wound infection. Generally we discovered that expression of a gene in vivo is not correlated with its importance for fitness, with the exception of metabolic genes. By combining metabolic models generated from in vivo gene expression data with mutant fitness profiles, we determined the nutritional requirements for colonization and persistence in these infections. Specifically, we found that long-chain fatty acids represent a major carbon source in both chronic and acute wounds, and P. aeruginosa must biosynthesize purines, several amino acids, and most cofactors during infection. In addition, we determined that P. aeruginosa requires chemotactic flagellar motility for fitness and virulence in acute burn wound infections, but not in non-diabetic chronic wound infections. Our results provide novel insight into the genetic requirements for acute and chronic P. aeruginosa wound infections and demonstrate the power of using both gene expression and fitness profiling for probing bacterial virulence.

  15. Topical Bactroban (mupirocin): efficacy in treating burn wounds infected with methicillin-resistant staphylococci.

    Science.gov (United States)

    Strock, L L; Lee, M M; Rutan, R L; Desai, M H; Robson, M C; Herndon, D N; Heggers, J P

    1990-01-01

    Bacterial antimicrobial susceptibility predictors such as the minimal inhibitory concentration (MIC) assay and Nathans Agar Well Diffusion (NAWD) assay provide essential information relevant to the therapeutic approach in burn-wound sepsis. The susceptibilities of 68 gram-positive burn-wound isolates were tested against topical Bactroban (mupirocin) (Beecham Laboratories, Bristol, Tenn.) and compared with other topical antimicrobials such as mafenide acetate, silver sulfadiazine, and bacitracin/neomycin/polymyxin (BNP). Topical susceptibility data were obtained with a modification of NAWD assay. Bactroban's antimicrobial activity was greater than that of mafenide acetate (100% vs 97%), and significantly greater than that of silver sulfadiazine and that of BNP (p less than 0.001). Of the 68 isolates that were susceptible to Bactroban, 51 were predominately methicillin-resistant staphylococci (MRSA). Bactroban showed in vitro activity against 71% of the 85 gram-negative isolates tested. Mafenide acetate showed activity against 89% of these isolates, a significant difference compared with Bactroban (p less than 0.02). In general, no significant difference was found between the activities of Bactroban and silver sulfadiazine against the gram-negative isolates. The activities of mafenide acetate and silver sulfadiazine against isolates of Pseudomonas aeruginosa were significantly greater than that of Bactroban (p less than 0.05). Bactroban may be used in the treatment of documented staphylococcal burn-wound infections. On the basis of the in vitro data, 13 patients with MRSA burn-wound infections susceptible to Bactroban were evaluated. Quantitative wound biopsies were employed to determine the efficacy of this therapeutic approach. The outcome of these infections was correctly predicted by the NAWD assay in 92.3% of the patients treated (p less than 0.0005).(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Maggot therapy for repairing serious infective wound in a severely burned patient

    Institute of Scientific and Technical Information of China (English)

    WU Jun-cheng; LU Ren-rong; HUO Ran; FU Hong-bin

    2012-01-01

    The larvae of musca domestica were put in use to discard the dead tissue of a case of severe burn.A total of 50 000 aseptic maggots were put onto the infective wound surface,and aseptic dressings overlaid the surface.Three days later,another 20 000 maggots were put onto the wound for the second therapy.After twice maggot debridement,most necrotic muscle tissues of the wound were cleaned up,and eventually fresh granulation tissue grew and later the wound was covered and healed by 3 times of skin grafting.The result demonstrates that maggot therapy is safe and effective with no adverse complications except pain.

  17. Burn wound: How it differs from other wounds?

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    V K Tiwari

    2012-01-01

    Full Text Available Management of burn injury has always been the domain of burn specialists. Since ancient time, local and systemic remedies have been advised for burn wound dressing and burn scar prevention. Management of burn wound inflicted by the different physical and chemical agents require different regimes which are poles apart from the regimes used for any of the other traumatic wounds. In extensive burn, because of increased capillary permeability, there is extensive loss of plasma leading to shock while whole blood loss is the cause of shock in other acute wounds. Even though the burn wounds are sterile in the beginning in comparison to most of other wounds, yet, the death in extensive burns is mainly because of wound infection and septicemia, because of the immunocompromised status of the burn patients. Eschar and blister are specific for burn wounds requiring a specific treatment protocol. Antimicrobial creams and other dressing agents used for traumatic wounds are ineffective in deep burns with eschar. The subeschar plane harbours the micro-organisms and many of these agents are not able to penetrate the eschar. Even after complete epithelisation of burn wound, remodelling phase is prolonged. It may take years for scar maturation in burns. This article emphasizes on how the pathophysiology, healing and management of a burn wound is different from that of other wounds.

  18. Negative pressure wound therapy decreases mortality in a murine model of burn-wound sepsis involving Pseudomonas aeruginosa infection.

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    Yang Liu

    Full Text Available BACKGROUND: The colonization of burn wounds by Pseudomonas aeruginosa can lead to septic shock, organ injuries, and high mortality rates. We hypothesized that negative pressure wound therapy (NPWT would decrease invasion and proliferation of P. aeruginosa within the burn wound and reduce mortality. METHODS: Thermal injuries were induced in anesthetized mice, and P. aeruginosa was applied to the wound surface for 24 h. After removing the burn eschar and debridement, the animals were subjected to either NPWT or wet-to-dry (WTD treatment protocols. The bacterial loads on the wound surface were assessed during 7 d of treatment, as were the concentrations of inflammatory cytokines in the peripheral blood samples. Survival was monitored daily for 14 d after burn induction. Finally, samples of wounded skin, lung, liver, and kidney were collected and subjected to histopathological examination. RESULTS: Applying P. aeruginosa to the burn wound surface led to sepsis. During early stages of treatment, NPWT reduced the mortality of the septic animals and levels of P. aeruginosa within the burn wound compared with WTD-treated animals. Circulating levels of cytokines and cytoarchitectural abnormalities were also significantly reduced via NPWT. CONCLUSIONS: Our data indicate that NPWT inhibits the invasion and proliferation of P. aeruginosa in burn-wounded tissue and decreases early mortality in a murine model of burn-wound sepsis. These therapeutic benefits likely result from the ability of NPWT to decrease bacterial proliferation on the wound surface, reduce cytokine serum concentrations, and prevent damage to internal organs.

  19. Bacterial isolates from burn wound infections and their antibiograms: A eight-year study

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    Mehta Manjula

    2007-01-01

    Full Text Available Background: Infection is an important cause of mortality in burns. Rapidly emerging nosocomial pathogens and the problem of multi-drug resistance necessitates periodic review of isolation patterns and antibiogram in the burn ward. Aim: Keeping this in mind, the present retrospective study from wounds of patients admitted to burns unit was undertaken to determine the bacteriological profile and the resistance pattern from the burn ward over a period of three years (June 2002 to May 2005 and was compared with the results obtained during the previous five years (June 1997-May 2002, to ascertain any change in the bacteriological profile and antimicrobial resistance pattern. Materials and Methods: Bacterial isolates from 268 wound swabs taken from burn patients were identified by conventional biochemical methods and antimicrobial susceptibility was performed. Statistical comparison of bacterial isolates and their resistance pattern with previous five years data was done using c2 test. Results and Conclusions: During the period from 2002 to 2005 Pseudomonas species was the commonest pathogen isolated (51.5% followed by Acinetobacter species (14.28%, Staph. aureus (11.15%, Klebsiella species (9.23% and Proteus species (2.3%. When compared with the results of the previous five years i.e., 1997 to 2002, Pseudomonas species was still the commonest pathogen in the burns unit. However, the isolation of this organism and other gram-negative organisms had decreased in comparison to previous years. Newer drugs were found to be effective.

  20. Serum Neopterin and Procalcitonin Levels in Relationship with Pediatric Burn Wound Infections.

    Science.gov (United States)

    Pilanci, Ozgur; Ergin, Sevgi; Sirekbasan, Serhat; Ersin, Idris; Habip, Zafer; Yuksel, Pelin; Kuvat, Nuray; Aslan, Mustafa; Dinc, Oyku; Saribas, Suat; Kocazeybek, Bekir

    2016-03-01

    Infection and septic complications in burn patients can be monitored by procalcitonin (PCT) and neopterin plasma values. The aim of the study was to investigate serum neopterin and PCT levels with WBC (white blood cell) and CRP (C-reactive protein) levels in patient group (PG) and healthy control group (HCG) and to investigate the relationship of these markers with burn wound infections (BWI). As the PG, 23 patients between 0-12 ages and up to 30% Total Body Surface Area (TBSA) burned and 15 HCG were included. PCT, neopterin, WBC, and CRP results on the first, the seventh, the fourteenth and the 21st day have been compared. During the follow-up period, 11 patients with BWI and 12 patients without BWI were classified as infected and non-infected patients, respectively. PCT and neopterin levels were detected higher in patients with BWI but no significant difference were present. Also, PCT and neopterin levels within the first 24 hours following the burn were detected higher in PG than HCG. CRP and WBC levels were detected high due to burn trauma. PCT and neopterin levels were increased in patients with BWI. PCT levels were increased during the pre-infectious period, while neopterin levels increased during the post-infectious period. PMID:27020868

  1. A comparative study of the effect of different topical agents on burn wound infections

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    Katara Gunjan

    2012-01-01

    Full Text Available Background: Topical agents are used to treat burn wound infections. Aims and Objective: The present work was aimed to find out the in vitro efficacy of different topical agents against burn wound pathogens. Settings and Design: Randomly selected gram-positive (29 and gram-negative bacterial (119 isolates from burn wound cases admitted in burn unit of Choithram Hospital and Research Centre, Indore, were included in the in vitro activity testing for silver nitrate, silver sulphadiazine (SSD, chlorhexidine, cetrimide, nitrofuran, soframycin, betadine, benzalkonium chloride and honey by growth inhibition on agar medium. Materials and Methods: Multidrug-resistant isolates of gram-positive and gram-negative bacteria were checked for different topical agents. 1% topical agent was mixed with Mueller-Hinton agar. Two microlitres of bacterial suspension adjusted to 0.5 McFarland turbidity standard was spread over the topical agent containing plates. The plates without the topical agent were used as control plates. The plates were incubated for 48 h at 37΀C. Results: SSD (148/148, silver nitrate (148/148 and chlorhexidine (148/148 showed excellent activity against all the pathogens. Neosporin had poor activity against Pseudomonas aeruginosa, (4/44 Proteus spp. (2/4 and group D streptococci (1/4. Betadine did not show activity against the bacterial isolates in the presence of organic matter. Honey did not exert any antimicrobial activity under the study conditions. Conclusion: SSD, silver nitrate and chlorhexidine have excellent activity against all the bacterial pathogens and could be used empirically, while identification of the infective agent is required for selecting the alternative topical agents such as nitrofuran, soframycin, and benzalkonium chloride.

  2. Topical silver treatment after escharectomy of infected full thickness burn wounds in rats.

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    Chu, Chi-Sing; McManus, Albert T; Mason, Arthur D; Pruitt, Basil A

    2005-05-01

    White male Sprague Dawley rats (200 g.) with 20% full thickness scald burns seeded with 10 Pseudomonas aeruginosa, strain 59-1244, were used as experimental animals. Studies including the following: (1). Control groups. (2). DC pretreatment groups. (3). Treatment groups. P. aeruginosa infected burn wounds were excised, and then treated with either autograft or silver-nylon dressings, with (SNDC) or without (SN) application direct current. Excision and treatment were initiated 1, 2, 3, 4 or 5 days after burning and inoculation. (4). Groups for antimicrobial barrier function study. Mortality of each group was recorded at 21 days PB. With burns alone, there was no mortality. Without treatment 19 of 20 burn inoculated controls died. In the pretreatment study, the mortality of the group pretreated with SN was 95% while that of the group pretreated with SNDC was only 30%. With excision and autografting, PB mortality rose from 5/20 at day 2 PB to 19/20 at day 3 PB. In the excision and SN groups, mortality rose from 5/20 at day 3 PB to 18/20 at day 4 PB. In the excision and SNDC groups, mortality rose from 5/20 at day 3 PB to 18/20 at day 4 PB. In the antimicrobial barrier function study, the 10% mortality in the SN dressing group was significantly less than that of 95% in the plain nylon dressed group. Histologic examination revealed progressively deepening colonization of non-viable wound tissue, progressing to invasion of underlying viable tissue by PB day 4. With wound excision, SN, SNDC, and autografting were equally protective for the first two days, but only SN and SNDC extended this effect to the third PB day. In conclusion, SN and SNDC have a strong local anti-microbial effect on the burn wound when applied within 72 hours of the time of bacterial inoculation, but little effect if applied after the bacteria have invaded unburned vessels and viable tissue adjacent to the burn. PMID:15920422

  3. Burn wounds infected with Pseudomonas aeruginosa triggers weight loss in rats

    OpenAIRE

    Su Grace; Lehnhardt Marcus; Jacobsen Frank; Fan Ming H; Burkhard Olaf; Steinstraesser Lars; Daigeler Adrien; Steinau Hans U; Remick Daniel; Wang Stewart C

    2005-01-01

    Abstract Background Despite dramatic improvements in the management of burns, infection still remains a serious risk for the burn patient. The aim of this study was to shed light on the impact of acute burn injury with or without infection on cytokine profiles. Methods Sprague-Dawley rats (n = 21) were randomized into three groups: 1) burn only 2) burn and infection or 3) sham burn. Weight was monitored and blood was collected for cytokine ELISA, LPS quantification, and peripheral blood analy...

  4. Wound Care in Burn Patients

    Directory of Open Access Journals (Sweden)

    Orhan Çizmeci

    2011-07-01

    Full Text Available Wound care in one of the most important prognostic factors in burn victims. Open wound carries risks for infection due to hypothermia, protein and fluid losses. In addition, unhealed wounds are the major risk factors for acute-subacute or chronic complications in burn patients. Although no exact algorithm exists for open wound treatment, early escarectomy or debridement together with grafting is the best option. Ointments together with topical epithelizing agents without dressings are genereally adequate for first-degree burns. However, topical antibacterial agents are usually required for second to third-degree wounds. Standart treatment for the open wound without epithelization is autologous skin grafting. In cases where more than 50% of the skin surface in affected, autologus donor skin may not be enough. For these cases, epidermal cell culture in vitro may be used. Mesenchymal stem cell applications which have immunosupressive effects should be utilized in cases where cells need to be prepared as allografts. (Journal of the Turkish Society intensive Care 2011; 9 Suppl: 51-4

  5. Enhanced efficacy and anti-biofilm activity of novel nanoemulsions against skin burn wound multi-drug resistant MRSA infections.

    Science.gov (United States)

    Song, Zhen; Sun, Hongwu; Yang, Yun; Jing, Haiming; Yang, Liuyang; Tong, Yanan; Wei, Chao; Wang, Zelin; Zou, Quanming; Zeng, Hao

    2016-08-01

    Multi-drug resistant MRSA (methicillin-resistant Staphylococcus aureus) is a global problem for human health, especially skin burn wound patients. Therefore, we estimated the antibacterial and anti-biofilm activity of a chlorhexidine acetate nanoemulsion (CNE) by previously ourselves designed against skin burn wound MRSA infections. Compared with its water solution (CHX), CNE showed a better and faster action against MRSA both in vitro and in vivo. Importantly, CNE was more effective at inhibiting biofilm formation and clearing the biofilm. We also found that the cell walls and membranes of MRSA were severely disrupted after treatment with CNE. Moreover, the relative electrical conductivity and the leakage of alkaline phosphates, K(+), Mg(2+), DNA and protein obviously increased because the cell wall and membrane were damaged. These data show that novel CNE is a promising potential antimicrobial candidate, especially for skin burn wound MRSA infections. PMID:26961464

  6. IL-15 Superagonist Expands mCD8+ T, NK and NKT Cells after Burn Injury but Fails to Improve Outcome during Burn Wound Infection.

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    Naeem K Patil

    Full Text Available Severely burned patients are highly susceptible to opportunistic infections and sepsis, owing to the loss of the protective skin barrier and immunological dysfunction. Interleukin-15 (IL-15 belongs to the IL-2 family of common gamma chain cytokines and stimulates the proliferation and activation of T (specifically memory CD8, NK and NKT cells. It has been shown to preserve T cell function and improve survival during cecal ligation and puncture (CLP-induced sepsis in mice. However, the therapeutic efficacy of IL-15 or IL-15 superagonist (SA during infection after burn injury has not been evaluated. Moreover, very few, if any, studies have examined, in detail, the effect of burn injury and infection on the adaptive immune system. Thus, we examined the effect of burn and sepsis on adaptive immune cell populations and the effect of IL-15 SA treatment on the host response to infection.Mice were subjected to a 35% total body surface area burn, followed by wound infection with Pseudomonas aeruginosa. In some experiments, IL-15 SA was administered after burn injury, but before infection. Leukocytes in spleen, liver and peritoneal cavity were characterized using flow cytometry. Bacterial clearance, organ injury and survival were also assessed.Burn wound infection led to a significant decline in total white blood cell and lymphocyte counts and induced organ injury and sepsis. Burn injury caused decline in CD4+ and CD8+ T cells in the spleen, which was worsened by infection. IL-15 treatment inhibited this decline and significantly increased cell numbers and activation, as determined by CD69 expression, of CD4+, CD8+, B, NK and NKT cells in the spleen and liver after burn injury. However, IL-15 SA treatment failed to prevent burn wound sepsis-induced loss of CD4+, CD8+, B, NK and NKT cells and failed to improve bacterial clearance and survival.Cutaneous burn injury and infection cause significant adaptive immune dysfunction. IL-15 SA does not augment host

  7. Burn wounds infected with Pseudomonas aeruginosa triggers weight loss in rats

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    Su Grace

    2005-09-01

    Full Text Available Abstract Background Despite dramatic improvements in the management of burns, infection still remains a serious risk for the burn patient. The aim of this study was to shed light on the impact of acute burn injury with or without infection on cytokine profiles. Methods Sprague-Dawley rats (n = 21 were randomized into three groups: 1 burn only 2 burn and infection or 3 sham burn. Weight was monitored and blood was collected for cytokine ELISA, LPS quantification, and peripheral blood analysis. Animals were sacrificed either after 6 or 12 days. Results Infected animals showed substantial weight loss until day 6 post-burn as compared to burn alone. Endotoxin and TNF-α levels were elevated early in the infected burn group within 48 hours post-burn. In contrast, significant up-regulation of the anti-inflammatory cytokine IL-10 occurred later in the clinical course and was associated with the recovery from weight loss. Conclusion Our results suggest that in the presence of infection, you get a SIRS response possibly due to transient endotoxemia that is only seen in the infection group. In contrast, both burn and infection get a late IL-10 (CARS response, which is then associated with a return to normal weight in the infection group.

  8. Antibiotic Resistance Pattern of Pseudomonas Aeruginosa, Isolated from Patient with Burn Wound Infection in Guilan,Iran

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    Iraj Nikokar

    2013-03-01

    Full Text Available Background and Objectives: Antibiotic resistance of Pseudomonas aeruginosa remains a major problem in burn patients. The main objective of this study was to determine the antibiotic resistance pattern and frequency of class 1 integrons among P. aeruginosa strains isolated from patients with burn wound infections in a new Burn Centre in Guilan, Iran.Materials and Methods: The bacterial isolates were collected from 182 patients with burn wound infections and P. aeruginosa species were identified by standard bacteriological methods. The drug susceptibility test, using 11 antimicrobial agents, was performed for all the isolates via agar disk diffusion method. PCR was carried out for the detection of integrons.Results: Out of a total of 182 hospitalized patients in the burn center assessed, 86 (47% found to have P. aeruginosa in their isolates. Resistance rates to various antibiotics were as follows: cloxacillin (91.8%, cotrimoxazole (86%, cephazolin (83.7%, carbenicillin (74.4%, piperacillin (69.9%, ceftazidime (68.8%, ciprofloxacin (66.3%, tobramycin (58.2%, amikacin (48.8% and gentamicin (37.2%, while the most effective antibiotic was imipenem with a resistance rate of 23.3%. Thirty nine (45.3% isolates were detected as multi-drug resistant. The PCR results showed that 37 (43% P. aeruginosa isolates and 27 (69.2% multi-drug resistant strains harbored class 1 integrons. A significant correlation was obtained between the presence of integrons and resistance against imipenem, ceftazidime, piperacillin and ciprofloxacin (P < 0.001.Conclusion: Optimization of using antimicrobial agents and control of infection is recommended to prevent the increasing population of drug resistant organisms in the new burn centre setting in this study. Furthermore, the high frequency of class 1 integrons among multi-drug resistant strains might be responsible for dissemination of antibiotic resistance gene.

  9. [Prevention and treatment strategy for burn wound sepsis in children].

    Science.gov (United States)

    Niu, Xihua; Li, Xiaoling

    2016-02-01

    Wound sepsis is one of the main causes of death in patients with severe burn and trauma. The high incidence of burn wound sepsis in children is attributed to their imperfect immune system function, poor resistance against infection, and the weakened skin barrier function after burn. The key to reduce the mortality of pediatric patients with burn wound sepsis is to enhance the understanding of its etiology, epidemiology, pathogenesis, and diagnostic criteria, in order to improve its early diagnosis and treatment. PMID:26902271

  10. Frequency of Pseudomonas aeruginosa serotypes in burn wound infections and their resistance to antibiotics.

    Science.gov (United States)

    Estahbanati, Hamid Karimi; Kashani, Parnian Pour; Ghanaatpisheh, Fahimeh

    2002-06-01

    Pseudomonas aeruginosa plays a prominent role as an etiological agent involved in serious infections in burned patients. In this study P. aeruginosa infections were analyzed at the Motahari Burn Center in Tehran (from 22 December 1998 to April 1999) to estimate their frequency, antibiotic susceptibility and serotypes. One hundred and eighty-four positive cultures and 205 bacterial strains were isolated among swabs or biopsy specimens during the study period. Pseudomonas was found to be the most common (57%) followed by Acinetobacter (17%), Escherichia coli (12%), Staphylococcus aureus (8%) and other organisms (6%). The frequency of P. aeruginosa resistance to gentamicin, ceftizoxime, carbenicillin, cephalothin and ceftazidime was over 90%. The antibiotics to which P. aeruginosa was most sensitive were amikacin and tetracyclin. The "O" serotypes isolated from the 117 Pseudomona aeroginosa isolates were serotypes O:2, O:5, O:6, O:8, O:11, O:12 and O:16. The most common serotype was O:6 (20/17%) followed by O:11 (18/15%) and O:5 (14/12%). The serotype most resistant was O:16 (8%) and the most sensitive was O:8 (2%). Since treatment of infection with available antibiotics according to the results attained proved to be difficult, prevention of infection in the burned patients is considered as an appropriate means of conquering overcoming infection problems. The sum of frequencies of serotypes O:6, O:11, O:5 and O:16 was more than 60%, therefore vaccination of burn patients with polyvalent antiserum to these serotypes could possibly produce immunity in more than half of the burned patients. PMID:12052372

  11. Aloe vera Gel: Effective Therapeutic Agent against Multidrug-Resistant Pseudomonas aeruginosa Isolates Recovered from Burn Wound Infections

    Directory of Open Access Journals (Sweden)

    Mehdi Goudarzi

    2015-01-01

    Full Text Available Objective. Aloe vera is an herbal medicinal plant with biological activities, such as antimicrobial, anticancer, anti-inflammatory, and antidiabetic ones, and immunomodulatory properties. The purpose of this study was investigation of in vitro antimicrobial activity of A. vera gel against multidrug-resistant (MDR Pseudomonas aeruginosa isolated from patients with burn wound infections. Methods. During a 6-month study, 140 clinical isolates of P. aeruginosa were collected from patients admitted to the burn wards of a hospital in Tehran, Iran. Antimicrobial susceptibility test was carried out against the pathogens using the A. vera gel and antibiotics (imipenem, gentamicin, and ciprofloxacin. Results. The antibiogram revealed that 47 (33.6% of all isolates were MDR P. aeruginosa. The extract isolated from A. vera has antibacterial activity against all of isolates. Also, 42 (89.4% isolates were inhibited by A. vera gel extract at minimum inhibitory concentration (MIC ≤ 200 µg/mL. MIC value of A. vera gel for other isolates (10.6% was 800 µg/mL. All of MDR P. aeruginosa strains were inhibited by A. vera at similar MIC50 and MIC90 200 µg/mL. Conclusion. Based on our results, A. vera gel at various concentrations can be used as an effective antibacterial agent in order to prevent wound infection caused by P. aeruginosa.

  12. Burn wound: How it differs from other wounds?

    OpenAIRE

    Tiwari, V K

    2012-01-01

    Management of burn injury has always been the domain of burn specialists. Since ancient time, local and systemic remedies have been advised for burn wound dressing and burn scar prevention. Management of burn wound inflicted by the different physical and chemical agents require different regimes which are poles apart from the regimes used for any of the other traumatic wounds. In extensive burn, because of increased capillary permeability, there is extensive loss of plasma leading to shock wh...

  13. Management of burn wounds.

    Science.gov (United States)

    Schiestl, Clemens; Meuli, Martin; Trop, Marija; Neuhaus, Kathrin

    2013-10-01

    Small and moderate scalds in toddlers are still the most frequent thermal injuries the pediatric surgeons have to face today. Over the last years, surgical treatment of these patients has changed in many aspects. Due to new dressing materials and new surgical treatment strategies that are particularly suitable for children, today, far better functional and aesthetic long-term results are possible. While small and moderate thermal injuries can be treated in most European pediatric surgical departments, the severely burned child must be transferred to a specialized, ideally pediatric, burn center, where a well-trained multidisciplinary team under the leadership of a (ideally pediatric) burn surgeon cares for these highly demanding patients. In future, tissue engineered full thickness skin analogues will most likely play an important role, in pediatric burn as well as postburn reconstructive surgery.

  14. Chloramphenicol encapsulated in poly-ε-caprolactone–pluronic composite: nanoparticles for treatment of MRSA-infected burn wounds

    Directory of Open Access Journals (Sweden)

    Kalita S

    2015-04-01

    Full Text Available Sanjeeb Kalita,1 Banasmita Devi,1 Raghuram Kandimalla,1 Kaustav Kalyan Sharma,1 Arup Sharma,2 Kasturi Kalita,3 Amal Chandra Kataki,4 Jibon Kotoky1 1Institute of Advanced Study in Science and Technology (IASST, Division of Life Sciences, Paschim Boragaon, Garchuk, Guwahati, Assam, India; 2College of Veterinary Science, Assam Agriculture University, Khanapara, Guwahati, Assam, India; 3Hyat Hospital, Lalganesh, Guwahati, Assam, India; 4Dr B Borooah Cancer Institute, Guwahati, Assam, India Abstract: The emergence of methicillin-resistant Staphylococcus aureus (MRSA infection has increased precipitously over the past several decades, with far-reaching health care and societal costs. MRSA infections in the context of burn wounds lead to invasive disease that could potentially cause mortality. Chloramphenicol is a well-known broad-spectrum bacteriostatic antibiotic that has been used since 1949, but due to its hydrophobicity, poor penetration in skin, fast degradation, and toxicity, its application has been hindered. Furthermore, it has been demonstrated that old antibiotics such as chloramphenicol remained active against a large number of currently prevalent resistant bacterial isolates due to their low-level use in the past. Recently, the novel nanoparticulate drug-delivery system has been used and reported to be exceptionally useful for topical therapeutics, due to its distinctive physical characteristics such as a high surface-to-volume ratio and minuscule size. It helps to achieve better hydrophilicity, bioavailability, and controlled delivery with enhanced therapeutic index, which has resulted in decreased toxicity levels compared to the crude drug. Here, we report a novel chloramphenicol loaded with poly(ε-caprolactone (PCL-pluronic composite nanoparticles (CAM-PCL-P NPs, physicochemical characterizations, and its bioactivity evaluation in a MRSA-infected burn-wound animal model. CAM-PCL-P NPs could encapsulate 98.3% of the drug in the

  15. Infection control in severely burned patients

    OpenAIRE

    Coban, Yusuf Kenan

    2012-01-01

    In the last two decades, much progress has been made in the control of burn wound infection and nasocomial infections (NI) in severely burned patients. The continiually changing epidemiology is partially related to greater understanding of and improved techniques for burn patient management as well as effective hospital infection control measures. With the advent of antimicrobial chemotherapeutic agents, infection of the wound site is now not as common as, for example, urinary and blood strea...

  16. Wound Coverage Technologies in Burn Care: Novel Techniques

    OpenAIRE

    Jeschke, Marc G.; Finnerty, Celeste C.; Shahrokhi, Shahriar; Branski, Ludwik K.; Dibildox, Manuel

    2013-01-01

    Improvements in burn wound care have vastly decreased morbidity and mortality in severely burned patients. Development of new therapeutic approaches to increase wound repair has the potential to reduce infection, graft rejection, and hypertrophic scarring. The incorporation of tissue engineering techniques, along with the use of exogenous proteins, genes, or stem cells to enhance wound healing, heralds new treatment regimens based on the modification of already existing biological activity. R...

  17. Nursing Experience of Burn Patients Developed Wound Infection%烧伤患者并发创面感染的护理体会

    Institute of Scientific and Technical Information of China (English)

    黄留华; 黄颖

    2012-01-01

    Objective; To explore burn patients wound infection prevention and nursing intervention. Methods: 90 cases of burn patients were randomly divided into two groups,45 patients in each group. In the control group was given common nursing care; in the observation group, besides conventional care, the nursing of wound infection was added. Results: The observation group of wound infection rate was 8.89% and 28.89% in control group. Two groups of wound infection rates comparative differences have statistically significant ( P<0.05 ). And the observation group wound healing time was significantly lower than than in the control group ( P<0.05 ). Conclusion: Strengthening the burn wound care can effectively control the occurrence of wound infection.%目的:探讨烧伤患者防治创面感染的护理措施.方法:将烧伤病人90例随机分为两组各45例,对照组采取常规护理,观察组在常规护理基础上重点加强创面的感染护理.结果:观察组的创面感染率为8.89%,对照组为28.89%,两组创面感染率比较差异有统计学意义(P<0.05),且观察组创面愈合时间明显低于对照组(P<0.05).结论:通过加强烧伤病人的创面护理,可有效控制创面感染的发生.

  18. BURN WOUND HEALING ACTIVITY OF Euphorbia hirta

    OpenAIRE

    Jaiprakash, B.; Chandramohan,; Reddy, D. Narishma

    2006-01-01

    The Ethanolic extract of whole plant of Euphorbia hirta was screened for burn wound healing activity in rats as 2% W/W cream. The study was carried out based on the assessment of percentage reduction in original wound. It showed significant burn wound healing activity.

  19. One year prevalence of critically ill burn wound bacterial infections in surgical ICU in Egypt: Retrospective study

    Directory of Open Access Journals (Sweden)

    Hossam Mohamed

    2016-07-01

    Results: The main finding of the current study described herein was the percent of isolates from burn wound (60%. The most common organism was pseudomonas (49%. Multidrug resistant gram negative organisms represent about 60% of the isolates. Pattern of antibiotic sensitivity was 84% for colistin, 39% for amikacin and 35% for imipenem. The mortalities in our study were 80%.

  20. Effect of Human Burn Wound Exudate on Pseudomonas aeruginosa Virulence.

    Science.gov (United States)

    Gonzalez, Manuel R; Fleuchot, Betty; Lauciello, Leonardo; Jafari, Paris; Applegate, Lee Ann; Raffoul, Wassim; Que, Yok-Ai; Perron, Karl

    2016-01-01

    Burn wound sepsis is currently the main cause of morbidity and mortality after burn trauma. Infections by notorious pathogens such as Pseudomonas aeruginosa, Staphylococcus aureus, and Acinetobacter baumannii impair patient recovery and can even lead to fatality. In this study, we investigated the effect of burn wound exudates (BWEs) on the virulence of those pathogens. BWEs were collected within 7 days after burn trauma from 5 burn patients. We first monitored their effect on pathogen growth. In contrast to A. baumannii and S. aureus, P. aeruginosa was the only pathogen able to grow within these human fluids. Expression of typical virulence factors such as pyocyanin and pyoverdine was even enhanced compared the levels seen with standard laboratory medium. A detailed chemical composition analysis of BWE was performed, which enabled us to determine the major components of BWE and underline the metabolic modifications induced by burn trauma. These data are essential for the development of an artificial medium mimicking the burn wound environment and the establishment of an in vitro system to analyze the initial steps of burn wound infections. IMPORTANCE Microbial infection of severe burn wounds is currently a major medical challenge. Of the infections by bacteria able to colonize such injuries, those by Pseudomonas aeruginosa are among the most severe, causing major delays in burn patient recovery or leading to fatal issues. In this study, we investigated the growth properties of several burn wound pathogens in biological fluids secreted from human burn wounds. We found that P. aeruginosa strains were able to proliferate but not those of the other pathogens tested. In addition, burn wound exudates (BWEs) stimulate the expression of virulence factors in P. aeruginosa. The chemical composition analysis of BWEs enabled us to determine the major components of these fluids. These data are essential for the development of an artificial medium mimicking the burn wound

  1. Requirements for Pseudomonas aeruginosa Acute Burn and Chronic Surgical Wound Infection

    OpenAIRE

    Turner, Keith H.; Jake Everett; Urvish Trivedi; Rumbaugh, Kendra P.; Marvin Whiteley

    2014-01-01

    Opportunistic infections caused by Pseudomonas aeruginosa can be acute or chronic. While acute infections often spread rapidly and can cause tissue damage and sepsis with high mortality rates, chronic infections can persist for weeks, months, or years in the face of intensive clinical intervention. Remarkably, this diverse infectious capability is not accompanied by extensive variation in genomic content, suggesting that the genetic capacity to be an acute or a chronic pathogen is present in ...

  2. CHARACTERISATION OF BACTERIAL ISOLATES FROM INFECTE D BURN WOUNDS OF PATIENTS ADMITTED IN A TERTIARY LEVEL HEA LTH CARE FACILITY IN NORTHERN REGION OF INDIA

    Directory of Open Access Journals (Sweden)

    Antariksh

    2013-04-01

    Full Text Available ABSTRACT: Infection is an important cause of mortality in bur ns. Emergence of multi drug resistant pathogens in hospital setting has seriously constrained the available therapeutic options. This necessitates periodic review of the iso lation pattern and study of antibiogram of the isolates to strengthen surveillance activities. To determine the bacteriological profile and antimic robial susceptibility pattern of pathogens isolated from infected burn wounds of pati ents admitted in the burns care unit. The present study was carried out over a duration of six months. Pus samples from infected burn wounds were processed following standard protocols. A ntimicrobial susceptibility of the bacterial isolates was performed by Kirby- Bauer dis c diffusion method. A total of 408 bacterial pathogens were isolated from 340 samples. The most fr equent cause of infection was found to be Pseudomonas aeruginosa (53%, followed by Staphyl ococcus aureus (9%, Escherichia coli (9%, Enterobacter spp. (8%, Citrobacter spp. (8%, Kl ebsiella spp. (5%, Acinetobacter spp. (3% and Proteus spp. (3%. High level of drug resist ance (95-100% was observed for cefepime, ceftazidime, amoxyclav, cotrimoxazole and doxycycline among gram negative pathogens. Meropenem, amikacin and ciprofloxacin were found to be most effective. Twenty one percent of the S. aureus isolates were resistant to methicillin. The high prevalence of antimicrobial resistance emphasizes the need for str engthening the infection control practices and regular and periodical surveillance activities t o contain the upward trend of resistance.

  3. Enzyme-responsive nanocomposites for wound infection prophylaxis in burn management: in vitro evaluation of their compatibility with healing processes

    Directory of Open Access Journals (Sweden)

    Grützner V

    2015-06-01

    Full Text Available Verena Grützner,1 Ronald E Unger,1 Grit Baier,2 Lars Choritz,3 Christian Freese,1 Thomas Böse,1 Katharina Landfester,2 C James Kirkpatrick11REPAIR-Lab, Institute of Pathology, University Medical Center, Mainz, 2Max Planck Institute for Polymer Research, Mainz, Germany; 3Department of Ophthalmology, University Clinic, Magdeburg, GermanyAbstract: Responsive, theranostic nanosystems, capable of both signaling and treating wound infections, is a sophisticated approach to reduce the most common and potentially traumatizing side effects of burn wound treatment: slowed wound healing due to prophylactic anti-infective drug exposure as well as frequent painful dressing changes. Antimicrobials as well as dye molecules have been incorporated into biodegradable nanosystems that release their content only in the presence of pathogens. Following nanocarrier degradation by bacterial enzymes, any infection will thus emit a visible signal and be effectively treated at its source. In this study, we investigated the effect of fluorescent-labeled hyaluronan nanocapsules containing polyhexanide biguanide and poly-L-lactic acid nanoparticles loaded with octenidine on primary human dermal microvascular endothelial cells, which play a major role in cutaneous wound healing. Microscopic and flow cytometric analysis indicated a time-dependent uptake of both the nanocapsules and the nanoparticles. However, enzyme immunoassays showed no significant influence on the expression of pro-inflammatory cell adhesion molecules and cytokines by the endothelial cells. Under angiogenic-stimulating conditions, the potential to form capillary-like structures in co-culture with dermal fibroblasts was not inhibited. Furthermore, cytotoxicity studies (the MTS and crystal violet assay after short- and long-term exposure to the materials demonstrated that both systems exhibited less toxicity than solutions of the antiseptic agents alone in comparable concentrations. The results indicate

  4. BACTERIOLOGICAL STUDY OF BURNS INFECTION

    Directory of Open Access Journals (Sweden)

    Shareen

    2015-10-01

    Full Text Available A burn is a wound in which there is coagulative necrosis of the tissue, majority of which are caused by heat. Burn injury is a major public health problem in many areas of the world. Burns predispose to infection by damaging the protective barrier function of the skin, thus facilitating the entry of pa thogenic microorganisms and by inducing systemic immunosuppression . (1 OBJECTIVE : The present study was therefore undertaken to isolate and identify the aerobic bacterial flora in burn patients and its antibiotic susceptibility pattern. MATERIAL & METHODS : A total of 100 patients admitted with different degree of burns were studied. Wound swabs were taken with aseptic precautions by dry sterile cotton swab sticks. These swabs were transported to the microbiology laboratory and the isolates were identified based on standard microbiological methods. Antibiotic susceptibility testing was done by Kirby Bauer’s disc diffusion method. RESULT : A total of 127 bacterial pathogens were isolated from 100 patients. Of these, 69% were monomicrobial in nature and 28% wer e polymicrobial. The most frequent cause of infection was found to be Staphylococcus aureus (39.4%, followed by Pseudomonas aeruginosa (14.2%, Klebsiella pneumonia (13.4%, E.coli (8.7% and Acinetobacter species (7.9%.Out of the total Staphylococcus au reus isolates, 19 were Methicillin sensitive and 31 were Methicillin resistant (MRSA. All the MRSA strains were 100% sensitive to Vancomycin and Linezolid. The Pseudomonas aeruginosa isolates were most sensitive to Amikacin (9 4.4%, Fluroquinolones (61.1% . CONCLUSION : Staphylococcus aureus and Pseudomonas aeruginosa were major causes of infection in burn wounds. Therefore it is necessary to implement urgent measures for restriction of nosocomial infections, sensible limitation on the use of antimicrobial agents, strict disinfection and hygiene.

  5. A preliminary study of the relationship between antibiotic administration and changes in bacteriological profile of wound infection in a burn unit

    Institute of Scientific and Technical Information of China (English)

    Yu Yong; Sheng Zhiyong; Yang Xiaoqiang; Chang Dong; Jiang Wei

    2003-01-01

    Objective:To investigate the relationship between antibiotic administration and the changes in bacteriological profile in a burn unit. Methods: The data of consumption of different kinds of antibiotics, including total antibiotic consumption [expressed as the number of defined daily doses (DDD)] as well as pathogen identification, were collected in a 8-year period. The constituent ratios of different kinds of antibiotics in total antibiotic consumption to isolation rates of various species of bacteria were calculated, and their correlation was analyzed. Results: Within this period, it was found that the aminoglycosides and first generation cephalosporins were used less frequently, while the polypeptides, carbopenem and macrolides were used proportionally more. At the same time, the isolation rates of Staphylococcus aureus, Acinetobacter sp, Enterobacter cloacae, Klebsiella pneumoniae and methicillin-resistant Staphylococcus aureus were gradually increased. The constituent ratios of predominant pathogens were correlated to the different kinds of antibiotics consumption in the burn unit. Conclusion: The results suggested that the consumption of different antibiotics was closely related to the trends of emergence of bacterial isolates from infected burn wounds. The result might imply that to regulate the administration of certain antibiotics might help decrease the emergence of certain pathogenic bacteria in burn infections.

  6. Effects of burn wound excision on bacterial colonization and invasion

    NARCIS (Netherlands)

    Barret, JP; Herndon, DN

    2003-01-01

    Rates of survival after thermal injury have improved in the past two decades, and rates of wound infections and sepsis have decreased during the same period. Early excision has been advocated as one of the major factors, but its safety and efficacy and the exact timing of burn excision are still und

  7. Silk sericin ameliorates wound healing and its clinical efficacy in burn wounds.

    Science.gov (United States)

    Aramwit, Pornanong; Palapinyo, Sirinoot; Srichana, Teerapol; Chottanapund, Suthat; Muangman, Pornprom

    2013-09-01

    The aim of this study was to evaluate the effect of silk sericin, a protein from silkworm cocoon, on scratch wound healing in vitro. For applicable result in clinical use, we also study the efficacy of sericin added to a standard antimicrobial cream, silver zinc sulfadiazine, for open wound care in the treatment of second-degree burn wounds. In vitro scratch assays show that sericin at concentration 100 μg/mL can promote the migration of fibroblast L929 cells similar to epidermal growth factor (positive control) at 100 μg/mL. After 1 day of treatment, the length of scratch in wounds treated with sericin was significantly shorter than the length of negative control wounds (culture medium without sericin). For clinical study, a total of 29 patients with 65 burn wounds which covered no less than 15 % of total body surface area were randomly assigned to either control (wounds treated with silver zinc sulfadiazine cream) or treatment (wounds treated with silver zinc sulfadiazine with added sericin cream) group in this randomized, double-blind, standard-controlled study. The results showed that the average time to reach 70 % re-epithelialization of the burned surface and complete healing in the treatment group was significantly shorter, approximately 5-7 days, than in the control group. Regarding time for complete healing, control wounds took approximately 29.28 ± 9.27 days, while wounds treated with silver zinc sulfadiazine with added sericin cream took approximately 22.42 ± 6.33 days, (p = 0.001). No infection or severe reaction was found in any wounds. This is the first clinical study to show that silk sericin is safe and beneficial for burn wound treatment when it is added to silver sulfadiazine cream. PMID:23748948

  8. Wound Coverage Technologies in Burn Care: Novel Techniques

    Science.gov (United States)

    Jeschke, Marc G.; Finnerty, Celeste C.; Shahrokhi, Shahriar; Branski, Ludwik K.; Dibildox, Manuel

    2013-01-01

    Improvements in burn wound care have vastly decreased morbidity and mortality in severely burned patients. Development of new therapeutic approaches to increase wound repair has the potential to reduce infection, graft rejection, and hypertrophic scarring. The incorporation of tissue engineering techniques, along with the use of exogenous proteins, genes, or stem cells to enhance wound healing, heralds new treatment regimens based on the modification of already existing biological activity. Refinements to surgical techniques have enabled the creation of protocols for full facial transplantation. With new technologies and advances such as these, care of the severely burned will undergo massive changes over the next decade. This review centers on new developments that have recently shown great promise in the investigational arena. PMID:23877140

  9. Modalities for the Assessment of Burn Wound Depth

    OpenAIRE

    Devgan, Lara; Bhat, Satyanarayan; Aylward, S.; Spence, Robert J.

    2006-01-01

    Objective: Burn wound depth is a significant determinant of patient treatment and morbidity. While superficial partial-thickness burns generally heal by re-epithelialization with minimal scarring, deeper wounds can form hypertrophic or contracted scars, often requiring surgical excision and grafting to prevent a suboptimal result. In addition, without timely intervention, more superficial burn wounds can convert to deeper wounds. As such, the rapid and accurate assessment of burn wound depth ...

  10. Diagnostic multiplex polymerase chain reaction assay for the identification of Pseudomonas aeruginosa from the skin biopsy specimens in burn wound infections and detection of antibiotic susceptibility

    International Nuclear Information System (INIS)

    Objective was to identify Pseudomonas aeruginosa (P. aeruginosa) from the skin biopsy specimens in burn wound infections by multiplex polymerase chain reaction (M-PCR) and detection of antimicrobial susceptibility of isolates from culture. We conducted the cross-sectional study in 140 patients with wound infections who admitted to referral burn center of Motahari, Tehran, Iran, during a 12-month period from 2005-2006. Skin biopsy specimens were aseptically taken from each patient, one for PCR and one for bacterial culture. A M-PCR test based on simultaneous amplification of 2 lipoprotein genes: oprI and oprL, was used to directly detect fluorescent pseudomonades and P. aeruginosa in skin biopsy specimens. The susceptibility of P. aeruginosa isolates to 16 antibiotics was determined using the disc diffusion method. Out of 140 biopsy specimens, M-PCR detected 66 (47.2%) isolates, while culture detected 57 (40.7%) isolates as P. aeruginosa. Positive results for both genes which observed only for P. aeruginosa, while only one gene, oprI, was amplified from other fluorescent pseudomonades (n=12) and all other bacterial tested (n=62) were negative by the amplification test. The most effective antibiotics against isolate of P. aeruginosa were cefepime (79%), azetreonam (76%), ticarcillin-clavulanic acid (68%), tobramycin (62%) and amikacin (61%). Multiplex PCR assay appears promising for the rapid and sensitive detection of P. aeruginosa from the burned skin biopsy specimens. Simultaneous amplification of 2 lipoprotein genes: oprI and oprL could detect P. aeruginosa and oprI gene only for other fluorescent pseudomonades. (author)

  11. Fungal Wound Infection

    Centers for Disease Control (CDC) Podcasts

    2016-01-28

    Dr. David Tribble, acting director of the infectious disease clinical research program at Uniformed Services University of the Health Sciences, discusses fungal wound infections after combat trauma.  Created: 1/28/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 1/28/2016.

  12. A Comparative Study of the Wound Healing Properties of Moist Exposed Burn Ointment (MEBO) and Silver Sulphadiazine

    OpenAIRE

    Jewo, P.I.; Fadeyibi, I.O.; Babalola, O.S.; L C Saalu; Benebo, A.S.; Izegbu, M.C.; Ashiru, O.A.

    2009-01-01

    Burns expose the deeper tissues of the skin or body to invasive microbes. Topical preparations for treating burn wounds, to be useful, should ideally have antibiotic power and promote healing. Silver compounds have been the mainstay of topical burn treatment for decades. However, most chemical substances retard wound healing. Several natural agents such as honey and moist exposed burn ointment (MEBO) are believed to protect wounds from infection and promote healing without causing any of the ...

  13. Dual therapeutic functions of F-5 fragment in burn wounds: preventing wound progression and promoting wound healing in pigs.

    Science.gov (United States)

    Bhatia, Ayesha; O'Brien, Kathryn; Chen, Mei; Wong, Alex; Garner, Warren; Woodley, David T; Li, Wei

    2016-01-01

    Burn injuries are a leading cause of morbidity including prolonged hospitalization, disfigurement, and disability. Currently there is no Food and Drug Administration-approved burn therapeutics. A clinical distinction of burn injuries from other acute wounds is the event of the so-called secondary burn wound progression within the first week of the injury, in which a burn expands horizontally and vertically from its initial boundary to a larger area. Therefore, an effective therapeutics for burns should show dual abilities to prevent the burn wound progression and thereafter promote burn wound healing. Herein we report that topically applied F-5 fragment of heat shock protein-90α is a dual functional agent to promote burn wound healing in pigs. First, F-5 prevents burn wound progression by protecting the surrounding cells from undergoing heat-induced caspase 3 activation and apoptosis with increased Akt activation. Accordingly, F-5-treated burn and excision wounds show a marked decline in inflammation. Thereafter, F-5 accelerates burn wound healing by stimulating the keratinocyte migration-led reepithelialization, leading to wound closure. This study addresses a topical agent that is capable of preventing burn wound progression and accelerating burn wound healing.

  14. Infections in critically ill burn patients.

    Science.gov (United States)

    Hidalgo, F; Mas, D; Rubio, M; Garcia-Hierro, P

    2016-04-01

    Severe burn patients are one subset of critically patients in which the burn injury increases the risk of infection, systemic inflammatory response and sepsis. The infections are usually related to devices and to the burn wound. Most infections, as in other critically ill patients, are preceded by colonization of the digestive tract and the preventative measures include selective digestive decontamination and hygienic measures. Early excision of deep burn wound and appropriate use of topical antimicrobials and dressings are considered of paramount importance in the treatment of burns. Severe burn patients usually have some level of systemic inflammation. The difficulty to differentiate inflammation from sepsis is relevant since therapy differs between patients with and those without sepsis. The delay in prescribing antimicrobials increases morbidity and mortality. Moreover, the widespread use of antibiotics for all such patients is likely to increase antibiotic resistance, and costs. Unfortunately the clinical usefulness of biomarkers for differential diagnosis between inflammation and sepsis has not been yet properly evaluated. Severe burn injury induces physiological response that significantly alters drug pharmacokinetics and pharmacodynamics. These alterations impact antimicrobials distribution and excretion. Nevertheless the current available literature shows that there is a paucity of information to support routine dose recommendations.

  15. Antimicrobial resistance pattern of bacterial isolates from burn wounds in an Iranian University Hospital

    OpenAIRE

    Sabzghabaee, Ali Mohammad; Abedi, Daryoush; Fazeli, Hossein; Javadi, Abbasali; Jalali, Mohammad; Maracy, Mohammad Reza; Soltani, Rasool; Karamyafti, Mohammad Javad

    2012-01-01

    Objective: About 73% of death cases in the first 5 days after burning are due to infection complications. The aim of this study was to identify the causing agents of infections in burn patients and the sensitivity pattern of them to the commonly used antimicrobials in an Iranian Burn center University Hospital. Methods: In this cross-sectional study, patients who were admitted to one of the Iranian Burn center University hospitals in 2009 and had nosocomial infection due to burn wound, whom r...

  16. Combination of silver nanoparticles and Drosera binata extract as a possible alternative for antibiotic treatment of burn wound infections caused by resistant Staphylococcus aureus.

    Science.gov (United States)

    Krychowiak, Marta; Grinholc, Mariusz; Banasiuk, Rafal; Krauze-Baranowska, Miroslawa; Głód, Daniel; Kawiak, Anna; Królicka, Aleksandra

    2014-01-01

    Staphylococcus aureus is the most common infectious agent involved in the development of skin infections that are associated with antibiotic resistance, such as burn wounds. As drug resistance is a growing problem it is essential to establish novel antimicrobials. Currently, antibiotic resistance in bacteria is successfully controlled by multi-drug therapies. Here we demonstrate that secondary metabolites present in the extract obtained from Drosera binata in vitro cultures are effective antibacterial agents against S. aureus grown in planktonic culture and in biofilm. Moreover, this is the first report demonstrating the synergistic interaction between the D. binata extract and silver nanoparticles (AgNPs), which results in the spectacular enhancement of the observed bactericidal activity, while having no cytotoxic effects on human keratinocytes. Simultaneous use of these two agents in significantly reduced quantities produces the same effect, i.e. by killing 99.9% of bacteria in inoculum or eradicating the staphylococcal biofilm, as higher amounts of the agents used individually. Our data indicates that combining AgNPs with either the D. binata extract or with its pure compound (3-chloroplumbagin) may provide a safe and highly effective alternative to commonly used antibiotics, which are ineffective towards the antibiotic-resistant S. aureus. PMID:25551660

  17. Combination of silver nanoparticles and Drosera binata extract as a possible alternative for antibiotic treatment of burn wound infections caused by resistant Staphylococcus aureus.

    Directory of Open Access Journals (Sweden)

    Marta Krychowiak

    Full Text Available Staphylococcus aureus is the most common infectious agent involved in the development of skin infections that are associated with antibiotic resistance, such as burn wounds. As drug resistance is a growing problem it is essential to establish novel antimicrobials. Currently, antibiotic resistance in bacteria is successfully controlled by multi-drug therapies. Here we demonstrate that secondary metabolites present in the extract obtained from Drosera binata in vitro cultures are effective antibacterial agents against S. aureus grown in planktonic culture and in biofilm. Moreover, this is the first report demonstrating the synergistic interaction between the D. binata extract and silver nanoparticles (AgNPs, which results in the spectacular enhancement of the observed bactericidal activity, while having no cytotoxic effects on human keratinocytes. Simultaneous use of these two agents in significantly reduced quantities produces the same effect, i.e. by killing 99.9% of bacteria in inoculum or eradicating the staphylococcal biofilm, as higher amounts of the agents used individually. Our data indicates that combining AgNPs with either the D. binata extract or with its pure compound (3-chloroplumbagin may provide a safe and highly effective alternative to commonly used antibiotics, which are ineffective towards the antibiotic-resistant S. aureus.

  18. Burn wound: Pathophysiology and its management by herbal plants

    Directory of Open Access Journals (Sweden)

    Dhirender Kaushik

    2013-01-01

    Full Text Available In human body, wound healing is a normal biological phenomenon. Burns may be acute or chronic depending upon the source and its time of exposure. Burn wounds may be superficial, partial or full thickness wounds. When skin comes in contact with higher temperature, protein denaturation takes place due to which the plasma membrane integrity is lost. When skin is burned, a number of inflammatory mediators and releasing agents such as histamine, nitric oxide, oxygen free radicals, eicosanoid products, tumor necrosis factors, and interleukins etc., are released at the site. For wound healing mechanism, the keratinocytes has to move from uninjured site to the burned area. For deeper burns this process takes a long time. By some unknown mechanisms, burn wounds may convert from one form to another form. So burn wound depth must be accurately measured before starting the treatment to prevent the complications. Burns can be induced in experimental animals by using different models. Many treatments such as herbal drugs, topical agents, gene therapy, volume therapy, and rehabilitation can be employed. This review article mainly deals with the theoretical and practical aspects of burn wound healing. Some burn wound healing plants with their chemical constituents, plant part used, uses and animal models are described here.

  19. Clinical observation on treating infected wounds with the moist burn ointment%湿润烧伤膏治疗感染伤口的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    邓国华

    2014-01-01

    目的:观察湿润烧伤膏(MEBO)治疗感染伤口的临床疗效。方法:82例患者感染伤口应用湿润烧伤膏治疗。结果:82例患者全部愈合,治愈率为100%。愈合创面平整,无挛缩畸形,无明显功能障碍。结论:湿润烧伤膏治疗手术切口感染有较好的治疗效果。%Objective: To observe clinical curative effects of the moist burn ointment (MEBO) for infected wounds. Methods: 82 patients with infected wounds were given moist burn cream treatment。 Results: 82 patients were all healed, the cure rate is 100%;the wound was flat, ther was no contracture deformity, no obvious dysfunction. Conclusion:Moist burn cream for surgical incision infection has good therapeutic effect.

  20. Investigation of wound healing activity of Lantana camara L. in Sprague dawley rats using a burn wound model

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    B S Nayak

    2008-03-01

    Full Text Available Summary: Lantana camara is used in herbal medicine for the treatment of skin itches, as an antiseptic for wounds, and externally for leprosy and scabies. The objective of our study is to investigate burn wound healing activity of the leaf extract of L.camara in rats. The animals were divided into two groups of 6 each. The test group animals were treated with the ethanol extract of L. camara (100 mg kg-1 day-1 topically and the control group animals were left untreated. Healing was assessed by the rate of wound contraction, period of epithelialization. Antimicrobial activities of the extract against the specific microorganisms were assessed. The extract showed antimicrobial activity against Staphylococcus aureus, Klebsiella Pneumoniae and E.coli. Extract treated wounds were healed in about 21 days which is not distinct from the controls. Our data suggest that L.camara has antimicrobial activity but not wound healing promoting activity on burn wound.   Industrial relevance: Extensive work has been done on the L. camara and demonstrated the antimicrobial and fungicidal activity of its chemical constituents. Lantana oil is used for the treatment of skin itches and as an antiseptic for wounds. It has been used in folk medicine for the treatment of cancers, chicken pox, measles, ulcers, swellings, eczema. Our earlier work showed the healing activity on excision wound model. However, there is no data to support the wound healing activity of L. camara on burn wound. Hence, we have conducted the present study to explore the wound healing activity and the antimicrobial activities of L. camara against the specific microorganisms which generally infect burn wound.

  1. American Burn Association consensus conference to define sepsis and infection in burns.

    Science.gov (United States)

    Greenhalgh, David G; Saffle, Jeffrey R; Holmes, James H; Gamelli, Richard L; Palmieri, Tina L; Horton, Jureta W; Tompkins, Ronald G; Traber, Daniel L; Mozingo, David W; Deitch, Edwin A; Goodwin, Cleon W; Herndon, David N; Gallagher, James J; Sanford, Art P; Jeng, James C; Ahrenholz, David H; Neely, Alice N; O'Mara, Michael S; Wolf, Steven E; Purdue, Gary F; Garner, Warren L; Yowler, Charles J; Latenser, Barbara A

    2007-01-01

    Because of their extensive wounds, burn patients are chronically exposed to inflammatory mediators. Thus, burn patients, by definition, already have "systemic inflammatory response syndrome." Current definitions for sepsis and infection have many criteria (fever, tachycardia, tachypnea, leukocytosis) that are routinely found in patients with extensive burns, making these current definitions less applicable to the burn population. Experts in burn care and research, all members of the American Burn Association, were asked to review the literature and prepare a potential definition on one topic related to sepsis or infection in burn patients. On January 20, 2007, the participants met in Tucson, Arizona to develop consensus for these definitions. After review of the definitions, a summary of the proceedings was prepared. The goal of the consensus conference was to develop and publish standardized definitions for sepsis and infection-related diagnoses in the burn population. Standardized definitions will improve the capability of performing more meaningful multicenter trials among burn centers.

  2. On-Demand Dissolution of a Dendritic Hydrogel-based Dressing for Second-Degree Burn Wounds through Thiol-Thioester Exchange Reaction.

    Science.gov (United States)

    Konieczynska, Marlena D; Villa-Camacho, Juan C; Ghobril, Cynthia; Perez-Viloria, Miguel; Tevis, Kristie M; Blessing, William A; Nazarian, Ara; Rodriguez, Edward K; Grinstaff, Mark W

    2016-08-16

    An adhesive yet easily removable burn wound dressing represents a breakthrough in second-degree burn wound care. Current second-degree burn wound dressings absorb wound exudate, reduce bacterial infections, and maintain a moist environment for healing, but are surgically or mechanically debrided from the wound, causing additional trauma to the newly formed tissues. We have developed an on-demand dissolvable dendritic thioester hydrogel burn dressing for second-degree burn care. The hydrogel is composed of a lysine-based dendron and a PEG-based crosslinker, which are synthesized in high yields. The hydrogel burn dressing covers the wound and acts as a barrier to bacterial infection in an in vivo second-degree burn wound model. A unique feature of the hydrogel is its capability to be dissolved on-demand, via a thiol-thioester exchange reaction, allowing for a facile burn dressing removal. PMID:27410669

  3. Burn Wound Cleansing - A Myth or a Scientific Practice

    OpenAIRE

    Hayek, S; El Khatib, A.; Atiyeh, B.

    2010-01-01

    Burn wound cleansing is an integral step in every wound management protocol. Yet a lot of this practice is based on myth rather than real scientific basis. The literature is poor in scientific papers comparing the outcome of patients who underwent wound cleansing to those who did not. A survey form was designed by the Mediterranean Council for Burns and Fire Disasters - MBC and sent by e-mail to its members as well as members of the European Burn Association and other burn specialists, and 76...

  4. Gram-Negative Bacterial Infection in Thigh Abscess Can Migrate to Distant Burn Depending on Burn Depth

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    Victoria Hamrahi

    2012-01-01

    Full Text Available Sepsis remains the major cause of death in patients with major burn injuries. In the present investigation we evaluated the interaction between burn injuries of varying severity and preexisting distant infection. We used Gram-negative bacteria (Pseudomonas aeruginosa and Proteus mirabilis that were genetically engineered to be bioluminescent, which allowed for noninvasive, sequential optical imaging of the extent and severity of the infection. The bioluminescent bacteria migrated from subcutaneous abscesses in the leg to distant burn wounds on the back depending on the severity of the burn injury, and this migration led to increased mortality of the mice. Treatment with ciprofloxacin, injected either in the leg with the bacterial infection or into the burn eschar, prevented this colonization of the wound and decreased mortality. The present data suggest that burn wounds can readily become colonized by infections distant from the wound itself.

  5. Wound Coverage Technologies in Burn Care: Established Techniques

    Science.gov (United States)

    Jeschke, Marc G.; Shahrokhi, Shahriar; Finnerty, Celeste C.; Branski, Ludwik K.; Dibildox, Manuel

    2013-01-01

    Major advances in burn care have reduced post-burn morbidity and mortality. The development and incorporation of new wound healing modalities into the clinical arena have contributed to this improvement by allowing standard-of-care regimens to be established. These regimens range from early excision to the use of cultured epithelial autograft. Here, we review the wound care options that are now well established and used by many burn surgeons. PMID:24165670

  6. Bee Pollen as a Promising Agent in the Burn Wounds Treatment

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    Paweł Olczyk

    2016-01-01

    Full Text Available The aim of the present study was to visualize the benefits and advantages derived from preparations based on extracts of bee pollen as compared to pharmaceuticals commonly used in the treatment of burns. The bee pollen ointment was applied for the first time in topical burn treatment. Experimental burn wounds were inflicted on two white, domestic pigs. Clinical, histopathological, and microbiological assessment of specimens from burn wounds, inflicted on polish domestic pigs, treated with silver sulfadiazine or bee pollen ointment, was done. The comparative material was constituted by either tissues obtained from wounds treated with physiological saline or tissues obtained from wounds which were untreated. Clinical and histopathological evaluation showed that applied apitherapeutic agent reduces the healing time of burn wounds and positively affects the general condition of the animals. Moreover the used natural preparation proved to be highly effective antimicrobial agent, which was reflected in a reduction of the number of microorganisms in quantitative research and bactericidal activity of isolated strains. On the basis of the obtained bacteriological analysis, it may be concluded that the applied bee pollen ointment may affect the wound healing process of burn wounds, preventing infection of the newly formed tissue.

  7. Boron and Poloxamer (F68 and F127) Containing Hydrogel Formulation for Burn Wound Healing.

    Science.gov (United States)

    Demirci, Selami; Doğan, Ayşegül; Karakuş, Emre; Halıcı, Zekai; Topçu, Atila; Demirci, Elif; Sahin, Fikrettin

    2015-11-01

    Burn injuries, the most common and destructive forms of wounds, are generally accompanied with life-threatening infections, inflammation, reduced angiogenesis, inadequate extracellular matrix production, and lack of growth factor stimulation. In the current study, a new antimicrobial carbopol-based hydrogel formulated with boron and pluronic block copolymers was evaluated for its healing activity using in vitro cell culture techniques and an experimental burn model. Cell viability, gene expression, and wound healing assays showed that gel formulation increased wound healing potential. In vitro tube-like structure formation and histopathological examinations revealed that gel not only increased wound closure by fibroblastic cell activity, but also induced vascularization process. Moreover, gel formulation exerted remarkable antimicrobial effects against bacteria, yeast, and fungi. Migration, angiogenesis, and contraction-related protein expressions including collagen, α-smooth muscle actin, transforming growth factor-β1, vimentin, and vascular endothelial growth factor were considerably enhanced in gel-treated groups. Macrophage-specific antigen showed an oscillating expression at the burn wounds, indicating the role of initial macrophage migration to the wound site and reduced inflammation phase. This is the first study indicating that boron containing hydrogel is able to heal burn wounds effectively. The formulation promoted burn wound healing via complex mechanisms including stimulation of cell migration, growth factor expression, inflammatory response, and vascularization.

  8. [A discussion regarding reconstruction and rehabilitation of patients with deep burn wound].

    Science.gov (United States)

    Hu, Da-hai

    2009-12-01

    With the advances in resuscitation, infection control, and metabolic management, the treatment strategies for burn patients have improved remarkably in the last half century. As a result, more patients with deep burn wound survived, and how to optimize the burn wound care aiming at recovery of the normal appearance and physiologic function of patients has been investigated and discussed widely through both the whole treatment strategy making and the new techniques performing. In the present discussion, early tissue reconstruction as well as early wound covering and repair are emphasized by summarizing the improved aesthetic and functional effects obtained by applying the principles of plastic surgery in early burn wound repair, the use of composite skin grafting, the grafting with split-thickness autografts on the preserved denatured dermis or on the preserved healthy fat tissue, etc. Besides these, more attention should be given to the repair and reconstruction in specialized functional parts of the body, such as head and face, neck, hand, female breast, perineum, and joint areas, after a deep burn. The role of rehabilitation during and after the burn wound treatment process is elucidated by demonstrating its potential biophysical mechanism and preventing scar deformity. Adequate treatment of deep burn wound demands a number of important measures including the timing of surgery, adoption of essential techniques, suitable types of wound covering materials, motivated rehabilitation, and necessary psychological therapy. The optimal recovery of damaged part of body after burn should depend on the similarity of rebuild tissue structure to simulate the nature of the original tissue in the cellular, histological, anatomic characteristics, which is the aim of all burn wound care and the basis of the appearance and function repair or reconstruction.

  9. Debridement Techniques in Pediatric Trauma and Burn-Related Wounds

    Science.gov (United States)

    Block, Lisa; King, Timothy W.; Gosain, Ankush

    2015-01-01

    Significance: Traumatic injuries are the leading cause of morbidity and mortality in children. The purpose of this review is to provide an overview of the initial assessment and management of traumatic and burn wounds in children. Special attention is given to wound cleansing, debridement techniques, and considerations for pain management and psychosocial support for children and families. Recent Advances: Basic and translational research over the last 5–7 years has advanced our knowledge related to the optimal care of acute pediatric traumatic and burn wounds. Data concerning methods, volume, solution and timing for irrigation of acute traumatic wounds, timing and methods of wound debridement, including hydrosurgery and plasma knife coblation, and wound dressings are presented. Additionally, data concerning the long-term psychosocial outcomes following acute injury are presented. Critical Issues: The care of pediatric trauma and burn-related wounds requires prompt assessment, pain control, cleansing, debridement, application of appropriate dressings, and close follow-up. Ideally, a knowledgeable multidisciplinary team cares for these patients. A limitation in the care of these patients is the relative paucity of data specific to the care of acute traumatic wounds in the pediatric population. Future Directions: Research is ongoing in the arenas of new debridement techniques and instruments, and in wound dressing technology. Dedicated research on these topics in the pediatric population will serve to strengthen and advance the care of pediatric patients with acute traumatic and burn wounds. PMID:26487978

  10. New treatment strategies to reduce burn wound progression

    Directory of Open Access Journals (Sweden)

    Schmauss, Daniel

    2014-01-01

    Full Text Available [english] Background: After a burn injury certain superficial partial-thickness burn wounds spontaneously progress into deep partial-thickness or full-thickness burn wounds. This poorly understood phenomenon is called burn wound progression. The aim of this study was to investigate whether treatment strategies using warm water (preservation of microcirculation on the one side and erythropoietin (EPO (molecule with anti-inflammatory, anti-apoptotic, vasodilatory and neoangiogenic properties can prevent, delay and/or reduce secondary burn wound progression in a rat model.Methods: We used a burn comb model in 63 rats, creating eight rectangular contact burns (2x1 cm each intercalated by unburned zones (2x0.5 cm prone to burn wound progression. In a first experimental set we treated burn wounds with locally applied warm (37°C or cold (17°C water for 20 minutes.In a second experimental set, animals were treated systemically with EPO at two different dosages of 500 and 2,500 IU/kg bodyweight (bw and initiated at 2 different time-points (45 minutes vs. 6 hours after burn injury. Evaluation of microcirculatory perfusion, interspace necrosis and burn depth was performed using respectively laser Doppler flowmetry, planimetry and histology. For statistical analysis the two-way ANOVA-test followed by an adequate post-hoc test (Bonferroni were used. Results: In untreated control animals a conversion from superficial to full-thickness burns was observed within 24 hours. Warm and cold water treatment significantly delayed burn depth progression, nevertheless after 4 days, burn depth was similar in all three groups. Warm water significantly reduced interspace necrosis compared to untreated controls and cold water with a significantly improved perfusion in the warm water group. Surface extension and particularly burn depth progression were significantly decreased by EPO only if administered at a dosage of bw and initiated 45 minutes after burn injury. EPO

  11. Antibacterial susceptibility of bacteria isolated from burns and wounds of cancer patients

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    Sulaiman A. Alharbi

    2014-01-01

    Full Text Available In this study 540 burns and wound swabs were collected from cancer patients of some Egyptian hospitals. The single infection was detected from 210, and 70 cases among wounded and burned patients, while mixed infection was 30 and 45, respectively. We recovered where 60 isolates of Pseudomonas aeruginosa, 60 isolates of Staphylococcus aureus, 7 isolates of Staphylococcus epidermidis, 4 isolates of Streptococcus pyogenes, 25 isolates of Escherichia coli, 23 isolates of Klebsiella pneumoniae and 27 isolates of Proteus vulgaris from 355 burn and surgical wound infections . All bacterial isolates showed high resistance to the commonly used β-lactams (amoxycillin, cefaclor, ampicillin, vancomycin, amoxicillin/clavulonic, and low resistance to imepenim and ciprofloxacin. Plasmid analysis of six multidrug resistant and two susceptible bacterial isolates revealed the same plasmid pattern. This indicated that R-factor is not responsible for the resistance phenomenon among the isolated opportunistic bacteria. The effect of ultraviolet radiation on the isolated bacteria was studied.

  12. Risk factors for wound infections in burn patients and preventive countermeasures%烧伤患者创面感染危险因素分析及预防对策

    Institute of Scientific and Technical Information of China (English)

    廖米荣; 章伏生; 叶礼岳; 王史辉; 林邦长

    2012-01-01

    OBJECTIVE To probe into the risk factors and preventive measures for wound infections in the burn patients so as to provide reference for the selection of effective therapy. METHODS The burn patients who enrolled the hospital from Dec 2010 to Dec 2011 were selected, totally 150 patients were positive for the wound bacterial culture,the incidence of the wound infections, the constituent ratio of the pathogens and the correlation with the age and burn area were statistically analyzed. RESULTS There were 420 burn patients investigated, 150 patients had wound infections, the infection rate was 35. 71%. ; there were 367 strains of pathogens cultured from 150 patients with wound infections , including 182 (49, 59%) strains of gram-negative bacteria, 143 (38. 96%) strains of gram-positive bacteria, and 42 (11. 44%) strains of fungi; the incidence of the wound infections increased as the patients' age got older and older, compared with the patients at the age of less than 20 years, the incidence of the wound infections in the patients at the age more than 20 years was significantly increased, the difference was statistically significant (P<0. 05) ; the wound infection rate was increased with the burn area, compared with the patients with the burn area less than 20% , the wound infection rate of the patients with the burn area more than 20% was significantly increased, the difference was statistically significant (P<0. 05). CONCLUSION In the course of treatmentof burn patients, the effective prevention measures should be taken on the basis of the specific condition of the patients to control the wound infections, relieve the patients and promote the recovery of the patients in early stage.%目的 探讨烧伤患者创面感染的相关危险因素以及预防对策,为临床选择有效的治疗方案提供参考依据.方法 选择2010年12月-2011年12月医院收治的烧伤患者,并经创面细菌培养阳性患者150例,统计分析患者创面感染率、病原菌

  13. Study of Bacterial Infections among Burn Patients Hospitalized in Isfahan Burn Center

    Directory of Open Access Journals (Sweden)

    J. Faghri

    2007-10-01

    Full Text Available Introduction & Objective: Burn patients are at risk of acquiring infection because of destroy skin barrier, suppression of immunity, prolonged hospitalization, and invasive therapeutic and diagnostic procedure, risk of acquiring infection is high among burned patients. The aim of this study was to assess the incidence rate of bacterial etiology and infections among burn patients in the burn center of Isfahan. Materials & Methods: The study was conducted descriptive – cross sectional during a period of one year, (from august 2004 until September 2005. A total of 106 patients presenting with no signs and symptoms of infection within the first 48 hours of admission were included. CDC definition for nosocomial infections was applied. Each patient’s clinical examinations and records investigated daily. Swab culture, blood culture (during fever time, tissue culture from biopsy specimen of burn wound and urine culture obtained. The data were analyzed and interpreted using SPSS 10 Software, using Chi – square and Kappa Coefficient. P.value < 0.05 was significant. Results: One-hundred and six patients met the inclusion criteria, 91 (85/8% acquired at least one type of infection, including, urinary tract 28 (26/4%, blood stream 30 (28/3%, and burn wound 91(85/8%. Pseudomonas aeroginosa was the most common causative agent isolated from blood culture and swab culture, 27/42% and 54/4% respectively. Also, E.coli was the major casautive agent of urinary tract infections (6.4% isolated from urine culture of these burn patients.Conclusion: The results indicated that, biopsy from burn wounds and study of histopathologic specimen day by other day depends on blood and urine culture conditions overall can be effective for early detection of burn wounds infections.

  14. The burn wound inflammatory response is influenced by midazolam.

    Science.gov (United States)

    Babcock, George F; Hernandez, Laura; Yadav, Ekta; Schwemberger, Sandy; Dugan, Amy

    2012-02-01

    Burn patients requiring hospitalization are often treated for anxiety with benzodiazepines (BDZs). Benzodiazepines are reported to influence immune system function. Immune system alterations are a major cause of burn-induced mortality. We wanted to determine whether the BDZ, midazolam given daily at an anxiolytic dose, had any influence on the burn injury-induced inflammatory response in the blood and wound. Mice received a 15% total body surface area flame burn and received either midazolam 1 mg/kg i.p. or saline 0.1 ml daily. Blood and skin wounds were harvested 24 h after injection on post-burn day 2, 3, 7, or 8. Mice treated with midazolam had significantly lower serum IL-1β (p=0.002), TNF-α (p=0.002), IL-6 (p=0.016), IL-10 (p=0.009), and TGF-β (p=0.004) than saline-treated mice, with little impact on serum chemokine levels. In the wound, TNF-α and IL-10 were the only cytokines significantly influenced by the drug, being lower (p=0.018) and higher (p=0.006), respectively. The chemokines in the wound influenced significantly by midazolam were MIP-1α, MIP-1β, and MIP-2 while MCP-1 and KC were not. There were more inflammatory cells at the burn wound margin in midazolam-treated mice on post-burn day 3. Although serum nitrate/nitrite was significantly increased by midazolam (p=0.03), both eNOS and iNOS mRNA expression in the wound were similar to the saline group. We found that midazolam given daily after burn injury significantly influenced the inflammatory response. The clinical implications of these findings on wound healing and shock following burn injury, especially larger burns, deserve further investigation.

  15. Honey for Wound Healing, Ulcers, and Burns; Data Supporting Its Use in Clinical Practice

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    Noori Al-Waili

    2011-01-01

    Full Text Available The widespread existence of unhealed wounds, ulcers, and burns has a great impact on public health and economy. Many interventions, including new medications and technologies, are being used to help achieve significant wound healing and to eliminate infections. Therefore, to find an intervention that has both therapeutic effect on the healing process and the ability to kill microbes is of great value. Honey is a natural product that has been recently introduced in modern medical practice. Honey's antibacterial properties and its effects on wound healing have been thoroughly investigated. Laboratory studies and clinical trials have shown that honey is an effective broad-spectrum antibacterial agent. This paper reviews data that support the effectiveness of natural honey in wound healing and its ability to sterilize infected wounds. Studies on the therapeutic effects of honey collected in different geographical areas on skin wounds, skin and gastric ulcers, and burns are reviewed and mechanisms of action are discussed. (Ulcers and burns are included as an example of challenging wounds. The data show that the wound healing properties of honey include stimulation of tissue growth, enhanced epithelialization, and minimized scar formation. These effects are ascribed to honey's acidity, hydrogen peroxide content, osmotic effect, nutritional and antioxidant contents, stimulation of immunity, and to unidentified compounds. Prostaglandins and nitric oxide play a major role in inflammation, microbial killing, and the healing process. Honey was found to lower prostaglandin levels and elevate nitric oxide end products. These properties might help to explain some biological and therapeutic properties of honey, particularly as an antibacterial agent or wound healer. The data presented here demonstrate that honeys from different geographical areas have considerable therapeutic effects on chronic wounds, ulcers, and burns. The results encourage the use of honey

  16. Nanoemulsion Therapy for Burn Wounds Is Effective as a Topical Antimicrobial Against Gram-Negative and Gram-Positive Bacteria.

    Science.gov (United States)

    Dolgachev, Vladislav A; Ciotti, Susan M; Eisma, Rone; Gracon, Stephen; Wilkinson, J Erby; Baker, James R; Hemmila, Mark R

    2016-01-01

    The aim of this study is to investigate the antimicrobial efficacy of two different nanoemulsion (NE) formulations against Gram-positive and Gram-negative bacteria in an in vivo rodent scald burn model. Male Sprague-Dawley rats were anesthetized and received a partial-thickness scald burn. Eight hours after burn injury, the wound was inoculated with 1 × 10(8) colony-forming units of Pseudomonas aeruginosa or Staphylococcus aureus. Treatment groups consisted of two different NE formulations (NB-201 and NB-402), NE vehicle, or saline. Topical application of the treatment was performed at 16 and 24 hours after burn injury. Animals were killed 32 hours after burn injury, and skin samples were obtained for quantitative wound culture and determination of dermal inflammation markers. In a separate set of experiments, burn wound progression was measured histologically after 72 hours of treatment. Both NE formulations (NB-201 and NB-402) significantly reduced burn wound infections with either P. aeruginosa or S. aureus and decreased median bacterial counts at least three logs when compared with animals with saline applications (p wound as measured by myeloperoxidase (MPO) assay and histopathology (p wound progression 72 hours after injury. Topically applied NB-201 and NB-402 are effective in decreasing Gram-positive and Gram-negative bacteria growth in burn wounds, reducing inflammation, and abrogating burn wound progression. PMID:26182074

  17. An understanding of burn infection%对烧伤感染的认识

    Institute of Scientific and Technical Information of China (English)

    许伟石

    2008-01-01

    Burn infection occurs when pathogenic bacte-ria colonized on the burn wound surfate,and they then invaded the viable tissue causing sepsis or sepsis with blood stream inva-sion.This infection pattern is particular to burn injury.Both in a model of pseudomonas burn wound sepsis and a clinical study of early eschar excision for bacteria quantification indicate that the bacteria not only are located on the burn wound surface but also invaded the deeper tissues.Finally,the bacteria penetrate into the neighboring viable tissue and even blood ves-sels.Therefore,we can say that burn infection is from local wound infection to invasive infection.and finally sepsis is devel-oped,and it is termed as burn wound sepsis.The cutoff count of subeschar tissue bacteria is 105/g.However,the burn wound sepsis may not occur when the number of subeschar tissue bacteria reaches 105/g.The criteria for the diagnosis of burn wound sepsis are mainly listed as below:(1)The number of bacteria in the subes-char reaches≥105/g.(2)Bacteria can be detected in the biopsy specimen.(3)Sepsis associated symptoms and signs.However,the sepsis associated symptoms and signs must be obvious in patients to make the clinical diagnosis of burn wound sepsis.If the sepsis associated symptoms and signs do not ap-pear.we should not make the diagnosis of burn wound sepsis e-ven with the number of bacteria in the subeschar tissue reaching 105/g or bacteria can be found in the biopsy specimen.Sepsis has been defined as the body's response to bacteria and their products.The occurrence of sepsis depends primarily on immune function and stress response intensity.and it is closely related to wound infection degree such as bacteria density and invasion depth in the burn wound,or plasma endotoxin level to certain extent.

  18. Aloe vera and Vitis vinifera improve wound healing in an in vivo rat burn wound model.

    Science.gov (United States)

    Lin, Li-Xin; Wang, Peng; Wang, Yu-Ting; Huang, Yong; Jiang, Lei; Wang, Xue-Ming

    2016-02-01

    Aloe vera and Vitis vinifera have been traditionally used as wound healing agents. The present study aimed to investigate the effects of aloe emodin and resveratrol in the burn wound healing procedure. Burn wounds are common in developed and developing countries, however, in developing countries, the incidence of severe complications is higher and financial resources are limited. The results of the present study demonstrated that neither aloe emodin or resveratrol were cytotoxic to THP-1 macrophages at concentrations of 1, 100 and 500 ng/ml. A significant increase in wound-healing activity was observed in mice treated with the aloe emodin and resveratrol, compared with those which received control treatments. The levels of IL-1β in the exudates of the burn wound area of the treated mice increased in a time-dependent manner over 7 days following burn wound injury. At 10 days post-injury, steady and progressive wound healing was observed in the control animals. The present study confirmed that increased wound healing occurs following treatment with aloe emodin,, compared with resveratrol, providing support for the use of Aloe vera plants to improve burn wound healing. PMID:26677006

  19. Evaluation of the antibacterial effect of Echium amoenum Fisch. et Mey. against multidrug resistant Acinetobacter baumannii strains isolated from burn wound infection

    Directory of Open Access Journals (Sweden)

    Mandana Sabour

    2015-02-01

    Full Text Available Introduction and aims: Acinetobacter baumannii in recent decay has become an increasing concern in hospitals for its ability to acquire antibiotic resistance determinants rapidly and becoming resistant to almost all of the antibiotic classes. Borage (Echium amoenum  Fisch. et Mey, is a wild annual plant of Boraginaceae family, grows in northern mountains of Iran and has largely been used by Iranian folk as a mood enhancer, anti anxiolytic, anti inflammatory, a laxative, an emollients and also it has been used  for treatment of infectious diseases. So, in this study the methanolic extract of dried flowers of Echium amoenom were tested against the isolates of Acinetobacter baumannii from wound of burn patients.Materials and methods: 30 drug resistant Acinetobacter baumannii strains which were isolated from burn wounds at the Motahari hospital of Tehran were selected. Antibacterial activity of the methanolic extract was evaluated by the disc diffusion method based on CLSI protocol 2012Results: The mean diameter of the inhibition zone for different extracts  were; 9.967±6.139 mm at the concentration of 4000 ppm, at the concentration of 400 ppm 13.37±5.45 mm, 13.53±5.49 mm at the concentration of 200 ppm, 14.77±5.17mm  at the concentration of 100 ppm and 14.13±5.7806mm  at the concentration of 50 ppm.Conclusion: clinical strains of the A. baumannii were almost highly resistant to imipenem which is the common choice of antibiotic therapy in the hospitals. Due to the calculated p value ≤ 0.05 in this study, it can say that borage extract can be as good as or even better than the imipenem which is used in the hospitals now.

  20. 烧伤创面合并单纯疱疹病毒Ⅰ型感染的临床观察%Clinical investigation of burn wound infection with type I herpes simplex virus

    Institute of Scientific and Technical Information of China (English)

    周玲; 张科验; 孙堂卿; 张磊; 张建平

    2001-01-01

    目的通过对62例患者浅度烧伤创面的观察,分析单纯疱疹病毒(HSV-Ⅰ)的感染特点,并提出治疗方案。方法采用细菌培养、PCR病毒检测和免疫组化染色、病理切片等方法对7例患者进行检测,排除其他原因并确诊。同时对62个病例的临床表现、发病过程及病理特点进行记录和总结。结果烧伤创面被瘤状物覆盖,外观呈菜花状。被检测的7例患者中,有5例HSV-Ⅰ阳性。显微镜下表皮细胞呈气球状及网状变性,气球状细胞内可见包涵体。后期表皮棘细胞层明显增生呈假乳头状瘤样,基底细胞液化明显。患者以局部症状为主,全身反应较轻,外用新霉素加无环鸟苷湿敷效果较好。结论烧伤创面被HSV-Ⅰ感染后临床症状典型,结合PCR病毒检测及免疫组化染色可明确诊断。非手术保守治疗可以治愈。%Objective To elucidate the clinical features of burn wound infection with type I herpes simplex virus ( HSV - 1 ) , so as to propose the possible therapeutic measures. Methods Burn wound infection with HSV - 1 was diagnosed in 7 cases by means of bacterial culture, PCR detection of virus, immunohistochemical staining and pathomorphological section with the exclusion of other causes. In addition, the clinical signs and the features of the development of the infection in 62 cases were recorded and analyzed.Results In the burn patients with the infection, the burn wounds were covered by tumor-like masses with the cauliflower appearance. In the 7 cases who underwent pathomorphological examination , 5 with positive HSV- Ⅰ. Epithelial cells exhibited balloon - like appearance, and reticular degeneration, and inclusion bodies were found in balloon-like cells under microscope examination. In the late stage, there revealed obvious proliferation of epithelial prickle cell layer in shape of pseudopapillomatous mass with the obvious liquefaction of basal cells. The sufferers

  1. Positive effect of propolis on free radicals in burn wounds.

    Science.gov (United States)

    Olczyk, Pawel; Ramos, Pawel; Komosinska-Vassev, Katarzyna; Stojko, Jerzy; Pilawa, Barbara

    2013-01-01

    Concentration and properties of free radicals in the burn wounds treated with propolis were examined by the use of electron paramagnetic resonance spectroscopy. Magnetic spin-spin interactions and complex free radicals structures in wound beds were studied. The results were compared to those obtained for silver sulphadiazine used as a standard pharmaceutical agent. The changes of free radicals in the matrix of injury with time of exposition on these substances were tested. The aim of this study was to check the hypothesis about the best influence of propolis on the burn wounds healing. It was confirmed that a relatively lower concentration of free radicals exists in the burn wounds treated with propolis. The homogeneously broadened spectra and a complex free radical system characterize the tested tissue samples. The fastening of spin-lattice relaxation processes in the matrix of injury after treatment with propolis and silver sulphadiazine was observed. Practical usefulness of electron paramagnetic resonance spectroscopy in alternative medicine was proved.

  2. ICU烧伤患者创面局部消毒对感染的影响%Effect of local wound disinfection on infections in burn patients in ICU

    Institute of Scientific and Technical Information of China (English)

    司琴; 孙卫

    2012-01-01

    目的 对ICU烧伤患者创面进行局部消毒,研究其对感染的影响.方法 选取2009年1月-2010年1月入住ICU治疗的烧伤患者52例,将其作为研究对象,随机分成两组,分别为试验组和对照组,每组各26例,试验组应用局部消毒处理烧伤创面后敷药,对照组不予处理直接敷药,以患者恢复和感染情况为指标,观察局部消毒对感染的影响.结果 试验组愈合率为73.08%,对照组为38.46%;试验组感染率为23.08%,对照组为53.85%;试验组中多为局部感染占83.33%,且轻微,对照组全身性感染占42.86%,且严重;以上差异均有统计学意义(P<0.05).结论 ICU护理中对创面进行局部消毒,可有效减低创面感染的概率,降低感染的严重程度,有助于伤口愈合,值得临床推广应用.%OBJECTIVE To perform the local disinfection for the burned patients in ICU and explore its effect on the infections. METHODS A total of 52 burn patients who enrolled the ICU for treatment from Jan 2009 to Jan 2010 were selected as the study objects, the patients were randomly divided into two groups, the study group and the control group, with 26 cases in each. The study group was treated with local disinfection of burns wound followed by dressings, while the control group did not conduct any treatment except the direct dressing. In the care, and the control group didn t processed dressings. The effect of local disinfection on the infections was observed by referring the recovery and the infection status of the patients as the indicators. RESULTS The healing rate was 73. 08% in the study group,and 38. 46% in the control group; the incidence rate of infections was 23. 08% in the study group,and 53. 85% in the control group; the patients with the slight local infections accounted for 83. 33% in the study group,and the patients with serious systemic infections accounted for 42. 86% in the control group; the difference in the indexes discussed above between the two

  3. Severe complications after negative pressure wound therapy in burned wounds: two case reports

    OpenAIRE

    Ren H; Li Y

    2014-01-01

    Haitao Ren,1 Yuan Li21Department of Burns and Wound Center, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China; 2Department of Ultrasound, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of ChinaAbstract: We present two typical cases of severe complications (sepsis and hemorrhage) after negative pressure wound therapy (NPWT) in burned patients. Necrotic tissues in some dee...

  4. Investigation of pathogenic bacteria causing burn wound infection and analysis of drug-resistance%烧伤创面感染病原菌调查及耐药性分析

    Institute of Scientific and Technical Information of China (English)

    张红升

    2012-01-01

    Objective To study the distribution and drug resistance of bacteria causing burn wound infection. Methods Results of culture and drug susceptibility of bacteria causing burn wound infection were retrospectively analyzed. Results The isolation rates of Gram negative bacilli,Gram positive coccus and fungi were 82. 3%,17. 7% and 0. 0%. In pathogenic Staphylococcus au reus,the isolation rate of methicillin resistant Staphylococcus aureus was 80. 0%. Isolation rates of Pseudomonas aeruginosa,Esche richia Coli and Proteus mirabilis were 33. 1% ,15. 3% and 11. 3%. No imipenem resistant Enterobacter was found. No vancomycin and linezolid resistant Staphylococcus was found. Conclusion Gram negative bacilli might be the main pathogenic bacteria causing burn wound infection, folio wed by Gram positive coccus. Drug resistance might be raising. Imipenem could be the first chosen anti biotic to treat Gram negative bacilli inifection. Vancomycin and linezolid could be the first chosen antibiotic to treat Gram positive coccus infection.%目的 探讨烧伤创面感染菌分布及耐药性情况,为临床用药提供参考.方法 对烧伤创面细菌培养及药敏结果进行回顾性分析.结果 革兰阴性杆菌占82.3%,革兰阳性球菌占17.7%,未检出真菌.铜绿假单胞菌占33.1%,大肠埃希菌占15.3%,奇异变形杆菌占11.3%;金黄色葡萄球菌占8.1%.其中大肠埃希菌ESBLs分离率为57.9%,耐甲氧西林金黄色葡萄球菌(MRSA)的分离率为80.0%,亚胺硫霉素对肠杆菌无一例耐药,万古霉素、利奈唑胺对葡萄球菌无一例耐药.结论 该院烧伤病房感染菌以革兰阴性杆菌为主,革兰阳性球菌次之.耐药率增加的问题不容忽视.亚胺硫霉素应作为抗革兰阴性杆菌和革兰阳性球菌的首选药物,万古霉素和利奈唑胺作为抗革兰阳性球菌首选药物.

  5. Control of burn wound sepsis in rats by methylene blue-mediated photodynamic treatment

    Science.gov (United States)

    Hasegawa, Hiroyuki; Sato, Shunichi; Kawauchi, Satoko; Saitoh, Daizoh; Shinomiya, Nariyoshi; Ashida, Hiroshi; Terakawa, Mitsuhiro

    2012-02-01

    Control of wound sepsis is an important challenge in traumatology. However, increase in the drug-resistant bacteria makes this challenge considerably difficult in recent years. In this study, we attempted to control burn wound sepsis in rats by photodynamic treatment, which has been reported to be effective against some drug-resistant bacteria. A 20% TBSA (total body surface area) full-thickness burn was made in rat dorsal skin, and five days after injury, a suspension of P. aeruginosa was applied to the wound surface. At 30 min after infection, a methylene blue (MB) solution was applied to the wound surface; 5 min afterwards, the wound was illuminated with a 665-nm light emitting diode (LED) array for 10 min. This treatment (application of MB and illumination) was repeated 3 times successively. The averaged light intensity on the wound surface was 3.3 mW/cm2, the corresponding total light dose being 5.9 J/cm2. One week after injury, the numbers of bacteria in the blood and liver were counted by colony forming assay. In the liver, the number of bacteria of the treated group was significantly lower than that of the sham control group without photodynamic treatment. In the blood, no bacteria were detected in the treated group, while a certain amount of bacteria was detected in the control group. These results demonstrate the efficacy of MB-mediated PDT with a red LED array to control burn wound sepsis.

  6. Effect of Malva sylvestris cream on burn injury and wounds in rats

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    Ebrahim Nasiri

    2015-06-01

    Full Text Available Objectives: Burn injury is one of the most health-threatening problems in the world. Malva sylvestris (M. sylvestris flowershave a high mucilage content and are used as a remedy for cut wound and dermal infected wounds in Iranian folklore Medicine. The purpose of this study was to investigate the effect of M. sylvestris cream on the second degree burn injury in rats. Materials and Methods: Five groups of 10 rats per group were burned with hot metal plate. Animals were administrated divided as control, normal saline, standard silver sulfadiazine 1% (SSD, 5% M. sylvestris, and 10% M. sylvestris into separate groups. Wound area, percentage of wound contraction, and histological and bacteriological assessments were evaluated. Results: Wound sizes were not significantly different among groups on 1st and 3rd days after burn injury, while they were significantly different among groups after 7th day post-burn injury. The average areas of wounds on the 15th day were 7.5±2.9, 6.7±2, 10.5±1.6, 4.7±2, and 4.5±2 cm2 for base cream, normal saline, SSD, 5% M. sylvestris, and 10% M. sylvestris, respectively. The results of histology exhibited well-formed horizontally-oriented collagen fibers in MS topical treatment groups. Microorganisms existed in the SSD group were most probably Staphilococcus epidermitis and for NS group were staphylococcus saprophiteccus. Conclusion: M. sylvestris cream improved histological changes of tissue components in the process of healing when compared with SSD cream. Therefore, it can be used as a topical treatment agent for burn wound.

  7. Otostegia persica extraction on healing process of burn wounds

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    Amin Ganjali

    2013-06-01

    Full Text Available PURPOSE: To investigate if the methanolic extract of the Otostegia persica can accelerating healing process of burn wound because of its anti-inflammatory and antioxidant effects. METHODS:Forty eight male Wistar rats were randomized into three study groups of 16 rats each. Burn wounds were created on dorsal part of shaved rats using a metal rod. In group I the burn wound was left without any treatment. Group was treated with topical silver sulfadiazine pomade. In group III, ointment containing the OP extract was administered. Skin biopsies were harvested from burn area on the 3rd, 5th, 14th and 21st days after burn and examined histologically. RESULTS: Re-epithelialization in the control group and in group II was lower than in group III. Re-epithelialization in groups II and III was significantly different from that in the control group. On the 5th day of the experiment, we assessed lower inflammation in the burn area compared to control group. This means that the inflammation was suppressed by methanolic extract of OP. From day 5 to 14; the fibroblast proliferation peaked and was associated with increased collagen accumulation. It was obvious that angiogenesis improved more in the groups II and III, which facilitated re-epithelialisation. CONCLUSION:Methanolic extract of Otostegia persica exhibited significant healing activity when topically applied on rats. OP is an effective treatment for saving the burn site.

  8. Application of topical drugs in burn wound%烧伤创面用药

    Institute of Scientific and Technical Information of China (English)

    张国安

    2008-01-01

    For bum patients, topical treatment is as important as systemic treatment. Reasonable and timely wound treatment will influence the homeostatic equilibrium, and the progression, the prognosis, and the outcome of the disease. The therapeutic principle should be varied for wounds with different depth of injury. But avoiding or at least alleviating infection, and accelerating healing period, were the common principles. In common, the medication for local wound treatment includes: topical antiseptic, surgical dressing products, artificial skins, and so on.Ideal topical antiseptic should have the following zcharacteristics: the antimierobial spectrum is broad, including Pseudomonas aeruginosa and MRSA; be able to penetrate necrotic tissue; does not induce drug resistatance easily; no local irritating effect and not painful; no side effect to body; can be applied easily; low cost. The functions of surgical dressing in clude: protect the wounds, keep the microcirculation open, and accelerate wound healing. Artificial skin has been used as the autoskin carrier in skin transplantation operation for large burn area to protect the autoskin grafts, accelerate wound healing, and cover the wounds temporarily. Bums therapy has developed for 50 years in China, the study of local treatment for burn wounds has also experienced a tortuous path of trial and error. This review might contribute some ideas future research.

  9. EXPERIMENTAL STUDY OF THE EFFECT OF MOIST EXPOSED BURN THERAPY/MOIST EXPOSED BURN OINTMENT ON MAINTAINING A PHYSIOLOGICAL MOIST ENVIRONMENT IN BURN WOUND

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To verify the moisture maintaining effect of moist exposed burn ointment (MEBO) in treating burn wound. Methods: Rabbit model with II degree burn wound was used in this study. Observations were conducted at 0 (before burn), 0.5, 6, 24, 48, 72, and 168 hours postburn. The data of wound water evaporation, wound appearance and pathological changes of the wounds were compared with that of the burn wounds treated with Vaseline or conventional dry exposed therapy. Results: It was found that wounds treated with MEBO had water evaporation close to that of normal skin and was significantly less than that of the wounds treated with dry exposed therapy (P<0.01) MEBO did not obstruct water evaporation from wound as Vaseline did(P<0.01).Wounds treated with MEBO had good permeability and adequate drainage. Conclusion: MEBO provided the wounds with a physiological moist environment

  10. Positive Effect of Propolis on Free Radicals in Burn Wounds

    OpenAIRE

    Pawel Olczyk; Pawel Ramos; Katarzyna Komosinska-Vassev; Jerzy Stojko; Barbara Pilawa

    2013-01-01

    Concentration and properties of free radicals in the burn wounds treated with propolis were examined by the use of electron paramagnetic resonance spectroscopy. Magnetic spin-spin interactions and complex free radicals structures in wound beds were studied. The results were compared to those obtained for silver sulphadiazine used as a standard pharmaceutical agent. The changes of free radicals in the matrix of injury with time of exposition on these substances were tested. The aim of this stu...

  11. Pathogenic bacteria distribution and drug resistance observation of early wound infection in burn patients%烧伤患者早期创面感染病原菌分布与耐药性观察

    Institute of Scientific and Technical Information of China (English)

    吕敏

    2015-01-01

    Objective:To explore the pathogenic bacteria distribution and drug resistance of early wound infection in burn patients. Methods:300 patients with burn wound infection were selected from July 2009 to July 2014.The infection test results of the patients were analyzed.The athogenic bacteria drug resistance was analyzed.Results:There detected 171 strains of gram negative bacteria,141 strains of gram positive bacteria,6 strains of fungi.The antibacterial drug resistance situation of pseudomonas aeruginosa:the drug resistance rates of imipenem,amikacin,ceftazidime and aztreonam were lower,the drug resistance rates were 10%,27.7%,33.7%,35.4%;the drug resistance rates of ampicillin,ceftriaxone,gentamicin,cefoperazone were higher,the drug resistance rates were 100%,79.2%,69.3%,65.3%.The drug resistance rate for majority antibacterial agents of acinetobacter were high,the drug resistance rates of imipenem,amikacin,netilmicin were lower,they were 0,46.9%,50%.Conclusion:Early burn wound infection gives priority to with pseudomonas aeruginosa,acinetobacter,staphylococcus aureus and staphylococcus epidermidis. Through drug sensitivity test to select the appropriate effective antimicrobial contribute to the prevention and treatment of early burn wound infection.%目的:探讨烧伤患者早期创面感染病原菌分布情况与耐药性情况。方法:2009年7月-2014年7月收治烧伤创面感染患者300例,分析患者的感染检测结果;对病原菌耐药性进行分析。结果:检测到革兰阴性菌171株,革兰阳性菌141株,真菌6株。铜绿假单胞菌对抗菌药耐药情况:对亚胺培南、阿米卡星、头孢他啶和氨曲南耐药率较低,耐药率分别为10.0%、27.7%、33.7%、35.4%;对氨苄西林、头孢曲松、庆大霉素、头孢哌酮耐药率较高,分别为100%、79.2%、69.3%、65.3%。不动杆菌属对多数抗菌药物耐药率均高,对亚胺培南、阿米卡星、奈替米星耐药率较低,分别为0、46

  12. Regenerative Medicine: Novel Approach in Burn Wound Healing

    Directory of Open Access Journals (Sweden)

    Zare

    2015-06-01

    Full Text Available Context Burn wounds of the skin require a long period to healing, which very often is incomplete, with functional and esthetic consequences for the patients. Stem cells in the traumatized tissue represent the promoters of the healing process and are a primary focus for regenerative medicine, which aims to find and use the triggers for the activation of stem cells of sin tissue. Evidence Acquisition At present, tissue engineering, composite epithelial autografts, multipotent stem cells and combined gene delivery with stem cell therapy are the approaches used in regenerative medicine. Alongside, the development of 3D scaffolds or matrices is a promising adjunct, as studies investigate the multiple uses of these supports for wound repair. Results Application of cells to the burn wound could be performed, either by the bedside, as a non-invasive procedure, or in the operating room, with the use of a matrix, scaffold or dermal substitute. Cell spraying, although under use in clinical setting, is not yet supported by conclusive data. Magnetic resonance imaging, optical imaging and positron emission tomography are currently used to assess the viability and location of stem cells, after transplantation. Conclusions Stem cell therapies in wound care may lessen the morbidities associated with wound healing. An ideal method for the effective administration of stem cells for burn patients has not yet been elucidated. Further comparison of the local and systemic effects in burn patients, associated with each route of stem cell delivery, needs to be performed.

  13. [Burn wounds caused by a hair-dryer].

    Science.gov (United States)

    Paulsen, Ida Felbo; Alsbjørn, Bjarne

    2014-06-01

    Burn wounds (ambustio) in children are frequent and occur in about 5% of all children and in about half of these before the age of three. The majority of the burn wounds in children occur at home, most frequently in the kitchen or the bathroom. This case describes an accidental ambustio caused by a hair dryer in a 3-month-old baby. Hair-dryers have become widely used in drying soar baby buttoms. Therefore, professionals as well as parents should be better informed about the potential risks of using hair-dryers for this purpose.

  14. Evidence-based surgical wound care on surgical wound infection.

    Science.gov (United States)

    Reilly, Jaqueline

    2002-09-01

    Surgical wound infection is an important outcome indicator in the postoperative period. A 3-year prospective cohort epidemiological study of 2202 surgical patients from seven surgical wards across two hospitals was carried out using gold standard surveillance methodology. This involved following patients up as inpatients and postdischarge surveillance to 30 days by an independent observer. The results led to the development of a mathematical model for risk of clean, elective surgical wound infection. Risk of surgical wound infection was increased by smoking, higher body mass index, presence of malignancy, haematoma formation, increasing numbers of people in theatre, adherent dressing usage, and higher times to suture removal (P<0.05). The results show that this type of surveillance is an effective way of collecting accurate data on wound infection rates. It was noted that patient care practices affected the surgical wound infection rate and the surveillance was used to facilitate the adoption of evidence-based practice, through recommendations for clean surgery, to reduce the risk from extrinsic risk factors for wound infection. As a result of the implementation of this evidence-based practice there was a significant reduction (P<0.05) in the clean wound infection rate.

  15. Severe complications after negative pressure wound therapy in burned wounds: two case reports

    Directory of Open Access Journals (Sweden)

    Ren H

    2014-07-01

    Full Text Available Haitao Ren,1 Yuan Li21Department of Burns and Wound Center, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China; 2Department of Ultrasound, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of ChinaAbstract: We present two typical cases of severe complications (sepsis and hemorrhage after negative pressure wound therapy (NPWT in burned patients. Necrotic tissues in some deep burn wounds are difficult to judge correctly and remove thoroughly. An electrically burned blood vessel looks “intact” but can easily break. Necrotic tissue or injured blood vessels when using NPWT are dangerous, both for causing sepsis and hemorrhage. This is the first article that reports the severe complications of NPWT in burned patients. It is imperative to heed indications and avoid contraindications. Proper preparation of wound beds, close observation, and sufficient irrigation are also crucial to avoid these severe complications, and there is an urgent need to substitute the central vacuum system with the low-pressure system.Keywords: negative pressure wound therapy, complication, burn sepsis, bleeding, drainage

  16. Distribution and drug resistance of pathogens causing early wound infections in burn patients%烧伤患者早期创面感染病原菌分布与耐药性分析

    Institute of Scientific and Technical Information of China (English)

    王进勇; 邹飞扬; 李莉莉; 徐向荣; 张承德; 朱志英; 龚海南

    2014-01-01

    OBJECTIVE To analyze the distribution and drug resistance of pathogens causing early wound infections in the burn patients so as to provide guidance for prevention and treatment of burn wound infections .METHODS A total of 2 981 burn patients who were treated in the hospital from Jan 2007 to Dec 2012 were enrolled in the study , among whom 310 patients with burn wound infections were chosen as the study objects ,then the pathogens isola-ted from the early wounds were detected ,and the drug resistance of the major species of pathogens was analyzed . RESULTS Of the 2 981 patients ,the wound infections occurred in 355 cases with the infection rate of 11 .9% , among whom 45 cases were complicated with other sites of infections .Totally 329 strains of pathogens have been isolated ,including 175 (53 .2% ) strains of gram-negative bacteria , 147 (44 .7% ) strains of gram-positive bacteria ,and the fungi (2 .1% );the Pseudomonas aeruginosa and Acinetobacter were the predominant species of gram-negative bacteria ;the Staphylococcus aureus was dominant among the gram-positive bacteria .The main gram-negative bacteria showed low drug resistance to imipenem but were highly resistant to ampicillin ,ceftriax-one ,and cefotaxime;the drug resistance rates of the S .aureus to penicillin ,ampicillin ,and clindamycin were high ,and the drug resistance rate to vancomycin was low ;the drug resistance rates of the fungi to penicillin and clindamycin were high , and the drug resistance rates to vancomycin and imipenem-cilastatin were low . CONCLUSION The incidence of early wound infections is high among the burn patients ,and the drug resistance rates of most of the pathogens are increased year by year ;it is necessary to prevent the infections according to the indications for use of antibiotics and perform corresponding supportive therapy so as to avoid cross drug resistance or mutations of the pathogens and ensure the curative effect as well as prevention of infections .%目的:分

  17. Natural and synthetic polymers for wounds and burns dressing.

    Science.gov (United States)

    Mogoşanu, George Dan; Grumezescu, Alexandru Mihai

    2014-03-25

    In the last years, health care professionals faced with an increasing number of patients suffering from wounds and burns difficult to treat and heal. During the wound healing process, the dressing protects the injury and contributes to the recovery of dermal and epidermal tissues. Because their biocompatibility, biodegradability and similarity to macromolecules recognized by the human body, some natural polymers such as polysaccharides (alginates, chitin, chitosan, heparin, chondroitin), proteoglycans and proteins (collagen, gelatin, fibrin, keratin, silk fibroin, eggshell membrane) are extensively used in wounds and burns management. Obtained by electrospinning technique, some synthetic polymers like biomimetic extracellular matrix micro/nanoscale fibers based on polyglycolic acid, polylactic acid, polyacrylic acid, poly-ɛ-caprolactone, polyvinylpyrrolidone, polyvinyl alcohol, polyethylene glycol, exhibit in vivo and in vitro wound healing properties and enhance re-epithelialization. They provide an optimal microenvironment for cell proliferation, migration and differentiation, due to their biocompatibility, biodegradability, peculiar structure and good mechanical properties. Thus, synthetic polymers are used also in regenerative medicine for cartilage, bone, vascular, nerve and ligament repair and restoration. Biocompatible with fibroblasts and keratinocytes, tissue engineered skin is indicated for regeneration and remodeling of human epidermis and wound healing improving the treatment of severe skin defects or partial-thickness burn injuries. PMID:24368109

  18. 儿童烧伤创面感染细菌种类分布及耐药情况%INVESTIGATION OF BACTERIAL SPECIES DISTRIBUTION AND DRUG RESISTANCE OF CHILDREN WITH BURN WOUND INFECTION

    Institute of Scientific and Technical Information of China (English)

    戴昆琦; 奕利娟; 陈群英

    2012-01-01

    目的 研究医院病房儿童烧(烫)伤患者创面感染细菌分布和耐药情况.方法 采用细菌分离培养和药敏试验方法,对住院儿童烧伤创面分泌物标本进行了检测.结果 从1 698份标本中检出致病菌379株,检出率为22.32%.烧伤感染致病菌中,革兰阳性球菌占65.17%,革兰阴性杆菌占32.98%,真菌占1.85%.检出的铜绿假单胞菌对氨苄西林、头孢曲松、复方新诺明耐药率均高达100%,鲍曼不动杆菌对氨曲南、环丙沙星和复方新诺明耐药率均高达80%以上.结论 该医院住院儿童烧伤感染致病菌以革兰阳性球菌为主,但革兰阴性杆菌耐药率高.%Objective To investigate the bacterial species distribution and drug resistance of children with bum wound infection. Methods The bacteria isolated culturing and the medicine sensitive test were used to detect secretion specimen from burn wound of children. Results From 1 698 specimen there were 379 strains pathogenic bacteria detected and the positive rate was 22. 32%. Of the burn infection pathogenic bacteria the gram positive coccus accounted for 63. 17% , the gram negative bacillus accounted for 32. 98% and the fungus accounted for 1.85%. The resistance rates of Pseudomonas aeruginosa detected to Amicillin, Ceftriaxone, Trimethoprim - sulfamethoxazole reached 100% , while the resistance rates of Acinetobacter buumannii detected to Aztreonam, Ciprofloxacin and Trimethoprim - sulfamethoxazole were above 80%. Conclusion The main infection pathogenic bacteria of children bum wound are the gram positive coccus and the drug resistance rate of negative bacillus is high.

  19. Topical silver for preventing wound infection

    NARCIS (Netherlands)

    M.N. Storm-Versloot; C.G. Vos; D.T. Ubbink; H. Vermeulen

    2010-01-01

    BACKGROUND: Silver-containing treatments are popular and used in wound treatments to combat a broad spectrum of pathogens, but evidence of their effectiveness in preventing wound infection or promoting healing is lacking. OBJECTIVES: To establish the effects of silver-containing wound dressings and

  20. Effects of minoxidil gel on burn wound healing in rats.

    Science.gov (United States)

    Khazaeli, Payam; Karamouzian, Mohammad; Rohani, Shohreh; Sadeghirad, Behnam; Ghalekhani, Nima

    2014-01-01

    Minoxidil has been reported to inhibit in-vitro fibroblast proliferation and lysyl hydroxylase activity, a key enzyme in collagen biosynthesis. These in-vitro effects proposed minoxidil to be a potential antifibrotic agent. The present study aimed to investigate the effects of minoxidil gel on wound healing procedure in a second-degree burn model in rats. Wistar rats were anesthetized and a second-degree burn was induced on the back of Wistar rats using a heated 2 cm diameter metal plate. Experimental groups received 2% or 5% topical minoxidil gel, dexpanthenol or sliver sulfadiazine. Histological parameters including collagen content, angiogenesis, number of preserved follicles and necrosis along with tensile strength of burn wound area were assessed on days 3, 7, 14 and 21 post-injury.Microscopic evaluation of specimens collected from sample animals were consistent and showed a second-degree burn. Main histological findings regarding minoxidil topical usage showed that collagen content and tensile strength of burned area did not differ between groups. However, minoxidil increased the number and diameter of blood vessels significantly compared with other groups.Although minoxidil improved the process of wound-healing, our results did not support the proposed idea of its usage as an antifibrotic agent. However, to reject its possible effects as an antifibrotic agent, more objective animal models should be developed and studied. PMID:24734077

  1. 21 CFR 878.4022 - Hydrogel wound dressing and burn dressing.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hydrogel wound dressing and burn dressing. 878... Hydrogel wound dressing and burn dressing. (a) Identification. A hydrogel wound dressing is a sterile or... percent) and capable of absorbing exudate. This classification does not include a hydrogel wound...

  2. Bacteriological evaluation of wounds in seriously burned hospitalized patients

    Directory of Open Access Journals (Sweden)

    Sueli de Lourdes Nogueira Vilela Silva

    1991-09-01

    Full Text Available During the period between May and December 1988, 21 patients were studied bacteriologically at Hospital João XXIII's burn's unit which belongs to "Fundação Hospitalar do Estado de Minas Gerais" in Belo Horizonte, Brazil. A qualitative and quantitative evaluation of aerobic and facultative bacteria from burn wounds was carried out by the standard filter paper disc technique, including antibiotic susceptibility. At the same time an evaluation of those bacteria isolated from the environmental unit was performed. The most common organisms recovered from wounds of patients were: Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus epidermidis. P. pseudomallei was the most frequent strain recovered from environmental specimens. In nearly all patients specimens (16 in total from whom P. aeruginosa was isolated, the rate of CFU/cm² of skin was above 10². In nine of these, it reached 10(5, wich is equivalent to 10(7 CFU/g of burned tissue.

  3. Evaluation of the Effects of Honey on Acute-Phase Deep Burn Wounds

    OpenAIRE

    Nakajima, Yukari; Mukai, Kanae; Nasruddin; kOMATSU, Emi; Iuchi, Terumi; Kitayama, Yukie; Sugama, Junko; Nakatani, Toshio

    2013-01-01

    This study aimed to clarify the effects of honey on acute-phase deep burn wounds. Two deep burn wounds were created on mice which were divided into four groups: no treatment, silver sulfadiazine, manuka honey, and Japanese acacia honey. Wound sizes were calculated as expanded wound areas and sampled 30 minutes and 1–4 days after wounding for histological observation. The wound sections were subjected to hematoxylin and eosin and immunohistological staining to detect necrotic cells, apoptotic ...

  4. Use of negative pressure wound therapy in burn patients.

    Science.gov (United States)

    Teng, Shou-Cheng

    2016-09-01

    According to previous research, adjunctive negative pressure wound therapy (NPWT) can help manage infected wounds when applied along with appropriate debridement and antibiotic therapy as deemed clinically relevant. NPWT not only removes fluid, and reduces oedema, but also promotes perfusion around the wounds. In addition, NPWT may lead to improved graft fixation when used as a bolster, especially in patients who are less compliant or have poor graft fixation that result from using traditional methods. NPWT is a good choice to bolster skin grafts in young, active and less-compliant patients. We propose an enhanced segmental compartment-covered technique, which uses NPWT adjunctively as first-line wound treatment to help manage postoperative infection. Moreover, NPWT promotes granulation tissue formation to prepare the wound bed for subsequent skin graft and may be used as a bolster over the graft, which helps to attain skin graft viability. PMID:27547959

  5. Positive Effect of Propolis on Free Radicals in Burn Wounds

    Directory of Open Access Journals (Sweden)

    Pawel Olczyk

    2013-01-01

    Full Text Available Concentration and properties of free radicals in the burn wounds treated with propolis were examined by the use of electron paramagnetic resonance spectroscopy. Magnetic spin-spin interactions and complex free radicals structures in wound beds were studied. The results were compared to those obtained for silver sulphadiazine used as a standard pharmaceutical agent. The changes of free radicals in the matrix of injury with time of exposition on these substances were tested. The aim of this study was to check the hypothesis about the best influence of propolis on the burn wounds healing. It was confirmed that a relatively lower concentration of free radicals exists in the burn wounds treated with propolis. The homogeneously broadened spectra and a complex free radical system characterize the tested tissue samples. The fastening of spin-lattice relaxation processes in the matrix of injury after treatment with propolis and silver sulphadiazine was observed. Practical usefulness of electron paramagnetic resonance spectroscopy in alternative medicine was proved.

  6. Remodeling of skin nerve fibers during burn wound healing

    Institute of Scientific and Technical Information of China (English)

    Yongqiang Feng; Xia Li; Rui Zhang; Yu Liu; Tingting Leng; Yibing Wang

    2010-01-01

    Burn wound healing involves a complex sequence of processes.Recent studies have revealed that skin reinnervation may have an impact on physiological wound repair.Few studies have addressed the process of reinnervation and morphological changes in regenerated nerve fibers.The regeneration of neurites during full-thickness burn wound healing was determined by immunofluorescent staining using an anti-neurofilament protein monoclonal antibody,and three-dimensional morphology was observed under a laser scanning confocal microscope.Morphology and the volume fraction of collagen and nerve fibers were measured.Skin reinnervation increased during wound healing,peaked during the proliferative scar stage,and then decreased to lower levels during the maturation period.The results from the skin nerve fibers correlated with those from collagen using semi-quantitative analysis.Disintegration and fragmentation were observed frequently in samples from the proliferative stage,and seldom occurred during the maturation stage.There was a remodeling process of regenerated nerve fibers during wound healing,which comprised changed innervation density and topical morphology.The mechanism of remodeling for nerve fibers requires further investigation.

  7. Analysis of drug resistance of Staphylococcus aureus infection at severely burned wounds surface%重度烧伤创面金黄色葡萄球菌感染的耐药性分析

    Institute of Scientific and Technical Information of China (English)

    孟朝晖; 钱小毛; 王亚玲

    2014-01-01

    MR-SA was obviously higher than MRSA .CONCLUSION It is important to reasonably use the antibacterial agents by timely detecting pathogenic bacteria ,taking full advantage of the tendency to the bacterial drug resistance supplied by the laboratory as well as the information related to the mechanism of drug resistance because of an increased rate of drug resistance of bacterial strains isolated from the burn wound .In addition ,other key approaches ,such as rational use of antibacterial agents and positive treatment to burn wound ,strict implement of disinfection and isolation regulation ,should not also be neglected ,by which the infection of SAU can be reduced and with its drug resistance lowered as well .

  8. Investigation and analysis of bacteria acute infection in severe burn wounds%严重烧伤急性感染期创面菌种调查与分析

    Institute of Scientific and Technical Information of China (English)

    于晓锋; 陶仁清

    2014-01-01

    目的:了解严重烧伤患者、急性感染期,创面感染菌群分布,为防治创面浸润性感染提供实验室依据。方法选择住院的、总面积(TBSA)>31%、以深二度和三度为主的患者163例,性别年龄不居。在伤后13~15 d急性感染期,进行一次性创面分泌物普通培养,用VITEK2全自动细菌鉴定仪,进行细菌鉴定;药敏实验采用纸片扩散法程序进行操作,按美国临床实验室国家标准化委员会(NCCLS)标准进行结果判断。结果共得菌种24种、163株,阳性率为100%,其中假单孢菌属占首位(33.1%),次为球菌属(22.7%)。伤后10 d左右,预防性应用亚胺培南或头孢吡圬、万古霉素或呋喃妥因3 d;163例治疗期间均未发生伤面脓毒症,并顺利治愈。结论重度烧伤伤后13~15 d,应用亚胺培南或头孢吡圬、万古霉素或呋喃妥因,能预防创面脓毒症的发生和提高临床治愈率。%Objective To understand the bacteria distribution in wound infection during acute infection period in severely burned pa-tients and provide laboratory basis for preventing and treating the invasive infection.Methods One hundred and sixty-three patients with TB-SA more than 3 1% and deep Пdegree and Ш degree of injury were investigated.The wound secretion was cultured and identified using VITEK2 automatic bacteria device in 13 to 15 d of acute infection period.Drug sensitive experiment was implemented and analysed according to the NCCLS.Results Twenty-four kinds of bacteria(163 strains)were harvested,and the positive rate was 100%,including false single spore fungus(33.1%)and staphylococcus aureus(22.7%).The imipenem,cefepime engine-grease,vancomycin and nitrofurantoin were used for 3 d.The wound sepsis in 163 patients was not found,and all patients were successfully cured.Conclusion The application of imipenem, cefepime engine-grease vancomycin and nitrofurantoincan can prevent the

  9. Comparison of Two Types of Gels in Improving Burn Wound

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    Rahimzadeh Golnar

    2014-01-01

    Full Text Available Objective: Kefir are natural probiotic compounds with anti-inflammatory properties, which were tested in experimental burn injury. Kefir gels were prepared from an extract of continuously cultured kefir in Man, Rogosa and Sharpe Broth medium for 48 and 96 h. Their extracts were used for evaluation of antibacterial effect against Pseudomonas aeruginosa in standard sample (ATCC 27853 and samples taken from patients with burns. The antibacterial effect of different kefir extract was assessment of minimum inhibitory concentration and minimum bactericidal concentration. The density of bacteria and percentage of organic acids (lactic and acetic acids were also determined. Materials and Methods: Similar burn injuries were made on dorsal skin surface of 40 rats. The rats were divided into 5 groups of 8 rats each. The base gel, silver sulfadiazine ointment, kefir 48 h gel, kefir 96 h gel were applied twice daily. Burn wound area was measured at baseline, 1 and 2 weeks. Results: Results indicated that by increasing the time of fermentation, concentration of lactic and acetic acid increased in orders of: Kefir 48 h < kefir 96 h, the end of the 2nd week the percentage of wound size were lowest in order of kefir 96 h gel < kefir grains 48 h gel < silver sulfadiazine 1% < untreated and based gel groups. Conclusion: In conclusion, the kefir gel therapy was an effective therapeutic approach to improve outcomes after severe burn when compared with conventional silver sulfadiazine treatment.

  10. Isolation of Bacillus Cereus from wounds and burns

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    Behzadiannejhad Gh

    1997-09-01

    Full Text Available The culture results of 203 cases with different wounds were studies; 150 of the latter were burn cases (mainly second and third degree burns, and 53 were of other types (surgical, traumatic, ect. Four subtypes of Bacillus cereus were isolated upon culture, and the different toxins produced in DHT broth with 0.1% glucose were assessed. The lethal toxin was injected intravenously to Syrian rats, none of whom died. VPR factor was assessed in the 4 subtypes. Three subtypes produced VPR in significant amounts.

  11. Release of insulin from PLGA-alginate dressing stimulates regenerative healing of burn wounds in rats.

    Science.gov (United States)

    Dhall, Sandeep; Silva, João P; Liu, Yan; Hrynyk, Michael; Garcia, Monika; Chan, Alex; Lyubovitsky, Julia; Neufeld, Ronald J; Martins-Green, Manuela

    2015-12-01

    Burn wound healing involves a complex set of overlapping processes in an environment conducive to ischaemia, inflammation and infection costing $7.5 billion/year in the U.S.A. alone, in addition to the morbidity and mortality that occur when the burns are extensive. We previously showed that insulin, when topically applied to skin excision wounds, accelerates re-epithelialization and stimulates angiogenesis. More recently, we developed an alginate sponge dressing (ASD) containing insulin encapsulated in PLGA [poly(D,L-lactic-co-glycolic acid)] microparticles that provides a sustained release of bioactive insulin for >20 days in a moist and protective environment. We hypothesized that insulin-containing ASD accelerates burn healing and stimulates a more regenerative, less scarring healing. Using heat-induced burn injury in rats, we show that burns treated with dressings containing 0.04 mg insulin/cm(2) every 3 days for 9 days have faster closure, a higher rate of disintegration of dead tissue and decreased oxidative stress. In addition, in insulin-treated wounds, the pattern of neutrophil inflammatory response suggests faster clearing of the burned dead tissue. We also observe faster resolution of the pro-inflammatory macrophages. We also found that insulin stimulates collagen deposition and maturation with the fibres organized more like a basket weave (normal skin) than aligned and cross-linked (scar tissue). In summary, application of ASD-containing insulin-loaded PLGA particles on burns every 3 days stimulates faster and more regenerative healing. These results suggest insulin as a potential therapeutic agent in burn healing and, because of its long history of safe use in humans, insulin could become one of the treatments of choice when repair and regeneration are critical for proper tissue function.

  12. 儿童烧伤创面脓毒症的防治策略%Prevention and treatment strategy for burn wound sepsis in children

    Institute of Scientific and Technical Information of China (English)

    牛希华; 李晓亮

    2016-01-01

    Wound sepsis is one of the main causes of death in patients with severe burn and trauma.The high incidence of burn wound sepsis in children is attributed to their imperfect immune system function,poor resistance against infection,and the weakened skin barrier function after burn.The key to reduce the mortality of pediatric patients with burn wound sepsis is to enhance the understanding of its etiology,epidemiology,pathogenesis,and diagnostic criteria,in order to improve its early diagnosis and treatment.

  13. Prevention and treatment strategy for burn wound sepsis in children%儿童烧伤创面脓毒症的防治策略

    Institute of Scientific and Technical Information of China (English)

    牛希华; 李晓亮

    2016-01-01

    Wound sepsis is one of the main causes of death in patients with severe burn and trauma.The high incidence of burn wound sepsis in children is attributed to their imperfect immune system function,poor resistance against infection,and the weakened skin barrier function after burn.The key to reduce the mortality of pediatric patients with burn wound sepsis is to enhance the understanding of its etiology,epidemiology,pathogenesis,and diagnostic criteria,in order to improve its early diagnosis and treatment.

  14. Wound healing activities of different extracts of Centella asiatica in incision and burn wound models: an experimental animal study

    Directory of Open Access Journals (Sweden)

    Somboonwong Juraiporn

    2012-07-01

    Full Text Available Abstract Background The efficacy of Centella asiatica for incision and burn wounds are not fully understood. Here, we report the wound healing activities of sequential hexane, ethyl acetate, methanol, and water extracts of Centella asiatica in incision and partial-thickness burn wound models in rats. Methods Male Sprague–Dawley rats weighing 250–300 g were randomly divided into incision and burn wound groups. Each group was stratified into seven subgroups: (1 untreated; (2 NSS-; (3 Tween 20®- (vehicle control; (4 hexane extract-; (5 ethyl acetate extract-; (6 methanol extract-; and (7 aqueous extract-treated groups. The test substances were applied topically once daily. The tensile strength of the incision wound was measured on the seventh day after wound infliction. The general appearance and degree of wound healing of the burn wound were assessed on Days 3, 7, 10 and 14 after burn injury and prior to histopathological evaluation. Results On the seventh day after wound infliction, the tensile strength of incision wound in all extract-treated groups was significantly higher than that of the vehicle control (Tween 20®, but comparable to the NSS-treated group. The degrees of healing in the burn wound with the four extracts were significantly higher than that of the control on Days 3, 10 and 14. Histopathological findings on Day 14 after burn injury revealed prominent fibrinoid necrosis and incomplete epithelialization in the control and untreated groups, whereas fully developed epithelialization and keratinization were observed in all extract-treated groups. Analysis by thin layer chromatography demonstrated that the phyto-constituents β-sitosterol, asiatic acid, and asiaticoside and madecassocide were present in the hexane, ethyl acetate and methanol extracts, respectively. Conclusions All extracts of Centella asiatica facilitate the wound healing process in both incision and burn wounds. Asiatic acid in the ethyl acetate extract seemed to

  15. Modulation of inflammatory and catabolic responses in severely burned children by early burn wound excision in the first 24 hours

    NARCIS (Netherlands)

    Barret, JP; Herndon, DN

    2003-01-01

    Hypothesis: Early burn wound excision modulates the hypermetabolic response in severe pediatric burn injuries. Design: Before-after trial. Setting: A 30-bed burn referral center in a private, university-affiliated hospital. Methods: We studied 35 severely burned children who were divided into 2 grou

  16. Analgesia and sedation for children undergoing burn wound care.

    Science.gov (United States)

    Bayat, Ahmad; Ramaiah, Ramesh; Bhananker, Sanjay M

    2010-11-01

    Standard care of burn wounds consists of cleaning and debridement (removing devitalized tissue), followed by daily dressing changes. Children with burns undergo multiple, painful and anxiety-provoking procedures during wound care and rehabilitation. The goal of procedural sedation is safe and efficacious management of pain and emotional distress, requiring a careful and systematic approach. Achieving the best results needs understanding of the mechanisms of pain and the physiologic changes in burn patients, frequent evaluation and assessment of pain and anxiety, and administration of suitable pharmacological and nonpharmacological therapies. Pharmacological therapies provide the backbone of analgesia and sedation for procedural pain management. Opioids provide excellent pain control, but they must be administered judiciously due to their side effects. Sedative drugs, such as benzodiazepines and propofol, provide excellent sedation, but they must not be used as a substitute for analgesic drugs. Ketamine is increasingly used for analgesia and sedation in children as a single agent or an adjuvant. Nonpharmacological therapies such as virtual reality, relaxation, cartoon viewing, music, massage and hypnosis are necessary components of procedural sedation and analgesia for children. These can be combined with pharmacological techniques and are used to limit the use of drugs (and hence side effects), as well as to improve patient participation and satisfaction. In this article, we review the pathophysiologic changes associated with major thermal injury in children, the options available for sedation and analgesia for wound care procedures in these children and our institutional guidelines for procedural sedation. PMID:20977331

  17. Ceasing down Pseudomonas aeruginosa Invasiveness in A Mouse Burn Wound Sepsis Model by Recombinant OprF

    Directory of Open Access Journals (Sweden)

    Zohreh Rasooli

    2015-10-01

    Full Text Available Background: Bacterial infections in burn and wound patients are common and difficult to control. The aim of the current study was to evaluate the ability of full length OprF to elicit the production of protective IgG in mice burn wound sepsis model against P. aeruginosa infection.Methods: OprF protein was expressed and purified by Ni-NTA. The purified protein as used to immunize BALB/c mice. The antibody raised against OprF was confirmed by ELISA and evaluated by immunoblot analysis. After burn and bacterial challenge, mortality rate was monitored in the control and immunized mice groups. Bacterial quantity in skin, blood, spleenand liver was evaluated to study spread or inhibition of the infection.Results: Immunization of mice with OprF brought about a significant rise in anti-OprF sera titer. Protection was imparted in the immunized group resulting in 100% survival against 1000 fold LD50 challenge with P. aeruginosa. The antiserum against OprF was able to significantlyinhibit the systemic spread of P. aeruginosa infection from the infection site to internal organs.Conclusions: The results suggest that anti-P. aeruginosa OprF antibodies elicited in burn wound sepsis model by active immunization are protective against infection with P. aeruginosa, and provide a rational for further development of the vaccine for prevention against P. aeruginosa infection in burn patients.

  18. Microbial profile of canine persistent wound infections

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    A. Padhy

    2014-04-01

    Full Text Available Aim: To analyse the microbial profile of canine persistent wound infections. Materials and Methods: The total wound samples (n=172 taken from both traumatic (140 and post-surgical (32 persistent wounds in canines were processed for routine microbial isolation and identification during a period of 15 months. Results: Staphylococcus intermedius was found to be the predominant isolate from all types of wounds under study. It was followed by Staphylococcus aureus, Pseudomonas aeruginosa, E. coli, Pasteurella spp., Corynaebacterium spp. and Bacillus spp. From different traumatic wounds of dogs, S. intermedius (92/140=65.7% and from surgical wounds, P. aeruginosa (24/32=75% were found to be the predominant isolates recovered whereas the most commonly isolated bacterial genus in both traumatic and surgical wounds of dogs was Staphylococcus spp. Conclusion: Canine wounds are polymicrobial in nature. Hence proper microbial laboratory diagnosis and presence of multiple organisms in a wound are to be taken into consideration for effective treatment of persistent wound infections in dogs.

  19. Clinical characteristics and treatment of burn wound sepsis in extensive burn patients: successful experience with eight cases

    Institute of Scientific and Technical Information of China (English)

    柴家科; 盛志勇; 杨红明

    2000-01-01

    Eight burn wound sepsis patients, in which 6 cases were diagnosed as MODS and two as septic shock, were treated consecutively in our hospital from September 1997 to October 1998. The plasma concentration of IL-6, IL-8, TNFα and LPS were assayed before and after surgical intervention, as well as when the patients' vital signs became stable. The results showed: ①The patients' conditions abruptly deteriorated when the burn wound sepsis emerged;②The major cause related to burn wound sepsis was extensive burn injuries, with large areas of deep burn remaining open; ③Although wound swabs taken on admission revealed the presence of colonization by many pathogenic bacteria, Pseudomonas aeruginosa was one of the most frequent bacteria isolated from the subeschar tissue; ④The plasma concentrations of IL-6, IL-8, TNF and LPS before surgical intervention were significantly higher than that after surgical intervention (P<0.05) ;⑤The lowest level of the inflammatory mediators was observed when the patients' conditions became stable, as compared with before surgical intervention (P<0. 001).These findings suggest that the clinical characteristics of burn wound sepsis are abrupt deterioration of the general condition and prominent septic symptoms, often complicated by MODS. The main cause of burn wound sepsis is the presence of a large area of open deep burn wounds, which should be excised and covered early. LPS and pro-inflammatory mediators play an important role in the pathogenesis of burn wound sepsis. Although success in treating these patients is the result of appropriate application of multiple treatments, early, aggressive and thorough surgical excision of invasive burn infectious tissue and closure of wound play a crucial role in the successful treatment of patients complicated by burn wound sepsis. Other treatments are adjuvant but also important.

  20. Perfusion of burn wounds assessed by Laser Doppler Imaging is related to burn depth and healing time

    NARCIS (Netherlands)

    Kloppenberg, FWH; Beerthuizen, GIJM; ten Duis, HJ

    2001-01-01

    Average perfusion in various burn wounds was assessed using Laser Doppler Imaging (LDI). The time necessary for a complete healing of the wound was compared to the results of the LDI measurements. A certain depth of burn was associated with a typical pattern of perfusion in the course of time. There

  1. The Use of Stem Cells in Burn Wound Healing: A Review

    OpenAIRE

    Fadi Ghieh; Rosalyn Jurjus; Amir Ibrahim; Alice Gerges Geagea; Hisham Daouk; Bassel El Baba; Sana Chams; Michel Matar; Wadih Zein; Abdo Jurjus

    2015-01-01

    Burn wound healing involves a series of complex processes which are subject to intensive investigations to improve the outcomes, in particular, the healing time and the quality of the scar. Burn injuries, especially severe ones, are proving to have devastating effects on the affected patients. Stem cells have been recently applied in the field to promote superior healing of the wounds. Not only have stem cells been shown to promote better and faster healing of the burn wounds, but also they h...

  2. EXPERIENCE IN TREATING SECONDARY SYSTEMIC MYCOTIC INFECTION AFTER SEVERE BURNS ASSOCIATED WITH ELECTRIC INJURY

    Institute of Scientific and Technical Information of China (English)

    谢卫兴; 李秀芝

    1995-01-01

    One patient with wound surface sepsis caused by secondary pyocyanic infection after extensive burns associated with visceral injuries (peptic ulcer hemorrhage, renal insufficiency and hepatic dysfunction) and generalized candidiasis albicans was cured after anti-infection treatment with proper antibiotics, removal of the infected focus, and effective anti-fungal drugs.

  3. Zymomonas mobilis Levan is Involved in Metalloproteinases Activation in Healing of Wounded and Burned Tissues

    Directory of Open Access Journals (Sweden)

    Cristina Sturzoiu

    2011-05-01

    Full Text Available Healing of burn tissue is a complete process involving reepitelization, granulation tissue formation and extracellular matrix remodeling. Thermal injury produces profound systemic changes, such as oligemic shock, anemia, renal failure and metabolic disorders. This causes direct tissue damages: inflammation and infection reactions. The tissue lesion also leads to increased oxidative stress in cells, as it has been observed by the low activity of endogenous antioxidant enzymatic and nonenzymatic systems. In this context, tissue matrix metalloproteinases (MMP plays a key role in normal physiology of conjunctive tissue during its development, morphogenesis or wound healing, having an irregular activity and being involved in the patho-physiological processes. The analysis of biological samples, MMP profiles contribute to the characterization of some processes involving tissue remodeling, processes related to wound or burn healing, possibly to the development of new therapies. In this context we studied the proliferative effect of levan, a polysaccharide produced by Gram negative bacteria, Zymomonas mobilis, a microorganism that plays an important role in modern biotechnology to produce substances of great interest in biotechnology, food industry or in biomedicine. Our studies focused on analysis of tissue MMPs profiles from Wistar rats with lesions caused by mechanic processes on skin (wounds and thermal (burn, treated by hallotherapy inCacica and Dej salt mines, before and after the treatment with levan. The results indicate that levan, a natural polysaccharide produced by wild type Z. mobilis NCIB 11163, as well as other bacterial strains, seems to have real value in the management of wounds and burns, applied individually or in combination with natural or artificial haloteraphy. The way that levan participates in the healing process is unknown, probably by activating the tissue metalloproteinases.

  4. The bio-positive effects of burned radioactive lantern mantle powder on the wound healing in rats

    Energy Technology Data Exchange (ETDEWEB)

    Mortazavi, S.M.J.; Rahmani, M.R.; Rahnama, A.; Rashidi-Nejad, H.R.; Ahmadi, J.; Aghaiee, M.M.; Behnejad, B. [Rafsanjan Univ. of Medical Sciences, (Iran, Islamic Republic of)

    2006-07-01

    Objective: Poor educated people in some parts of Iran use burned mantles as a wound healing powder to prevent the two main threats with the injuries, bleeding and the infection. Some lantern mantles contain low levels of radioactive thorium for maximizing the light output, while non-radioactive mantles contain yttrium. Although radioactive lantern mantles present a minimal radiation health hazard, it is generally believed when inhaled or ingested, thorium containing mantle powder, will be dangerous. To evaluate the effect of burned radioactive lantern mantles on wound healing this study was conducted. Materials and Methods: Twenty rats were divided randomly into two groups of 10 animals each. After inducing general anesthesia, full thickness excision wound was made on the dorsal neck in all animals. The 1. group received topical burned radioactive lantern mantle powder at 1-3 day after making excision wounds. The 2. group received non-radioactive lantern mantle powder at the same days. Accurate blind surface measurement of the wounds by transparency tracing was used for assessment of the wound healing at 1, 3, 7, 10 and 15 days after making wounds. Results: Surface area measurement of the wounds showed a progressive surface reduction in both groups. However, for thorium treated group, the rate of recovery was significantly enhanced compared to that of the control group. Although the wound area in the thorium group was not significantly different from that of the control group at the 3. and 5. days after wounding, a statistically significant difference was observed between the thorium and the control groups at the day 7, day 10 and day 15. The mean wound surface in thorium and control groups were 150.20{+-}15.87 and 186.37{+-}12.68 mm{sup 2} at day 7 (P<0.001), 92.90{+-}15.97 and 134.12{+-}14.19 mm{sup 2} at day 10 (P<0.001), 1.4{+-}0.41 and 8.56{+-}2.04 mm{sup 2} at day 15 after wounding, respectively (P<0.01) Conclusions: These findings suggest that low

  5. Wound infections on board ship--prevention, pathogens, and treatment.

    Science.gov (United States)

    Dahl, Eilif

    2011-01-01

    Wounds are common in seafarers and they can easily become infected in the marine environment. Pre-sea tetanus immunization is essential. Without diagnostic facilities and only a limited range of antibiotics onboard, injury prevention and early treatment to reduce the likelihood of infection are important measures. Suturing clean cuts reduces healing time and risk of infection. Fresh, clean cuts, especially on the face or head, can be closed by adhesive tape or sutures, but if infection arises, then one or more sutures should be removed to enable drainage. Most wounds must be considered contaminated and should not be closed, just covered with sterile dressing after cleaning. Antibiotic treatment should be started immediately in seafarers with hand and puncture wounds. The primary treatment for a simple abscess is incision and drainage. Antibiotic treatment is recommended for abscesses if the infection spreads to the surrounding tissue (associated cellulitis), if there is lack of response to incision and drainage alone, or if the abscess is in an area difficult or dangerous to drain (e.g. face, palm, genitalia). Recommended therapy for cellulitis is 5-10 days of dicloxacillin, cephalexin, clindamycin, or erythromycin, but if there is no improvement after 2-3 days, methicillin-resistant Staphylococcus aureus (MRSA) should be suspected. Bites and burn wounds require special attention. Since wound infections can deteriorate rapidly, a telemedicine advice service (TMAS) should be consulted during the early stages, and serial digital photographs of the affected area, transmitted by e-mail to TMAS, are often useful during treatment at sea. PMID:22258845

  6. Wounds with complicated shapes tend to develop infection during negative pressure wound therapy

    OpenAIRE

    Fujioka, Masaki; Hayashida, Kenji; Senjyu, Chikako

    2014-01-01

    Introduction: While negative pressure wound therapy (NPWP) has been shown to be useful, we felt that patients with wounds of complicated shapes were likely to develop infection during performing NPWT. We conducted an investigation to determine the factors of wound shape responsible for the occurrence of infection. Materials and methods: A total of 55 patients with wounds were treated using NPWT in our unit in 2011. Eight whose wounds formed a pocket, 7 whose wounds were deep, and 40 whose wou...

  7. Sternal Wound Infection by Trichosporon inkin following Cardiac Surgery

    OpenAIRE

    Davies, Frances; Logan, Sarah; Johnson, Elizabeth; Klein, John L.

    2006-01-01

    Wound infection following cardiac surgery is well described but is rarely due to fungal infection. We describe a case of sternal wound infection caused by Trichosporon inkin with a fatal outcome, in an immunocompetent patient following aortic root surgery.

  8. APPLICATION OF CREATE DRESSING CARE IN BURN INFECTION WOUND%汇涵术泰护创液在烧伤感染创面中的临床应用

    Institute of Scientific and Technical Information of China (English)

    金先革; 晁生武

    2011-01-01

    [目的]观察汇涵术泰护创液(Create dressing care)对烧伤感染创面的疗效.[方法]2008年2月~2010年5月对60例120处烧伤感染创面应用汇涵术泰护创液,观察创面局部细菌清除、创面愈合情况及全身反映情况.[结果]汇涵术泰护创液对皮肤无刺激、无致敏,杀菌力强,对金黄色葡萄球菌、绿脓杆菌等多种细菌具有杀灭作用;预防伤口感染,促进创面愈合.[结论]应用汇涵术泰护创液有控制局部创面感染;促进烧伤创面愈合的作用.%[Objective] To observe the effect of Create dressing care on the healing of bum wound infection. [Methods] From 2008 to 2010, 60 patients of 120 bum wound used the Create dreassing care. The 120 patients with bum wounds. The healing time of wounds and the local and systemic reactions were observed. [Results] Application to Create dressing caretrans-parent, non-stimulating the shin, non-allergenic, highly bactericidal against staphylococcus aureus, pesudomonas aeruginosa and other bacteria in minutes kill, the prevention of wound infection and promote wound healing. [Conclusion] Create dressing care can control the wound infection and accelerate the healing of wound.

  9. Effect of Phyllanthus niruri.Linn on burn wound in rats

    Institute of Scientific and Technical Information of China (English)

    Tara Shanbhag; Arul Amuthan; Smita Shenoy; Sudhakar

    2010-01-01

    Objective:To evaluate the effect of ethanolic extract ofPhyllanthus niruri.Linn (Euphorbiaceae) on experimentally induced burn wound model in rats and to evaluate whether it reverses the wound healing in steroid suppressed rats.Methods: Two models including burn wound model and dexamethasone suppressed burn wound model were used in the study. The formulations of ethanolic extract ofPhyllanthus niruri were prepared in gum acacia at 8% and in ointment base at 10% and were administered orally (400 mg/kg) and externally respectively. The parameters studied were the wound contraction and the period of epithelialisation.Results: In burn wound model, oral and topical administration ofPhyllanthus niruri did not show any significant effects in wound contraction and period of epithelialisation when compared to control. In dexamethasone suppressed burn wound model, wound contraction rate was increased significantly by topical (P< 0.001) and oral (P < 0.001) administrations ofPhyllanthus niruriby about 47.57% and 26.16% respectively. Topical administration has shown significant (P< 0.05) enhancement of wound contraction than oral dosage form. Dexamethasone depressed epithelialisation period was reversed significantly by topical (P< 0.0001) and oral (P <0.001) administrations ofPhyllanthus niruri by about 32.5% and 21.3% respectively.Conclusions:Both topical and oral administrations of ethanolic extract ofPhyllanthus niruriare found to reverse dexamethasone suppressed burn wound healing.

  10. Amish Culture and Their Utilization of Burns and Wounds Ointment for the Treatment of Burns.

    Science.gov (United States)

    Trinkle, Krystal Melich

    2016-01-01

    As indicated in the 2010 United States Religion Census, there are approximately 251,000 Amish people in the United States and Ontario. This census also demonstrated that a new Amish community is founded on average about every three-and-a-half weeks, suggesting that this religious culture is the fastest-growing religion throughout the United States. Because of the rapid growth of the Amish population, it is essential for health care workers to understand their background, cultural, and health care beliefs, especially in the treatment of burns. The purpose of this article is to examine the Amish background, cultural, and health care beliefs, specifically the utilization of burns and wounds ointment and burdock leaves in the treatment of burns.

  11. Clinical Efficacy Test of Polyester Containing Herbal Extract Dressings in Burn Wound Healing.

    Science.gov (United States)

    Muangman, Pornprom; Praditsuktavorn, Banjerd; Chinaroonchai, Kusuma; Chuntrasakul, Chomchark

    2016-09-01

    Technological advancement has assisted in developing various availabilities of wound products that help in not only in healing and preventing infection but also in providing patients' comfort and pain reduction during application. However, most of advanced wound healing products in Thailand were imported at high costs to patients. Nowadays, there are increased numbers of local researches of herbs that could provide healing environment for successful wound care. Herbal wound products are currently being introduced as alternatives to those imported dressings. The aim of this study was to report the clinical efficacy of using polyester containing herbal extract dressings in healing of second-degree burns. The volunteers were divided by simply randomized method into the study group of patient using polyester containing herbal extract dressing and the control group of patients treating with dressings that are commercially available and common use. The standard treatment protocols were performed at every 3 days of dressing change. Comparative evaluation consisted of time of healing, length of hospital stays, pain analog score assessment, percentage of infection, and descriptive notification of unfavorable clinical symptoms or signs or side effects.

  12. Therapeutic efficacy of Lactobacillus acidophilus against bacterial isolates from burn wounds

    Directory of Open Access Journals (Sweden)

    Mohammed Sh. Jebur

    2010-12-01

    : The results of the study concluded that lactobacillus acidophilus concentration of 1X108 cells/mL had a high activity to inhibit the growth in-vitro of all pathogenic gram-positive and gram-negative bacteria, which cause burn wound infections. This indicated the therapeutic efficacy of lactobacillus acidophilus bacteria.

  13. Therapeutic efficacy of Lactobacillus acidophilus against bacterial isolates from burn wounds

    Directory of Open Access Journals (Sweden)

    Mohammed Sh. Jebur

    2010-01-01

    -100%. Conclusion : The results of the study concluded that lactobacillus acidophilus concentration of 1X10 8 cells/mL had a high activity to inhibit the growth in-vitro of all pathogenic gram-positive and gram-negative bacteria, which cause burn wound infections. This indicated the therapeutic efficacy of lactobacillus acidophilus bacteria.

  14. Current concepts on burn wound conversion-A review of recent advances in understanding the secondary progressions of burns.

    Science.gov (United States)

    Salibian, Ara A; Rosario, Angelica Tan Del; Severo, Lucio De Almeida Moura; Nguyen, Long; Banyard, Derek A; Toranto, Jason D; Evans, Gregory R D; Widgerow, Alan D

    2016-08-01

    Burn wound conversion describes the process by which superficial partial thickness burns convert into deeper burns necessitating surgical intervention. Fully understanding and thus controlling this phenomenon continues to defy burn surgeons. However, potentially guiding burn wound progression so as to obviate the need for surgery while still bringing about healing with limited scarring is the major unmet challenge. Comprehending the pathophysiologic background contributing to deeper progression of these burns is an essential prerequisite to planning any intervention. In this study, a review of articles examining burn wound progression over the last five years was conducted to analyze trends in recent burn progression research, determine changes in understanding of the pathogenesis of burn conversion, and subsequently examine the direction for future research in developing therapies. The majority of recent research focuses on applying therapies from other disease processes to common underlying pathogenic mechanisms in burn conversion. While ischemia, inflammation, and free oxygen radicals continue to demonstrate a critical role in secondary necrosis, novel mechanisms such as autophagy have also been shown to contribute affect significantly burn progression significantly. Further research will have to determine whether multiple mechanisms should be targeted when developing clinical therapies.

  15. Evaluation of the Effects of Honey on Acute-Phase Deep Burn Wounds

    Directory of Open Access Journals (Sweden)

    Yukari Nakajima

    2013-01-01

    Full Text Available This study aimed to clarify the effects of honey on acute-phase deep burn wounds. Two deep burn wounds were created on mice which were divided into four groups: no treatment, silver sulfadiazine, manuka honey, and Japanese acacia honey. Wound sizes were calculated as expanded wound areas and sampled 30 minutes and 1–4 days after wounding for histological observation. The wound sections were subjected to hematoxylin and eosin and immunohistological staining to detect necrotic cells, apoptotic cells, neutrophils, and macrophages. The no treatment group formed a scar. The redness around the wound edges in the silver sulfadiazine group was the most intense. All groups exhibited increased wound areas after wounding. The proportions of necrotic cells and the numbers of neutrophils in the manuka and acacia honey groups were lower than those in the no treatment and silver sulfadiazine groups until day 3; however, there were no significant differences between all groups on day 4. These results show that honey treatment on deep burn wounds cannot prevent wound progression. Moreover, comparing our observations with those of Jackson, there are some differences between humans and animals in this regard, and the zone of hyperemia and its surrounding area fall into necrosis, which contributes to burn wound progression.

  16. EFFECT OF ETHANOLIC EXTRACT OF PLECTRANTHUS AMBOINICUS LEAF ON HEALING OF BURN WOUND IN WISTAR RATS

    OpenAIRE

    Smita Shenoy; Sukesh,; Vinod MS; Shruthi; Mohan Amberkar; Arul Amuthan

    2012-01-01

    Objectives: To study the effect of ethanolic extract of the leaf of Plectranthus amboinicus on the healing of burn wounds in wistar rats and compare it with silver sulfadiazine treated group. Materials and Methods: Five groups of rats were used in the study. Partial thickness burn wounds were made on each rat under ketamine anesthesia.The wounds in the five groups of rats were treated topically with petroleum base, silver sulfadiazine,1%, 2% and 3% ointment of ethanolic extract of Plectran...

  17. Clinical effects of nano-silver burn dressings and silver sulfadiazine cream on treatment of deep Ⅱ degree burn wounds infections%纳米银烧伤敷料与磺胺嘧啶银乳膏治疗深Ⅱ度烧伤患者创面感染的研究

    Institute of Scientific and Technical Information of China (English)

    蒋瑞明; 张元海; 叶春江; 倪良方; 何勇

    2015-01-01

    OBJECTIVE To explore the clinical effects of conventional drug dressings such as nano‐silver burn dress‐ings and silver sulfadiazine cream on treatment of deep Ⅱ degree burn wounds infections so as to provide guidance for clinical diagnosis and treatment .METHODS A total of 90 thermal burns patients who were hospitalized from Jan 2012 to Dec 2014 were enrolled in the study ,with the total burn area varying from 5 .00% to 29 .00% of body surface area ,and they had different deep Ⅱ degree of limb burns .The subjects were randomly divided into the control group and the observation group ,with 45 cases in each .The control group was treated with silver sulfadi‐azine cream ,while the observation group was given nano‐silver burn dressings for conventional drug dressing ,and the wounds were treated with debridement ,rinsing ,bandaging ,and dressing once every two days .RESULTS Af‐ter the treatment for 2 weeks ,the CRP level of the observation group was (16 .28 ± 2 .95)mg/L ,the wound heal‐ing time (18 .94 ± 3 .75)days ,the pigmentation subsided time (43 .45 ± 8 .26) days ,significantly better than those of the control group (P<0 .05) .The positive rate of bacterial culture of the observation group was 8 .89% after the treatment for 1 week ,significantly lower than that of the control group ;the positive rate of bacterial culture of the observation group was 0 after the treatment for 2 weeks ,significantly lower than that of the control group (P<0 .01) .The excellent and good rate of cicatrices of the observation group was 93 .34% ,significantly higher than 77 .78% of the control group (P< 0 .01) .CONCLUSION Nano‐silver burn dressings can achieve significant clinical effect on treatment of deep Ⅱ degree burn wounds ,shorten the wound healing time ,facilitate the recover‐y ,and improve the prognosis .It is worthy to be promoted in the hospital .%目的:探讨纳米银烧伤敷料、磺胺嘧啶银乳膏常规换药治疗深Ⅱ度烧伤创面感

  18. Re: Infection control in burn patients: are fungal infections underestimated?

    OpenAIRE

    Dries David J

    2009-01-01

    Abstract A response to Struck MF. Infection control in burn patients: are fungal infections underestimated? Scand J Trauma Resusc Emerg Med. 2009 Oct 9;17(1):51. [Epub ahead of print] PubMed PMID: 19818134.

  19. Treatment of hypergranulation tissue in burn wounds with topical steroid dressings: a case series.

    Science.gov (United States)

    Jaeger, Marie; Harats, Moti; Kornhaber, Rachel; Aviv, Uri; Zerach, Amir; Haik, Josef

    2016-01-01

    Hypergranulation tissue (or also known as overgranulation) may negatively influence burn wound healing time and contribute to recurrence of contractures in burn wounds and grafts. Subsequently, the treatment of hypergranulation tissue remains controversial and problematic. In this case series, we aimed to examine the feasibility and document the use of topical hydrocortisone in the treatment of hypergranulation tissue formation resulting from burn wounds. We report five cases where hypergranulation tissue developed following deep dermal/full-thickness burns. Initial burn wound treatment included necrotic tissue debridement, wound cleansing, and Flaminal(®). All five cases underwent surgical debridement and split-skin grafting. Upon identification of hypergranulation tissue, hydrocortisone acetate 0.25% was applied topically as usual care for the treatment of hypergranulation tissue. All five patients had deep dermal/full-thickness burns with a total body surface area ranging from 22% to 61% and were aged from 3-41 years. All five cases developed hypergranulation tissue during their admission after debridement and split-thickness skin grafts. All patients showed an improvement in the treated areas with a complete regression of hypergranulation tissue and closure of the burn wounds. No clinically apparent local or systemic side effects of the treatment were observed. Topical hydrocortisone can be utilized as an effective, inexpensive, and noninvasive practical option in the treatment of hypergranulation tissue resulting from burn wounds. PMID:27570466

  20. 大面积侵袭感染组织切除对烧伤创面脓毒症患者静息能量消耗的影响%The effects of extensive excision of massive invasive infected burn wound on the REE of burn patients with sepsis

    Institute of Scientific and Technical Information of China (English)

    柴家科; 盛志勇; 高建川; 杨红明; 许明火; 李利根; 贾晓明; 刁力; 常东; 郭振荣

    2001-01-01

    目的观察大面积侵袭感染组织切除对烧伤创面脓毒症患者高代谢的影响。方法对连续救治的8例烧伤创面脓毒症患者,分别于大面积侵袭感染组织切除前,手术后和病情稳定时,对静息能量消耗( resting energy expenditure, REE )白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子α(TNFα)、内毒素(LPS)进行监测。结果侵袭感染组织切除后REE水平[(307.7±31.3)kJ·h-1·(m2)-1]较手术前[(365.6±18.9)kJ·h-1·(m2)-1]显著降低(P<0.01),病情平稳时REE值[(258.9±12.6)kJ·h-1·(m2)-1]较手术后明显下降(P<0.01);侵袭性感染组织切除后IL-6、IL-8、TNFα、LPS含量较手术前降低显著(P<0.05),病情平稳时下降更明显(P<0.001),REE与IL-6、IL-8、TNFα、LPS水平呈正相关(P<0.01)。结论大面积侵袭感染组织切除后可减轻炎症介质的过度释放,有助于控制或减轻烧伤创面脓毒症患者高代谢反应。%Objective To explore the effects of extensive excision of massive invasive infected burn wound on the REE of burn patients with sepsis. Methods REEs and plasma levels of IL - 6,IL - 8 ,TNFα and LPS were determined before and after surgical interventions and when patients condition improved in 8 burned cases with sepsis. Results All the 8 patients survived after treatment. The REE level in patients after operation was significantly lower than those before the operation ( P < 0. 01 ). REE in patients whose condition improved decreased obviously when compared to that after operation( P < 0. 01 ). The plasma levels of IL - 6,IL - 8, TNFα and LPS decreased markedly after the operation when compared to those before operation ( P < 0. 05 ). and there were lower levels of these factors when the patients condition improved( P <0. 001 ). Furthermore, there were closely positive correlations between REE and plasma IL- 6, IL- 8, TNFα and LPS( P < 0. 01 ). Conclusion Over- releasing of some inflammatory

  1. Management of postoperative instrumented spinal wound infection

    Institute of Scientific and Technical Information of China (English)

    FANG Xiu-tong; Kirkham B.Wood

    2013-01-01

    Background Wound infection following spinal instrumented surgery is a frequent complication.The optimal treatment of acute deep wound infection following spinal instrumentation fusion remains controversial because of variability in cohort identification,definition of an infection,and the instrument used to measure outcomes.This retrospective study evaluated the clinical curative effect for postoperative spinal infection after instrumented spine fusion with extensive debridement,or implant removal.Methods From January 2004 to October 2009,851 patients were identified who underwent surgical treatment of spinal diseases.The medical records of patients who developed infections were reviewed in detail.Results Of 851 patients,41 (4.9%) developed an infection.Thirty-three were acute,and eight were delayed.Acute infected cases were managed with antibiotic therapy,and aggressive debridement of the wound and soft tissues leaving all instrumentation in situ in all but one patient.The most common symptoms of acute infection included:posterior incisional drainage (26 of 33 patients),back pain (22 of 33 patients) and fever (13 of 33 patients).Among patients with delayed onset infection,five of eight patients had local pain,four of eight patients had incision drainage,and one patient had a prolonged period of intermittent fever.The most frequent causative organism for postoperative spinal infection following spine surgery is Staphylococcus aureus.Pseudarthrosis was noted in long-term follow-up in four of 41 patients.Conclusions We recommend irrigation and debridement,no instrumentation removal,and,if necessary,repeat debridement followed by delayed primary closure for the treatment of acute deep infection with instrumentation.

  2. Bacteriological evaluation of wounds in seriously burned hospitalized patients

    Directory of Open Access Journals (Sweden)

    Sueli de Lourdes Nogueira Vilela Silva

    1991-09-01

    Full Text Available During the period between May and December 1988, 21 patients were studied bacteriologically at Hospital João XXIII's burn's unit which belongs to "Fundação Hospitalar do Estado de Minas Gerais" in Belo Horizonte, Brazil. A qualitative and quantitative evaluation of aerobic and facultative bacteria from burn wounds was carried out by the standard filter paper disc technique, including antibiotic susceptibility. At the same time an evaluation of those bacteria isolated from the environmental unit was performed. The most common organisms recovered from wounds of patients were: Pseudomonas aeruginosa, Staphylococcus aureus, and Staphylococcus epidermidis. P. pseudomallei was the most frequent strain recovered from environmental specimens. In nearly all patients specimens (16 in total from whom P. aeruginosa was isolated, the rate of CFU/cm² of skin was above 10². In nine of these, it reached 10(5, wich is equivalent to 10(7 CFU/g of burned tissue.No período de maio a dezembro de 1988, foram avaliados bacteriologicamente 21 pacientes da Unidade de Queimados do Hospital João XXIII pertencente à Fundação Hospitalar do Estado de Minas Gerais, em Belo Horizonte, Brasil. A avaliação qualitativa e quantitativa de bactérias aeróbicas e facultativas de queimaduras foi realizada através da técnica do disco de papel de filtro padronizado, incluindo a susceptibilidade a antimicrobianos. Ao mesmo tempo, foi realizada uma avaliação das bactérias isoladas do ambiente da Unidade. Os microrganismos mais frequentemente recuperados das feridas dos pacientes foram: Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis. A espécie P. pseudomallei foi a mais frequente nos espécimes ambientais. Em quase todos os espécimes de pacientes dos quais P. aeruginosa (16 pacientes foi isolada, a taxa CFU/cm² de pele estava acima de 10². Em nove destes, alcançou 10(5, o que equivale a 10(7 CFU/g de tecido queimado.

  3. Mortality rate associated with hospital acquired infections among burn patients

    Directory of Open Access Journals (Sweden)

    Saima Aslam Bharwana

    2016-09-01

    Full Text Available Hospital acquired infections (HAIs are the major contributors of mortality associated with burn injuries. The aim of this research was to document the antecedents affiliated with major burn injuries, hospitalization and mortality in burn patients. We performed a single center prospective study of patients admitted during 3 months period (April-June 2014 in burn wards of government hospital. There were 100 patients in this investigation which were observed weekly. The inclusion criterion was based on the shifting of patients from emergency to the wards after initial treatment of more than 24 h. Variables included were age and gender of the patient, the percent total body surface area (%TBSA burn, the cause of the burn. Mean age of patients was 30.29 years. More females (55.67% were admitted than males (44.32%. The total body surface area (%TBSA burnt were from 15%- 95% respectively moreover children were more sensitive to hospital acquired infections (HAIs and mortality rate was 34% in children with mean age of 5 years and disability of body parts were 42% among 75% were females. Whereas the most common (HAIs were primary blood stream (PBS with mean value of 30.50, wound infections (WIS were at second prevalence with mean value of 27.50, followed by sepsis (S and pneumonia (P 10.33, eye infections (EIs 4.833 and urinary tract infections (UTIs 2.667. Factors significantly (p-value= 0.000 associated with increased duration of hospitalization caught HAIs mortality include the age and gender of the patient, the cause of burn, inhalation injury, the region affected and %TBSA burnt. It concluded that the mortality was very much dependent on age and gender of the patient, burn causes, affected area as well as %TBSA burnt are considerable factors in determining the relationship of HAIs and whether the patients will survive or knuckle to injuries. Better compliance techniques, stricter control over disinfection and sterilization practices and usage of

  4. Beneficial effects of hydrogen-rich saline on early burn-wound progression in rats.

    Directory of Open Access Journals (Sweden)

    Song Xue Guo

    Full Text Available Deep burn wounds undergo a dynamic process known as wound progression that results in a deepening and extension of the initial burn area. The zone of stasis is more likely to develop more severe during wound progression in the presence of hypoperfusion. Hydrogen has been reported to alleviate injury triggered by ischaemia/reperfusion and burns in various organs by selectively quenching oxygen free radicals. The aim of this study was to investigate the possible protective effects of hydrogen against early burn-wound progression.Deep-burn models were established through contact with a boiled, rectangular, brass comb for 20 s. Fifty-six Sprague-Dawley rats were randomly divided into sham, burn plus saline, and burn plus hydrogen-rich saline (HS groups with sacrifice and analysis at various time windows (6 h, 24 h, 48 h post burn. Indexes of oxidative stress, apoptosis and autophagy were measured in each group. The zone of stasis was evaluated using immunofluorescence staining, ELISA, and Western blot to explore the underlying effects and mechanisms post burn.The burn-induced increase in malondialdehyde was markedly reduced with HS, while the activities of endogenous antioxidant enzymes were significantly increased. Moreover, HS treatment attenuated increases in apoptosis and autophagy postburn in wounds, according to the TUNEL staining results and the expression analysis of Bax, Bcl-2, caspase-3, Beclin-1 and Atg-5 proteins. Additionally, HS lowered the level of myeloperoxidase and expression of TNF-α, IL-1β, and IL-6 in the zone of stasis while augmenting IL-10. The elevated levels of Akt phosphorylation and NF-κB p65 expression post burn were also downregulated by HS management.Hydrogen can attenuate early wound progression following deep burn injury. The beneficial effect of hydrogen was mediated by attenuating oxidative stress, which inhibited apoptosis and inflammation, and the Akt/NF-κB signalling pathway may be involved in regulating the

  5. Treatment of hypergranulation tissue in burn wounds with topical steroid dressings: a case series

    Directory of Open Access Journals (Sweden)

    Jaeger M

    2016-08-01

    Full Text Available Marie Jaeger,1,* Moti Harats,1,* Rachel Kornhaber,2 Uri Aviv,1 Amir Zerach,1 Josef Haik1,3 1Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel Hashomer, Israel; 2School of Health Sciences, Faculty of Health, University of Tasmania, Sydney, NSW, Australia; 3Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel *These authors contributed equally to this work. Abstract: Hypergranulation tissue (or also known as overgranulation may negatively influence burn wound healing time and contribute to recurrence of contractures in burn wounds and grafts. Subsequently, the treatment of hypergranulation tissue remains controversial and problematic. In this case series, we aimed to examine the feasibility and document the use of topical hydrocortisone in the treatment of hypergranulation tissue formation resulting from burn wounds. We report five cases where hypergranulation tissue developed following deep dermal/full-thickness burns. Initial burn wound treatment included necrotic tissue debridement, wound cleansing, and Flaminal®. All five cases underwent surgical debridement and split-skin ­grafting. Upon identification of hypergranulation tissue, hydrocortisone acetate 0.25% was applied ­topically as usual care for the treatment of hypergranulation tissue. All five patients had deep dermal/full-thickness burns with a total body surface area ranging from 22% to 61% and were aged from 3–41 years. All five cases developed hypergranulation tissue during their admission after debridement and split-thickness skin grafts. All patients showed an improvement in the treated areas with a complete regression of hypergranulation tissue and closure of the burn wounds. No clinically apparent local or systemic side effects of the treatment were observed. Topical hydrocortisone can be utilized as an effective, inexpensive, and noninvasive practical option in the treatment of hypergranulation tissue resulting from burn wounds

  6. Noninvasive measurement of burn wound depth applying infrared thermal imaging (Conference Presentation)

    Science.gov (United States)

    Jaspers, Mariëlle E.; Maltha, Ilse M.; Klaessens, John H.; Vet, Henrica C.; Verdaasdonk, Rudolf M.; Zuijlen, Paul P.

    2016-02-01

    In burn wounds early discrimination between the different depths plays an important role in the treatment strategy. The remaining vasculature in the wound determines its healing potential. Non-invasive measurement tools that can identify the vascularization are therefore considered to be of high diagnostic importance. Thermography is a non-invasive technique that can accurately measure the temperature distribution over a large skin or tissue area, the temperature is a measure of the perfusion of that area. The aim of this study was to investigate the clinimetric properties (i.e. reliability and validity) of thermography for measuring burn wound depth. In a cross-sectional study with 50 burn wounds of 35 patients, the inter-observer reliability and the validity between thermography and Laser Doppler Imaging were studied. With ROC curve analyses the ΔT cut-off point for different burn wound depths were determined. The inter-observer reliability, expressed by an intra-class correlation coefficient of 0.99, was found to be excellent. In terms of validity, a ΔT cut-off point of 0.96°C (sensitivity 71%; specificity 79%) differentiates between a superficial partial-thickness and deep partial-thickness burn. A ΔT cut-off point of -0.80°C (sensitivity 70%; specificity 74%) could differentiate between a deep partial-thickness and a full-thickness burn wound. This study demonstrates that thermography is a reliable method in the assessment of burn wound depths. In addition, thermography was reasonably able to discriminate among different burn wound depths, indicating its potential use as a diagnostic tool in clinical burn practice.

  7. [Invasive yeast infections in severely burned patients].

    Science.gov (United States)

    Renau, Ana Isabel; García-Vidal, Carolina; Salavert, Miguel

    2016-01-01

    Currently, there are few studies on candidaemia in the severely burned patient. These patients share the same risk factors for invasive fungal infections as other critically ill patients, but have certain characteristics that make them particularly susceptible. These include the loss of skin barrier due to extensive burns, fungal colonisation of the latter, and the use of hydrotherapy or other topical therapies (occasionally with antimicrobials). In addition, the increased survival rate achieved in recent decades in critically burned patients due to the advances in treatment has led to the increase of invasive Candida infections. This explains the growing interest in making an earlier and more accurate diagnosis, as well as more effective treatments to reduce morbidity and mortality of candidaemia in severe burned patients. A review is presented on all aspects of the burned patient, including the predisposition and risk factors for invasive candidiasis, pathogenesis of candidaemia, underlying immunodeficiency, local epidemiology and antifungal susceptibility, evolution and prognostic factors, as well as other non-Candida yeast infections. Finally, we include specific data on our local experience in the management of candidaemia in severe burned patients, which may serve to quantify the problem, place it in context, and offer a realistic perspective. PMID:27395025

  8. PREPARATIVE SKIN PREPARATION AND SURGICAL WOUND INFECTION

    OpenAIRE

    Anjanappa; Arjun

    2015-01-01

    BACKGROUND AND OBJECTIVE: It is an established fact now that the normal skin of healthy human beings harbours a rich bacterial fl ora. Normally considered non - pathogenic , these organisms way be a potential source of infection of the surgical wound. Approximately 20% of the resident flora is beyond the reach of surgical scrubs and antiseptics. The goal of surgical preparation of the skin with antiseptics is to remove transient and pathogenic microorganism...

  9. Assessment of the effectiveness of silver-coated dressing, chlorhexidine acetate (0.5%), citric acid (3%), and silver sulfadiazine (1%) for topical antibacterial effects against the multi-drug resistant Pseudomonas aeruginosa infecting full-skin thickness burn wounds on rats.

    Science.gov (United States)

    Yabanoglu, Hakan; Basaran, Ozgur; Aydogan, Cem; Azap, Ozlem Kurt; Karakayali, Feza; Moray, Gokhan

    2013-01-01

    The aim of this study was to compare the effects of four different topical antimicrobial dressings on a multi-drug resistant Pseudomonas aeruginosa contaminated full-thickness burn wound rat model. A total of 40 adult male Wistar albino rats were used. The control group (group 1), silver sulfadiazine (1%) group 2, chlorhexidine acetate (0.5%) group 3, citric acid (3%) group 4, and silver-coated dressing group 5 were compared to assess the antibacterial effects of a daily application to a 30% full-skin thickness burn wound seeded 10 minutes earlier with 10(8) CFU (colony forming unit)/0.5 mL of a multi-drug resistant Pseudomonas aeruginosa strain. Five groups (1 control group and 4 treatment groups) were compared. The administration of third-degree burns to all rats was confirmed based on histopathologic data. The tissue cultures from groups 2 and 5 exhibited significant differences compared to those of the other 3 groups, whereas no significant differences were observed between groups 1, 3, and 4. The effectiveness of the treatments was as follows: 1% silver sulfadiazine > silver-coated dressing > 3% citric acid > 0.5% chlorhexidine acetate > control group. Our results supported the efficacy of topical therapy by silver sulfadiazine and silver-coated dressing on infections caused by multi-drug resistant Pseudomonas spp.

  10. Clinical Experience in Using the Water Jet in Burn Wound Debridement

    Science.gov (United States)

    Yang, J.-Y.; Hwuang, J.-Y.; Chuang, S.-S.

    2007-01-01

    Summary Water jets have been used in many areas of surgery. Recently a new surgical debridement device was launched onto the market - VersajetTM. VersajetTM is a unique hydrosurgical device that uses a precise jet of water to simultaneously hold, cut, and remove devitalized or necrotic tissue. This paper describes our experience with ten patients comparing Weck knives with the newly designed hydrosurgical device when debriding burn wounds. The patients' age ranged from 27 to 60 yr (average, 37.8 yr) and the burn wounds treated were between 3 and 7% total body surface area, involving the face, abdomen, and limbs. The hydrosurgical system is a very useful tool for irregular and complex burn wound debridement. This paper represents the first written clinical experience utilizing hydrosurgery in the burn wound management in an Eastern country. PMID:21991073

  11. PREPARATIVE SKIN PREPARATION AND SURGICAL WOUND INFECTION

    Directory of Open Access Journals (Sweden)

    Anjanappa

    2015-01-01

    Full Text Available BACKGROUND AND OBJECTIVE: It is an established fact now that the normal skin of healthy human beings harbours a rich bacterial fl ora. Normally considered non - pathogenic , these organisms way be a potential source of infection of the surgical wound. Approximately 20% of the resident flora is beyond the reach of surgical scrubs and antiseptics. The goal of surgical preparation of the skin with antiseptics is to remove transient and pathogenic microorganisms on the skin surface and to reduce the resident flora to a low level. Povidone iodine (I odophors and chlorhexidine are most often used antiseptics for pre - operative skin preparation. OBJECTIVES : To evaluate the efficacy of povidone iodine alone and in combination with antiseptic agent containing alcoholic chlorhexidine in preoperative skin p reparation by taking swab culture. (2 To compare the rate of postoperative wound infection in both the groups. METHODS: One hundred patients (fifty in each group undergoing clean elective surgery with no focus of infection on the body were included in th e study. The pre - operative skin preparation in each group is done with the respective antiseptic regimen. In both the groups after application of antiseptics , sterile saline swab culture was taken immediately from site of incision. In cases which showed gr owth of organisms , the bacteria isolated were identified by their morphological and cultural characteristics. Grams staining , coagulase test and antibiotic sensitivity test were done wherever necessary and difference in colonization rates was determined as a measure of efficacy of antiseptic regimen. RESULTS: The results of the study showed that when compared to povidone iodine alone , using a combination of povidone iodine and alcoholic solution of chlorhexidine , the colonization rates of the site of incisi on were reduced significantly. As for the rate of post - operative wound infection , it is also proven that wound infections are also

  12. Gelam (Melaleuca spp.) Honey-Based Hydrogel as Burn Wound Dressing

    OpenAIRE

    Rozaini Mohd Zohdi; Zuki Abu Bakar Zakaria; Norimah Yusof; Noordin Mohamed Mustapha; Muhammad Nazrul Hakim Abdullah

    2012-01-01

    A novel cross-linked honey hydrogel dressing was developed by incorporating Malaysian honey into hydrogel dressing formulation, cross-linked and sterilized using electron beam irradiation (25 kGy). In this study, the physical properties of the prepared honey hydrogel and its wound healing efficacy on deep partial thickness burn wounds in rats were assessed. Skin samples were taken at 7, 14, 21, and 28 days after burn for histopathological and molecular evaluations. Application of honey hydrog...

  13. Biological Activity of Propolis-Honey Balm in the Treatment of Experimentally-Evoked Burn Wounds

    OpenAIRE

    Żaneta Jastrzębska-Stojko; Rafał Stojko; Anna Rzepecka-Stojko; Agata Kabała-Dzik; Jerzy Stojko

    2013-01-01

    Medicines of biogenic origin with micro-organic, regenerative and analgesic properties are becoming more and more significant in the treatment of burn wounds. These properties are found in apitherapeutics such as propolis and honey—products collected and processed by a honey bee. Their effect on the course of the healing processes is multidirectional. The aim of the study was a histopathological and biochemical analysis of the processes of scar formation in experimentally evoked burn wounds ...

  14. Effect of electrolyzed oxidizing water on deep second degree burn wounds infected with Pseudomonas aeruginosa%酸性氧化电位水对铜绿假单胞菌感染的深Ⅱ度烧伤创面的效果

    Institute of Scientific and Technical Information of China (English)

    丁敬美; 李武平; 钱皎月; 白晓智; 胡大海

    2014-01-01

    目的:探讨酸性氧化电位水(EOW)用于冲洗铜绿假单胞菌感染的深Ⅱ度烧伤创面的临床效果,为医护人员合理选择液体进行创面冲洗与消毒提供依据。方法实验用SD雄性大鼠54只,在SD大鼠背部建立两个一致的铜绿假单胞菌感染的深Ⅱ度烧伤创面,随机分为3组,A组采用醋酸氯己定溶液冲洗、B组采用酸性氧化电位水冲洗、C组采用生理盐水冲洗擦干后,3组均用斯丽凯纳米银抗菌凝胶进行换药,记录换药后创面组织细菌含量的降低值和创面愈合过程中的创面收缩率、上皮化率和创面愈合时间,数据采用SPSS19.0统计软件进行处理。结果换药前后3组创面的细菌定量的差值差异明显,B组创面换药前后差值最大为(1.21±0.51)×108 CFU/g ,抑菌率为(52.41±6.42)%,差异有统计学意义(P<0.05);烫伤后早期两组创面的收缩率无明显差异,随着换药次数的增加,两组之间的差异逐渐增大;在烫伤第16天B组创面的上皮化率(89.79±5.43)%明显快于A组(62.35±9.65)%和C组(72.92±5.73)%,差异有统计学意义( P<0.05);B组创面愈合时间最短为(17.75±1.49)d ,C组次之(22.00±2.20)d ,A组时间最长(24.25±2.12)d ,3组愈合时间比较差异有统计学意义( P<0.05)。结论 EOW的杀菌能力和促进创面愈合能力明显优于醋酸氯己定溶液和生理盐水,是治疗深Ⅱ度烧伤创面的重要手段之一。%OBJECTIVE To observe the clinical effect of electrolyzed oxidizing water (EOW) on flushing of deep second degree burn wounds infected with Pseudomonas aeruginosa so as to provide guidance for flushing and disinfection of the burn wounds with appropriate solutions .METHODS Totally 54 male Sprague-Dawley (SD) rats with two consistent deep second degree burn were infected with P .aeruginosa on the back ,the

  15. Clinical observation of the effects of combined FE enzymes in the treatment of residual infected burn wounds at late postburn stage%FE复合溶菌酶治疗烧伤后期感染残余创面的临床研究

    Institute of Scientific and Technical Information of China (English)

    杨新刚; 李金娥; 张宝泉; 高伟; 党正杰; 王守峰

    2009-01-01

    目的 确证FE复合溶菌酶对烧伤后期残余创面杀菌作用与促愈作用.方法 选取笔者单位烧伤残余创面患者30例,随机分为治疗组,用无菌纱布浸湿FE复合溶菌酶后湿敷创面.对照组用庆大霉素盐水纱布湿敷创面,2次/d.于用药前后取创面分泌物培养,观察FE复合溶菌酶对创面细菌敏感率并观察愈合时间及肝肾功情况.结果 FE复合溶菌酶应用3 d后,能杀死残余创面中89.9%的细菌,治疗组愈合时间明显短于对照组.差异有统计学意义(P<0.01)使用后未见全身不良反应.结论 FE复合溶菌酶治疗烧伤后期残余创面安全有效,可以有效控制残余创面感染,提高创面愈合率.%Objective To confiming the effect of combined FE combined enzymes in the treatment of residual infected burn wounds at late postburn stage.Methods Thirty patients with residual wounds at late postburn stage were enrolled in the study,and they were randomly divided into A(treated with combined FE combined enzymes)and B( treated with gentamicin)groups,with 15 patients in each group,several layers of gauze,either soaked with combined FE combined enzymes in A or gentmnicin in B group,were used to cover the residual wounds at late postbum stage once to twice a day.Bacterial culture from the burn wounds exudation before and after drug administration was done before the application of the agents.Susceptibility of the bacteria to antibiotics were identified.The healing time of the burn wounds was recorded,and also bepatia and renal functions of the patients were examined.Results Eighty-nine percent bacteria could be killed by FE combined enzymes after gauze with FE enzymes had been used for over 3 d.The wound healing time the residual wounds at late posthurn stage in A group was siginificandy shorter than that in B group.No adverse side-effects were observed in either group.Condusion Combined FE combined enzymes is safe and effective for the elimination of residual wounds

  16. Perineal Burns in Children

    OpenAIRE

    Ameh AEmmanuel

    2004-01-01

    Perineal burns are not common in childhood but when they occur, they can produce severe complications. Conservative management by open wound care and topical agents is effective in most cases. However, in deep burns and when control of infection proves problematic, diverting colostomy may be necessary to control infection and achieve wound healing and graft take. Burns wound excision and skin grafting may be required in such cases. Contractures of various forms may develop and require plastic...

  17. Exploration of the effects of burn parameters on THz wound imaging

    Science.gov (United States)

    Bajwa, Neha; Sung, Shijun; Fishbein, Michael; Grundfest, Warren S.; Taylor, Zachary D.

    2015-08-01

    The high contrast resolution afforded by terahertz (1 THz = 1012 Hz) imaging of physiologic tissue continues to drive explorations into the utility of THz technology for burn wound detection. Although we have previously reported the use of a novel, reflective THz imaging technology to sense spatiotemporal differences in reflectivity between partial and full thickness burn wounds, no evidence exists of a one-to-one correlation between structural damage observed in histological assessments of burn severity and THz signal. For example, varying burn induction methods may all result in a common burn wound severity, however, burn features observed in parallel THz imagery may not be identical. Successful clinical translation of THz technology as a comprehensive burn guidance tool, therefore, necessitates an understanding of THz signal and its relation to wound pathophysiology. In this work, longitudinal THz imagery was acquired with a quartz (n = 2.1, 500 μm) window of cutaneous wounds induced with the same brand geometry and contact pressure but varying contact times (5, 7, and 10 seconds) in in vivo, pre-clinical rat models (n=3) over a period of 3 days. Though all burn wounds were evaluated to be deep partial thickness with histology, THz contrasts observed for each burn contact time were intrinsically unique. This is the first preliminary in vivo evidence of a many-to-one relationship between changes in THz contrast and burn severity as ascertained by histology. Future large-scale studies are required to assess whether these observed changes in THz contrast may be interpreted as physiological changes occurring over time, morphometric changes related to anatomical change, or electromagnetic changes between dielectric substrate windows and the underlying tissue.

  18. Comparison between topical honey and mafenide acetate in treatment of burn wounds

    OpenAIRE

    Maghsoudi, H.; Salehi, F.; Khosrowshahi, M.K.; M BAGHAEI; M.Nasirzadeh; Shams, R.

    2011-01-01

    Histological and clinical studies of wound healing were performed in comparable cases of fresh partial-thickness burns treated with honey dressing or mafenide acetate in two groups of 50 randomly allocated patients. Of the patients with honey-treated wounds, 84% showed satisfactory epithelialization by day 7 and 100% by day 21. In wounds treated with mafenide acetate, epithelialization occurred by day 7 in 72% of cases and in 84% by day 21. Histological evidence of reparative activity was obs...

  19. Comparison of dextranomer and streptokinase-streptodornase in the treatment of venous leg ulcers and other infected wounds.

    Science.gov (United States)

    Hulkko, A; Holopainen, Y V; Orava, S; Kangas, J; Kuusisto, P; Hyvärinen, E; Ervasti, E; Silvennoinen, E

    1981-01-01

    The clinical efficacy of dextranomer (Debrisan) and streptokinase-streptodornase (Varidase) was compared in a controlled randomized in-patient study. There were two patient groups: Group A consisting of 28 patients with a total of 31 venous leg ulcers and Group B consisting of 56 patients with other infected wounds (posttraumatic and postoperative wounds, amputation stumps, burn wounds, arteriosclerotic ulcers, decubital ulcers, ulcers due to bone disease, rheumatic ulcers, ulcers due to erysipelas and wounds of mixed aetiology). Both agents have a good cleansing effect as well as a good effect on infection and wet necrosis. Dextranomer stimulates the formation of granulation tissue faster than streptokinase-streptodornase. PMID:6172073

  20. Fabrication and evaluation of auto-stripped tri-layer wound dressing for extensive burn injury

    Energy Technology Data Exchange (ETDEWEB)

    Lin, F.-H. [Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan (China); Department of Biomedical Engineering, National Taiwan University Hospital, Taipei, Taiwan (China); Tsai, J.-C. [Department of Materials Engineering, Ta Tung University, Taipei, Taiwan (China); Chen, T.-M. [Department of Plastic Surgery, Tri-service Hospital, Taipei, Taiwan (China); Chen, K.-S. [Department of Materials Engineering, Ta Tung University, Taipei, Taiwan (China); Yang, J.-M. [Department of Chemical Engineering, Chang Gung University, Tao-Yuan, Taiwan (China); Kang, P.-L. [Cardiovascular Division, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan (China)]. E-mail: plkang@vghks.gov.tw; Wu, T-H. [Institute of Nuclear Energy Research, ROCEA, Tao-Yuan, Taiwan (China)

    2007-04-15

    In the study, we are going to develop a tri-layer membrane as the artificial skin for extensive burn injury. The first layer is a three-dimensional tri-copolymer sponge of gelatin/hyaluronan/chodroitin-6-sulfate with 70% in porosity and 20-100 {mu}m in pore size. The layer is constructed as a dermis analogous layer to stimulate capillaries penetration, to promote dermal fibroblast migration and to induce the secretion of extra-cellular matrix, which provides a better physiological environment for burn patient recovery. The second layer is as so called auto-stripped layer composed by poly-N-isopropyacrylamide (PNIPAAm). The layer will be automatically peeled off from the tri-copolymer layer once the wound site closed and recovered. The third layer is composed by polypropylene (PP) non-woven fabric, which provides an open structure for exudates drainage out that will reduce the risk of second infection. The tri-layer wound dressing has been successfully prepared by subsequently high-energy plasma treatment, {gamma}-ray irradiation, UV light exposure, and lyophilized process. From the results of MTT, IL-8, IL-1{alpha}, IL-6, and TNF-{alpha} measurement, the developed material will not induce tissue inflammatory or immune response. The dermal fibroblasts showed initial contact with the material surface through the radial extension of filopodia followed by cytoplasmic webbing that could be examined by SEM. Dermal fibroblasts subsequently flattened for further proliferation and extra-cellular matrix secretion. Dermal analog layer provides a three-dimensional architecture for normal dermis regeneration. The layer can be completely biodegraded within 4 weeks post-operation. After served as a scaffold for the ingrowth of self-fibroblasts, a normal dermis like layer will be regenerated. The dressing will fall off automatically without any damage once the wound site healed completely.

  1. Development and characterization of a novel, antimicrobial, sterile hydrogel dressing for burn wounds: single-step production with gamma irradiation creates silver nanoparticles and radical polymerization.

    Science.gov (United States)

    Boonkaew, Benjawan; Barber, Philip M; Rengpipat, Sirirat; Supaphol, Pitt; Kempf, Margit; He, Jibao; John, Vijay T; Cuttle, Leila

    2014-10-01

    Patients with burn wounds are susceptible to wound infection and sepsis. This research introduces a novel burn wound dressing that contains silver nanoparticles (SNPs) to treat infection in a 2-acrylamido-2-methylpropane sulfonic acid sodium salt (AMPS-Na(+) ) hydrogel. Silver nitrate was dissolved in AMPS-Na(+) solution and then exposed to gamma irradiation to form SNP-infused hydrogels. The gamma irradiation results in a cross-linked polymeric network of sterile hydrogel dressing and a reduction of silver ions to form SNPs infused in the hydrogel in a one-step process. About 80% of the total silver was released from the hydrogels after 72 h immersion in simulated body fluid solution; therefore, they could be used on wounds for up to 3 days. All the hydrogels were found to be nontoxic to normal human dermal fibroblast cells. The silver-loaded hydrogels had good inhibitory action against Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus. Results from a pilot study on a porcine burn model showed that the 5-mM silver hydrogel was efficient at preventing bacterial colonization of wounds, and the results were comparable to the commercially available silver dressings (Acticoat(TM) , PolyMem Silver(®) ). These results support its use as a potential burn wound dressing.

  2. [Phage therapy for bacterial infection of burn].

    Science.gov (United States)

    Peng, Y Z; Huang, G T

    2016-09-20

    With the long-term and widespread use of antibiotics, drug resistance of bacteria has become a major problem in the treatment of burn infection. For treating multidrug resistant bacteria, phage therapy has become the focus of attention. Development of phage therapy to fill the blank of this field in China is extremely urgent. PMID:27647065

  3. Management of burn injuries – recent developments in resuscitation, infection control and outcomes research

    Directory of Open Access Journals (Sweden)

    Dries David J

    2009-03-01

    Full Text Available Abstract Introduction Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve remote organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage soft tissue problems outside thermal injury including soft tissue infection and Toxic Epidermal Necrolysis. Methods A selected review of recent reports published by the American Burn Association is provided. Results The burn-injured patient is easily and frequently over resuscitated with complications including delayed wound healing and respiratory compromise. A feedback protocol is designed to limit the occurrence of excessive resuscitation has been proposed but no new "gold standard" for resuscitation has replaced the Parkland formula. Significant additional work has been included in recent guidelines identifying specific infectious complications and criteria for these diagnoses in the burn-injured patient. While new medical therapies have been proposed for patients sustaining inhalation injury, a new standard of medical therapy has not emerged. Renal failure as a contributor to adverse outcome in burns has been reinforced by recent data generated in Scandinavia. Of special problems addressed in burn centers, soft tissue infections and Toxic Epidermal Necrolysis have been reviewed but new treatment strategies have not been identified. The value of burn centers in management of burns and other soft tissue problems is supported in several recent reports. Conclusion Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury exists but new standards for description of burn-related infections have been presented. The value of the burn center in care of soft tissue problems including Toxic Epidermal Necrolysis and soft tissue

  4. Open burn wound dressing: a practical option in resource constrained settings

    OpenAIRE

    Olawoye, O.A.; Osinupebi, O.O.; Ayoade, B.A.

    2013-01-01

    Various types of wound care products abound for the treatment of burn injuries. Most of these products are rather expensive and beyond the means of many patients in poorer countries. This poses a challenge to burn care workers in these environments and calls for the adoption of practical solutions with the use of less expensive and readily available alternatives. The aim of this study is to review the outcome of our burn patients managed with topical silver sulphadiazine dressing in terms of ...

  5. Propolis Induces Chondroitin/Dermatan Sulphate and Hyaluronic Acid Accumulation in the Skin of Burned Wound

    OpenAIRE

    Pawel Olczyk; Katarzyna Komosinska-Vassev; Katarzyna Winsz-Szczotka; Jerzy Stojko; Katarzyna Klimek; Kozma, Ewa M.

    2013-01-01

    Changes in extracellular matrix glycosaminoglycans during the wound repair allowed us to apply the burn model in which therapeutic efficacy of propolis and silver sulfadiazine was compared. Burns were inflicted on four pigs. Glycosaminoglycans isolated from healthy and burned skin were quantified using a hexuronic acid assay, electrophoretic fractionation, and densitometric analyses. Using the reverse-phase HPLC the profile of sulfated disaccharides released by chondroitinase ABC from chondro...

  6. Skin nerve regeneration and burn wound healing following spinal nerve root incision

    Institute of Scientific and Technical Information of China (English)

    Yibing Wang; Pengfei Guo; Yongqiang Feng; Yongqian Cao; Shourong Zhu; Rui Zhang

    2011-01-01

    Burn wounds were produced on two sides on the backs of Wistar rats, in addition to denervation on one side. The skin neural regeneration at the injury site and burn wound healing were evaluated following spinal nerve root incision. No nerve regeneration was observed in the burn wound region post-denervation, and the degree of epithelization was significantly less than the control group. With increasing time, expression of type Ⅰ collagen, which plays a supporting role, and collagen Ⅲ, which exhibits elastic properties, were significantly increased in the two groups, but the expression was less in the denervation group compared with the control group, and the wound healing was faster in the control group. The ratio of type Ⅰ collagen to type Ⅲ collagen was significantly lower in the denervation group compared with the control group. The ratio gradually decreased with prolonged time in the denervation group, but remained unchanged in the control group. However, the elasticity of the tissues in the denervation group was better than the control group. During burn wound healing, innervations can promote wound healing, but denervation can improve the quality of wound remodeling.

  7. Infection control in burn patients: are fungal infections underestimated?

    OpenAIRE

    Struck Manuel F

    2009-01-01

    Abstract With great interest, I read the paper of David J. Dries about recent developments, infection control and outcomes research in the management of burn injuries 1. I have some comments about an important, however missing, topic in the paragraphs concerning infection control.

  8. Individualized therapy for burn wound%烧伤创面的个性化治疗

    Institute of Scientific and Technical Information of China (English)

    徐庆连; 夏正国

    2016-01-01

    Individualized therapy denotes that a suitable treatment project is chosen according to specific conditions of the patients with full benefit and minimal damage,and it is one of the contemporary surgical procedures that surgeons are looking for.But certain difficulties still exist in the treatment of burn patients,as well as repair of refractory or chronic wound as performed by burn surgeons.In this issue of the journal,application of individualized therapy in burn wound was discussed from various angles.For instance,through using Meek skin grafting technique,large sheets of skin graft could be saved for repair of wound on special body part of patients with severe burn,and combined flaps surgery could be applied to repair skin and soft tissue defects.

  9. Epidermal-dermal crosstalk during burn wound scar maturation

    NARCIS (Netherlands)

    T.E. Hakvoort (Eveline)

    1999-01-01

    textabstractBurn injuries arc among the worst traumas which can happen to man. The larger a burn injury, the more severe the consequences and the highcr the chance of an adverse outcome or even death. In The Netherlands each year 40,000 people visit a general practitioner for treatment of a burn wou

  10. Effect of oral olive oil on healing of 10-20% total body surface area burn wounds in hospitalized patients.

    Science.gov (United States)

    Najmi, Mahtab; Vahdat Shariatpanahi, Zahra; Tolouei, Mohammad; Amiri, Zohreh

    2015-05-01

    The purpose of this study was to evaluate the effect of consumption of oral olive oil on clinical outcomes and wound healing of thermally injured patients with hospital stays. One hundred patients (mean age; 33.34±7 years) with 10-20% total body surface area, deep second degree and more burn wounds were randomized to receive either oral olive oil or sunflower oil as the oil in their diet. Patients were evaluated daily for occurrence of wound infection, sepsis and healing of the grafted skin. Also the duration of hospitalization and admission to the intensive care unit were compared in two groups. Results showed that there was no significant difference between the olive oil group and the control group in percent of TBSA involvement (14.28±0.53 vs. 13.02±0.48, P=0.7), albumin concentration (3.25±0.5 vs. 3.13±0.5, P=0.5) and mean calorie intake (2034±216.9 kcal vs2118±192.1 kcal, P=0.2). We found a significant difference in the duration of wound healing (7.2±0.5 vs. 8.7±0.5, P=0.04) and duration of hospitalization (7.4±0.5 vs. 8.9±0.4, P=0.05) in the olive oil group versus the control group. We did not find any difference in ICU admission, wound infection and occurrence of sepsis between two groups. This study showed that an oral diet provided with olive oil in patients with burn may accelerate wound healing and decrease the duration of hospitalization. PMID:25306088

  11. Managing severe burn injuries: challenges and solutions in complex and chronic wound care

    Directory of Open Access Journals (Sweden)

    Rogers AD

    2016-06-01

    Full Text Available Alan D Rogers, Marc G Jeschke Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Abstract: Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased literature rather than robust randomized controlled trials. Burn units are well placed to address this considerable need, as a result of their infrastructure, their multispecialty staffing, and their need to evolve in light of the declining incidence of major burn injury in developed countries. The aim of this review is to evaluate some of the ideological and practical challenges facing wound practitioners and burn surgeons while managing chronic and complex wounds. It also includes an approach to wound assessment and how to conceptualize and implement dressing strategies and new and existing multimodal therapies. Keywords: negative pressure wound therapy, instillation, antiseptic solutions, dressings, multidisciplinary wound care, stem cells, surgery, autograft, allograft, reconstructive ladder

  12. IMPORTANCE OF SOUTHAMPTON WOUND GRADING SYSTEM IN SURGICAL SITE INFECTION

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    Shaleen

    2014-05-01

    Full Text Available : Post-operative wound infection is defined as surgical site infection from 0-30 days after surgery, or infection to surgical site till one year in cases of implants like mesh, vascular grafts and prosthesis. This study was done to find out incidence of post-operative wound infection in surgical patients in rural setup. This study of post-operative wound infection was carried out from August 2008 to August 2010. The study is of 3275 patients who underwent surgery in the A.V.B.R.H. Significant association was observed between the nature of surgery and Southampton Wound Grading System. It concluded that severity rate of post-operative wound infection was increased from grade I to grade V which was found to be similar in clean to contaminated nature of surgery and that was found to be statistically significant at P value less than 0.001.

  13. The efficacy of aloe vera used for burn wound healing: a systematic review.

    Science.gov (United States)

    Maenthaisong, Ratree; Chaiyakunapruk, Nathorn; Niruntraporn, Surachet; Kongkaew, Chuenjid

    2007-09-01

    Aloe vera has been traditionally used for burn healing but clinical evidence remains unclear. We conducted a systematic review to determine the efficacy of topical aloe vera for the treatment of burn wounds. We electronically searched relevant studies in MEDLINE, CINAHL, Cochrane Library, HealthSTAR, DARE, South-East Asia Database, Chinese Databases, and several Thai local Databases (1918-June 2004). Only controlled clinical trials for burn healing were included. There were no restrictions on any language of publication. Two reviewers independently extracted data on study characteristics, patient characteristics, intervention, and outcome measure. Four studies with a total of 371 patients were included in this review. Based on a meta-analysis using duration of wound healing as an outcome measure, the summary weighted mean difference in healing time of the aloe vera group was 8.79 days shorter than those in the control group (P=0.006). Due to the differences of products and outcome measures, there is paucity to draw a specific conclusion regarding the effect of aloe vera for burn wound healing. However, cumulative evidence tends to support that aloe vera might be an effective interventions used in burn wound healing for first to second degree burns. Further, well-designed trials with sufficient details of the contents of aloe vera products should be carried out to determine the effectiveness of aloe vera.

  14. Psychological principles of burn wound pain in children. I: theoretical framework.

    Science.gov (United States)

    Thurber, C A; Martin-Herz, S P; Patterson, D R

    2000-01-01

    Burn injuries and the care of burn injuries are punishing experiences for hospitalized children. Pain, novelty, and altered reinforcement schedules elicit instinctive escape and avoidance behaviors that complicate wound care. An understanding of the psychological principles that underlie these complex, complicating behaviors paves the way for effective cognitive and behavioral interventions. In this first article of a two-part series, we use the principles of classical conditioning, operant conditioning, and control coping to describe the developmentally normal emergence of avoidance behaviors that are incompatible with burn wound care. Then, using brief case examples, we outline how classical conditioning transforms neutral stimuli into anxiety-producing, fearful stimuli, how operant behaviors are intentionally or unintentionally reinforced, and how the umbrella of reduced control in the novel hospital environment makes coping difficult for children. We conclude by discussing obstacles to effective application of cognitive and behavioral strategies for the enhancement of control and of compliance with wound care.

  15. Medicinal plants and their natural components as future drugs for the treatment of burn wounds: an integrative review.

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    Bahramsoltani, Roodabeh; Farzaei, Mohammad Hosein; Rahimi, Roja

    2014-09-01

    Burn wound healing is a complicated process including inflammation, re-epithelialization, granulation, neovascularization and wound contraction. Several biochemicals are involved in burn healing process including antioxidants, cytokines and liver and kidney damage biomarkers. Although several preparations are available for the management of burn wound, there is still a necessity of researching for efficacious medicine. The aim of the present study was to evaluate herbal preparations and their phytochemical constituents for burn wound management. For this purpose, electronic databases including Pubmed, Scirus, Scopus and Cochrane library were searched from 1966 to July 2013 for in vitro, in vivo or clinical studies which examined the effect of any herbal preparation on different types of burn wound. Only 3 human studies were found to include in this review. In contrast, there were 62 in vivo and in vitro studies that show the need for more clinical trials to prove the plant's potential to cure burn wound. Among single herbal preparations, Allium sativum, Aloe vera, Centella asiatica and Hippophae rhamnoides showed the best burn wound healing activity. Flavonoids, alkaloids, saponins and phenolic compounds were active constituents present in different herbs facilitating wound closure. Glycosides including madecassoside and asiaticoside and proteolytic enzymes were among the main active components. Phytochemicals represented positive activity at different stages of burn wound healing process by various mechanisms including antimicrobial, anti-inflammatory, antioxidant, collagen synthesis stimulation, cell proliferative and angiogenic effect. Overall, several herbal medicaments have shown marked activity in the management of wounds-especially burn wounds-and therefore can be considered as an alternative source of treatment. Furthermore, various natural compounds with verified burn-induced wound healing potential can be assumed as future natural drugs. PMID:24895176

  16. The importance of illumination in a non-contact photoplethysmography imaging system for burn wound assessment

    Science.gov (United States)

    Mo, Weirong; Mohan, Rachit; Li, Weizhi; Zhang, Xu; Sellke, Eric W.; Fan, Wensheng; DiMaio, J. Michael; Thatcher, Jeffery E.

    2015-02-01

    We present a non-contact, reflective photoplethysmogram (PPG) imaging method and a prototype system for identifying the presence of dermal burn wounds during a burn debridement surgery. This system aims to provide assistance to clinicians and surgeons in the process of dermal wound management and wound triage decisions. We examined the system variables of illumination uniformity and intensity and present our findings. An LED array, a tungsten light source, and eventually high-power LED emitters were studied as illumination methods for our PPG imaging device. These three different illumination sources were tested in a controlled tissue phantom model and an animal burn model. We found that the low heat and even illumination pattern using high power LED emitters provided a substantial improvement to the collected PPG signal in our animal burn model. These improvements allow the PPG signal from different pixels to be comparable in both time-domain and frequency-domain, simplify the illumination subsystem complexity, and remove the necessity of using high dynamic range cameras. Through the burn model output comparison, such as the blood volume in animal burn data and controlled tissue phantom model, our optical improvements have led to more clinically applicable images to aid in burn assessment.

  17. Fms-like tyrosine kinase-3 ligand alters antigen-specific responses to infections after severe burn injury

    OpenAIRE

    Bohannon, Julia; Fang, Geping; Cui, Weihua; Sherwood, Edward; Toliver-Kinsky, Tracy

    2009-01-01

    Burn patients are susceptible to opportunistic infections due partly to decreased immune functions, especially Th1-driven antigen-specific responses, which are regulated by dendritic cells. The dendritic cell growth factor, fms-like tyrosine kinase-3 ligand (FL), has been shown to increase resistance to P. aeruginosa, in a dendritic cell-dependent manner, in a mouse model of burn wound infection. The specific mechanisms of protection are not known. This study tested the hypothesis that FL can...

  18. The morphogenesis features of burn wounds by applying chitosan membranes in different age periods

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    Kornienko V.V.

    2014-05-01

    Full Text Available Background. The number of research devoted to chitosan application for burn defects treatment has increased during the last decades. However, the age-related features of skin regeneration with chitosan application are still uninvestigated Objective. The aim of our research was to evaluate effectiveness of chitosan coatings application to treat burns in different age periods. Methods. We studied the tissue morphogenesis features of the thermal damaged skin. We modeled the burn wounds of IIIb degree on the rats of experimental and control groups. And then we applied chitosan coatings on the animals of the experimental group to analyze the effectiveness of topical treatment. We analyzed the healing of burn wounds by the following morphological criteria: types of the epidermis and dermis damage; terms and features of wound cleaning; presence and degree of inflammation intensity and blood circulation disorders; quantity and quality of cellular infiltration. Other criteria were terms and degree of connective and epithelial tissue formation and levels of their differentiation and distribution; presence or absence of synchrony regenerative processes in the epithelium and connective tissue (especially features of vessel formation; presence or absence of morphological manifestations of pathological regeneration in the epithelium and connective tissue. Results. We found that the rate of burn healing applying chitosan coatings speeded up as they stimulated both macrophage reaction (with further inflammation reduction; cellular proliferation of fibroblasts and vessel formation. Moreover, granulation tissue and collagen fibers formed faster. Besides, epithelium regeneration and scar formation enhanced. As a result, epithelial cell migration and tissue contraction covered the wound. Conclusion. Application of chitosan membranes to treat thermal burns enhanced wound cleaning from dead tissue and reduced eschar, decreased the intensity of inflammatory reactions

  19. “Sugar-coating wound repair: A review of FGF-10 and dermatan sulfate in wound healing and their potential application in burn wounds”

    OpenAIRE

    Plichta, Jennifer K.; Katherine A Radek

    2012-01-01

    Thousands of patients suffer from burn injuries each year, yet few therapies have been developed to accelerate the wound healing process. Most fibroblast growth factors (FGFs) have been extensively evaluated, but only a few have been found to participate in wound healing. In particular, FGF-10 is robustly increased in the wound microenvironment following injury and has demonstrated some ability to promote wound healing in vitro and in vivo. Glycosaminoglycans (GAGs) are linear carbohydrates t...

  20. Healing efficacy of sea buckthorn (Hippophae rhamnoides L.) seed oil in an ovine burn wound model.

    Science.gov (United States)

    Ito, Hiroshi; Asmussen, Sven; Traber, Daniel L; Cox, Robert A; Hawkins, Hal K; Connelly, Rhykka; Traber, Lillian D; Walker, Timothy W; Malgerud, Erik; Sakurai, Hiroyuki; Enkhbaatar, Perenlei

    2014-05-01

    To investigate the efficacy of sea buckthorn (SBT) seed oil - a rich source of substances known to have anti-atherogenic and cardioprotective activity, and to promote skin and mucosa epithelization - on burn wound healing, five adult sheep were subjected to 3rd degree flame burns. Two burn sites were made on the dorsum of the sheep and the eschar was excised down to the fascia. Split-thickness skin grafts were harvested, meshed, and fitted to the wounds. The autograft was placed on the fascia and SBT seed oil was topically applied to one recipient and one donor site, respectively, with the remaining sites treated with vehicle. The wound blood flow (LASER Doppler), and epithelization (ultrasound) were determined at 6, 14, and 21 days after injury. 14 days after grafting, the percentage of epithelization in the treated sites was greater (95 ± 2.2% vs. 83 ± 2.9%, pseed oil has significant wound healing activity in full-thickness burns and split-thickness harvested wounds. PMID:24007892

  1. Gelam (Melaleuca spp. Honey-Based Hydrogel as Burn Wound Dressing

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    Rozaini Mohd Zohdi

    2012-01-01

    Full Text Available A novel cross-linked honey hydrogel dressing was developed by incorporating Malaysian honey into hydrogel dressing formulation, cross-linked and sterilized using electron beam irradiation (25 kGy. In this study, the physical properties of the prepared honey hydrogel and its wound healing efficacy on deep partial thickness burn wounds in rats were assessed. Skin samples were taken at 7, 14, 21, and 28 days after burn for histopathological and molecular evaluations. Application of honey hydrogel dressings significantly enhanced (P<0.05 wound closure and accelerated the rate of re-epithelialization as compared to control hydrogel and OpSite film dressing. A significant decrease in inflammatory response was observed in honey hydrogel treated wounds as early as 7 days after burn (P<0.05. Semiquantitative analysis using RT-PCR revealed that treatment with honey hydrogel significantly (P<0.05 suppressed the expression of proinflammatory cytokines (IL-1α, IL-1β, and IL-6. The present study substantiates the potential efficacy of honey hydrogel dressings in accelerating burn wound healing.

  2. Effect of electrolyzed oxidizing water and hydrocolloid occlusive dressings on excised burn-wounds in rats

    Institute of Scientific and Technical Information of China (English)

    辛华; 郑雅娟; 中永士师明; 韩振国

    2003-01-01

    Objective: To study the efficacy of electrolyzed oxidizing water (EOW) and hydrocolloid occlusive dressings in the acceleration of epithelialization in excised burn-wounds in rats. Methods: Each of the anesthetized Sprague-Dawley rats (n=28) was subjected to a third-degree burn that covered approximately 10% of the total body surface area. Rats were assigned into four groups: Group I (no irrigation), Group II (irrigation with physiologic saline), Group III (irrigation with EOW) and Group IV (hydrocolloid occlusive dressing after EOW irrigation). Wounds were observed macroscopically until complete epithelialization was present, then the epithelialized wounds were examined microscopically. Results: Healing of the burn wounds was the fastest in Group IV treated with hydrocolloid occlusive dressing together with EOW. Although extensive regenerative epidermis was seen in each Group, the proliferations of lymphocytes and macrophages associated with dense collagen deposition were more extensive in Group II, III and IV than in Group I. These findings were particularly evident in Group III and IV. Conclusions: Wound Healing 05- be accelerated by applying a hydrocolloid occlusive dressing on burn surfaces after they are cleaned with EOW.

  3. Large-area burns with pandrug-resistant Pseudomonas aeruginosa infection and respiratory failure

    Institute of Scientific and Technical Information of China (English)

    NING Fang-gang; ZHAO Xiao-zhuo; BIAN Jing; ZHANG Guo-an

    2011-01-01

    Background Infection due to pandrug-resistant Pseudomonas aeruginosa (PDRPA) has become a challenge in clinical practice. The aim of this research was to summarize the treatment of large-area burns (60%-80%) with PDRPA infection and respiratory failure in our hospital over the last two years, and to explore a feasible treatment protocol for such patients.Methods We retrospectively analyzed the treatment of five patients with large-area burns accompanied by PDRPA infection and respiratory failure transferred to our hospital from burn units in hospitals in other Chinese cities from January 2008 to February 2010. Before PDRPA infection occurred, all five patients had open wounds with large areas of granulation because of the failure of surgery and dissolving of scar tissue; they had also undergone long-term administration of carbapenems. This therapy included ventilatory support, rigorous repair of wounds, and combined antibiotic therapy targeted at drug-resistance mechanisms, including carbapenems, ciprofloxacin, macrolide antibiotics and β-lactamase inhibitors.Results Four patients recovered from bums and one died after therapy.Conclusions First, compromised immunity caused by delayed healing of burn wounds in patients with large-area bums and long-term administration of carbapenems may be the important factors in the initiation and progression of PDRPA infection. Second, if targeted at drug-resistance mechanisms, combined antibiotic therapy using carbapenems,ciprofloxacin, macrolide antibiotics and β-lactamase inhibitors could effectively control PDRPA infection. Third, although patients with large-area burns suffered respiratory failure and had high risks from anesthesia and surgery, only aggressive skin grafting with ventilatory support could control the infection and save lives. Patients may not be able to tolerate a long surgical procedure, so the duration of surgery should be minimized, and the frequency of surgery increased.

  4. EFFECT OF ETHANOLIC EXTRACT OF PLECTRANTHUS AMBOINICUS LEAF ON HEALING OF BURN WOUND IN WISTAR RATS

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    Smita Shenoy

    2012-08-01

    Full Text Available Objectives: To study the effect of ethanolic extract of the leaf of Plectranthus amboinicus on the healing of burn wounds in wistar rats and compare it with silver sulfadiazine treated group. Materials and Methods: Five groups of rats were used in the study. Partial thickness burn wounds were made on each rat under ketamine anesthesia.The wounds in the five groups of rats were treated topically with petroleum base, silver sulfadiazine,1%, 2% and 3% ointment of ethanolic extract of Plectranthus amboinicus, respectively, once daily for 21 days or till complete healing whichever was earlier. The wound contraction rate and period of epithelization were monitored. Results: The rate of wound contraction was significantly more in Plectranthusamboinicustreated groups in comparison to the control. The mean period of epithelization was significantly decreased in Plectranthus amboinicus treated group when compared to control (P < 0.01 and silver sulfadiazine (P =0.02 treated group. Conclusion: The ethanolic extract of Plectranthusamboinicus promoted healing of burn wound in wistar rats.

  5. 复合溶葡萄球菌酶消毒剂治疗烧伤创面革兰阳性球菌感染%Effect of compound lysostaphin disinfectant in treatment of gram-positive coccus infection of burn wounds

    Institute of Scientific and Technical Information of China (English)

    马杰; 郭明锋; 蔡卫林; 丁智超; 励俊

    2013-01-01

    目的 比较复合溶葡萄球菌酶(Fudan enzyme,FE)消毒剂(百克瑞)和传统消毒剂碘伏防治烧伤创面革兰阳性(G+)球菌感染的疗效. 方法 收集60例浅Ⅱ度烧伤患者(烧伤面积1% ~5%,年龄18 ~50岁),每例患者治疗前创面取分泌物做细菌培养,其中20例培养出金黄色葡萄球菌(staphylococcus aureus,SA),按随机数字表法分为对照组和试验组,每组10例.20例培养出表皮葡萄球菌(staphylococcus epidermidis,SE),按随机数字表法分为对照组和试验组,每组10例.20例培养出肠球菌(enterococcus,EC),按随机数字表法分为对照组和试验组,每组10例.试验组用百克瑞浸透4层无菌纱布外敷创面换药,对照组用碘伏浸透4层无菌纱布外敷创面换药,均每日换药1次,治疗5d期间每天每例患者创面取分泌物培养.比较各组患者的愈合情况.结果 经过5d治疗后,SA感染创面,试验组10例全部转阴,对照组3例转阴(P<0.01).SE感染创面,试验组10例全部转阴,对照组6例转阴(P<0.05).EC感染创面,试验组9例转阴,对照组7例转阴(P>0.05).试验组平均愈合时间为(10.87±1.93)d,对照组为(13.31±2.89)d(P<0.05). 结论 百克瑞能有效防止烧伤创面常见G+球菌感染,并能促进创面愈合.%Objective To compare the effect of Baikerui compound lysostaphin (FE complex phosphoesterasum) disinfectant and povidone iodine in treatment of burn wound infection resulted from gram-positive (G ±) coccus.Methods The study involved 60 patients with superficial second degree burns (1%-5% TBSA; age range of 18-50 years).All the patients received bacterial culturing of wound secretions prior to treatment.Every 20 patients were indentified with infection of staphylococcus aureus (SA),staphylococcus epidermidis (SE),and enterococcus (EC) respectively and randomized into control group and experiment group,with 10 patients per group.Patients allocated to the experiment group were covered with four

  6. Acellular Hydrogels for Regenerative Burn Wound Healing: Translation from a Porcine Model.

    Science.gov (United States)

    Shen, Yu-I; Song, Hyun-Ho G; Papa, Arianne E; Burke, Jacqueline A; Volk, Susan W; Gerecht, Sharon

    2015-10-01

    Currently available skin grafts and skin substitutes for healing following third-degree burn injuries are fraught with complications, often resulting in long-term physical and psychological sequelae. Synthetic treatment that can promote wound healing in a regenerative manner would provide an off-the-shelf, non-immunogenic strategy to improve clinical care of severe burn wounds. Here, we demonstrate the vulnerary efficacy and accelerated healing mechanism of a dextran-based hydrogel in a third-degree porcine burn model. The model was optimized to allow examination of the hydrogel treatment for clinical translation and its regenerative response mechanisms. Hydrogel treatment accelerated third-degree burn wound healing by rapid wound closure, improved re-epithelialization, enhanced extracellular matrix remodeling, and greater nerve reinnervation, compared with the dressing-treated group. These effects appear to be mediated through the ability of the hydrogel to facilitate a rapid but brief initial inflammatory response that coherently stimulates neovascularization within the granulation tissue during the first week of treatment, followed by an efficient vascular regression to promote a regenerative healing process. Our results suggest that the dextran-based hydrogels may substantially improve healing quality and reduce skin grafting incidents and thus pave the way for clinical studies to improve the care of severe burn injury patients.

  7. Propranolol attenuates hemorrhage and accelerates wound healing in severely burned adults

    OpenAIRE

    Ali, Arham; Herndon, David N; Mamachen, Ashish; Hasan, Samir; Andersen, Clark R.; Grogans, Ro-Jon; Brewer, Jordan L.; Lee, Jong O; Heffernan, Jamie; Oscar E Suman; Finnerty, Celeste C.

    2015-01-01

    Introduction Propranolol, a nonselective β-blocker, exerts an indirect effect on the vasculature by leaving α-adrenergic receptors unopposed, resulting in peripheral vasoconstriction. We have previously shown that propranolol diminishes peripheral blood following burn injury by increasing vascular resistance. The purpose of this study was to investigate whether wound healing and perioperative hemodynamics are affected by propranolol administration in severely burned adults. Methods Sixty-nine...

  8. The Effects of Argan Oil in Second-degree Burn Wound Healing in Rats.

    Science.gov (United States)

    Avsar, Umit; Halici, Zekai; Akpinar, Erol; Yayla, Muhammed; Avsar, Ummu; Harun, Un; Harun, Un; Hasan Tarik, Atmaca; Bayraktutan, Zafer

    2016-03-01

    Argan oil, produced from the kernels of the argan tree (Argania spinosa), has been shown to have antioxidant properties. To examine the effect of argan oil in second-degree burn wound healing, an in vivo experiment was conducted among 30 adult male Wistar rats divided into 5 equal groups: a sham group, a control group (burned but no topical agent), a group in which argan oil was applied once a day, a group in which argan oil was applied twice a day, and a group treated with 1% silver sulfadiazine once a day. Second-degree burns were created by scalding hot water (85˚ C for 15 seconds). Treatment began 24 hours after the burn injury; in the argan oil groups, 1 mL of argan oil was administered via syringe to the wound. The rate of wound healing was quantified by wound measurements on days 1, 7, and 14 after burn injury. Tissues were analyzed for molecular and histologic changes in TGF-β expression and fibroblast activity. Percent contraction of burned skin tissue was determined using the stereo investigator program, which calculated the burn field to the millimeter. Means (SD) were calculated and compared using Duncan's multiple comparison test. The group receiving argan oil twice daily showed significantly increased mRNA levels of TGF-β1 from 39.66- to 58.70-fold compared to the burn control group on day 14 (P less than 0.05). Both argan oil-treated groups showed significantly increased contraction compared to the burn control group at all 3 timepoints; the group receiving argan oil twice daily had a greater contraction rate (31% on day 7, 76% on day 14) than the silver sulfadiazine group (22% on day 7, 69% on day 14), (P less than 0.05). Histopathological assessments on days 3, 7, and 14 showed greater healing/contraction in both argan oil and silver sulfadiazine groups compared to the control group. These results suggest argan oil is effective in healing experimentally created second-degree burns in rats. Prospective, randomized, controlled clinical studies are

  9. The Effects of Argan Oil in Second-degree Burn Wound Healing in Rats.

    Science.gov (United States)

    Avsar, Umit; Halici, Zekai; Akpinar, Erol; Yayla, Muhammed; Avsar, Ummu; Harun, Un; Harun, Un; Hasan Tarik, Atmaca; Bayraktutan, Zafer

    2016-03-01

    Argan oil, produced from the kernels of the argan tree (Argania spinosa), has been shown to have antioxidant properties. To examine the effect of argan oil in second-degree burn wound healing, an in vivo experiment was conducted among 30 adult male Wistar rats divided into 5 equal groups: a sham group, a control group (burned but no topical agent), a group in which argan oil was applied once a day, a group in which argan oil was applied twice a day, and a group treated with 1% silver sulfadiazine once a day. Second-degree burns were created by scalding hot water (85˚ C for 15 seconds). Treatment began 24 hours after the burn injury; in the argan oil groups, 1 mL of argan oil was administered via syringe to the wound. The rate of wound healing was quantified by wound measurements on days 1, 7, and 14 after burn injury. Tissues were analyzed for molecular and histologic changes in TGF-β expression and fibroblast activity. Percent contraction of burned skin tissue was determined using the stereo investigator program, which calculated the burn field to the millimeter. Means (SD) were calculated and compared using Duncan's multiple comparison test. The group receiving argan oil twice daily showed significantly increased mRNA levels of TGF-β1 from 39.66- to 58.70-fold compared to the burn control group on day 14 (P less than 0.05). Both argan oil-treated groups showed significantly increased contraction compared to the burn control group at all 3 timepoints; the group receiving argan oil twice daily had a greater contraction rate (31% on day 7, 76% on day 14) than the silver sulfadiazine group (22% on day 7, 69% on day 14), (P less than 0.05). Histopathological assessments on days 3, 7, and 14 showed greater healing/contraction in both argan oil and silver sulfadiazine groups compared to the control group. These results suggest argan oil is effective in healing experimentally created second-degree burns in rats. Prospective, randomized, controlled clinical studies are

  10. Photobiomodulatory effects of superpulsed 904nm laser therapy on bioenergetics status in burn wound healing.

    Science.gov (United States)

    Yadav, Anju; Gupta, Asheesh; Keshri, Gaurav K; Verma, Saurabh; Sharma, Sanjeev K; Singh, Shashi Bala

    2016-09-01

    Burn wounds exhibit impaired healing as the progression through the normal sequential stages of tissue repair gets hampered by epidermal barrier disruption, compromised blood circulation, abrogated defence mechanism, pathologic inflammation, and septicemia. Our earlier results reported that superpulsed 904nm LLLT enhanced healing and attenuated inflammatory response in burn wounds. The present study investigated the effect of superpulsed 904nm LLLT (200ns pulse width; 100Hz; 0.7mW mean output power; 0.4mW/cm(2) average irradiance) on biochemical and molecular markers pertaining to bioenergetics and redox homeostasis on full-thickness burn wounds in experimental rats. Results indicated that superpulsed laser irradiation for 7days post-wounding propelled the cellular milieu towards aerobic energy metabolism as evidenced by significantly enhanced activities of key energy regulatory enzymes viz. HK, PFK, CS and G6PD, whereas LDH showed reduced activity as compared to the non-irradiated controls. LLLT showed a significant increased CCO activity and ATP level. Moreover, LLLT also regulated redox homeostasis as evidenced by enhanced NADPH levels and decreased NADP/NADPH ratio. Western blot analysis demonstrated that LLLT produced an up-regulation of GLUT1, pAMPKα and down-regulation of glycogen synthase1 (GS1). Our findings suggest that superpulsed 904nm LLLT augments burn wound healing by enhancing intracellular energy contents through modulation of aerobic metabolism for maximum energy output. Bioenergetic activation and maintenance of redox homeostasis could be one of the noteworthy mechanisms responsible for the beneficial NIR photobiomodulatory effect mediated through superpulsed 904nm LLLT in burn wound healing. PMID:27344636

  11. Mechanism of Wound-Healing Activity of Hippophae rhamnoides L. Leaf Extract in Experimental Burns

    Directory of Open Access Journals (Sweden)

    Nitin K. Upadhyay

    2011-01-01

    Full Text Available The present investigation was undertaken to evaluate the healing efficacy of lyophilized aqueous leaf extract of Sea buckthorn (Hippophae rhamnoides L., family Elaeagnaceae (SBT and to explore its possible mechanism of action on experimental burn wounds in rats. The SBT extract, at various concentrations, was applied topically, twice daily for 7 days. Treatment with silver sulfadiazine (SSD ointment was used as reference control. The most effective concentration of the extract was found to be 5.0% (w/w for burn wound healing and this was further used for detailed study. The SBT-treated group showed faster reduction in wound area in comparison with control and SSD-treated groups. The topical application of SBT increased collagen synthesis and stabilization at the wound site, as evidenced by increase in hydroxyproline, hexosamine levels and up-regulated expression of collagen type-III. The histological examinations and matrix metalloproteinases (MMP-2 and -9 expression also confirmed the healing efficacy of SBT leaf extract. Furthermore, there was significant increase in levels of endogenous enzymatic and non-enzymatic antioxidants and decrease in lipid peroxide levels in SBT-treated burn wound granulation tissue. The SBT also promoted angiogenesis as evidenced by an in vitro chick chorioallantoic membrane model and in vivo up-regulated vascular endothelial growth factor (VEGF expression. The SBT leaf extract had no cytotoxic effect on BHK-21 cell line. In conclusion, SBT aqueous leaf extract possesses significant healing potential in burn wounds and has a positive influence on the different phases of wound repair.

  12. Ciprofloxacin-loaded keratin hydrogels reduce infection and support healing in a porcine partial-thickness thermal burn.

    Science.gov (United States)

    Roy, Daniel C; Tomblyn, Seth; Isaac, Kameel M; Kowalczewski, Christine J; Burmeister, David M; Burnett, Luke R; Christy, Robert J

    2016-07-01

    Infection is a leading cause of morbidity and mortality in burn patients. Current therapies include silver-based creams and dressings, which display limited antimicrobial effectiveness and impair healing. The need exists for a topical, point-of-injury antibiotic treatment that provides sustained antimicrobial activity without impeding wound repair. Fitting this description are keratin-based hydrogels, which are fully biocompatible and support the slow-release of antibiotics. Here we develop a porcine model of an infected partial-thickness burn to test the effects of ciprofloxacin-loaded keratin hydrogels on infection and wound healing. Partial-thickness burns were inoculated with either Pseudomonas aeruginosa or Methicillin-resistant Staphylococcus aureus, resulting in infections that persisted for >2 weeks that exceeded 10(5) and 10(6) cfu per gram of tissue, respectively. Compared to silver sulfadiazine, ciprofloxacin-loaded keratin hydrogel treatment significantly reduced the amount of P. aeruginosa and S. aureus in the burn by >99% on days 4, 7, 11, and 15 postinjury. Further, burns treated with ciprofloxacin-loaded keratin hydrogels exhibited similar healing patterns as uninfected burns with regards to reepithelialization, macrophage recruitment, and collagen deposition and remodeling. The ability of keratin hydrogels to deliver antibiotics to fight infection and support healing of partial-thickness burns make them a strong candidate as a first-line burn therapy. PMID:27238250

  13. Innate Defense Regulator Peptide 1018 in Wound Healing and Wound Infection

    DEFF Research Database (Denmark)

    Steinstraesser, Lars; Hirsch, Tobias; Schulte, Matthias;

    2012-01-01

    -37 or HB-107. Furthermore, administration of IDR-1018 resulted in a dose-dependent increase in fibroblast cellular respiration. In vivo, IDR-1018 demonstrated significantly accelerated wound healing in S. aureus infected porcine and non-diabetic but not in diabetic murine wounds. However...

  14. Biological Activity of Propolis-Honey Balm in the Treatment of Experimentally-Evoked Burn Wounds

    Directory of Open Access Journals (Sweden)

    Żaneta Jastrzębska-Stojko

    2013-11-01

    Full Text Available Medicines of biogenic origin with micro-organic, regenerative and analgesic properties are becoming more and more significant in the treatment of burn wounds. These properties are found in apitherapeutics such as propolis and honey—products collected and processed by a honey bee. Their effect on the course of the healing processes is multidirectional. The aim of the study was a histopathological and biochemical analysis of the processes of scar formation in experimentally evoked burn wounds in white pigs treated with the 1% and 3% Sepropol balms containing standardized extracts of propolis and honey. The results were compared with the therapeutic effects obtained with dermazin cream (1% silver sulfadiazine. The level of collagen was determined in the wounds treated with 1% and 3% Sepropol and compared with the collagen level in healthy skin and wounds treated with dermazin. Granulation and regenerated epithelium formation times were compared, with the 3% Sepropol being by far the most effective. The 3% Sepropol also increased the collagen level to 116% with the control sub-groups scoring between 80% and 98%. The results show the healing process of burn wounds in pigs treated with the Sepropol balm starts earlier and has a faster course than the standard dermazin therapy.

  15. Biological activity of propolis-honey balm in the treatment of experimentally-evoked burn wounds.

    Science.gov (United States)

    Jastrzębska-Stojko, Zaneta; Stojko, Rafał; Rzepecka-Stojko, Anna; Kabała-Dzik, Agata; Stojko, Jerzy

    2013-01-01

    Medicines of biogenic origin with micro-organic, regenerative and analgesic properties are becoming more and more significant in the treatment of burn wounds. These properties are found in apitherapeutics such as propolis and honey--products collected and processed by a honey bee. Their effect on the course of the healing processes is multidirectional. The aim of the study was a histopathological and biochemical analysis of the processes of scar formation in experimentally evoked burn wounds in white pigs treated with the 1% and 3% Sepropol balms containing standardized extracts of propolis and honey. The results were compared with the therapeutic effects obtained with dermazin cream (1% silver sulfadiazine). The level of collagen was determined in the wounds treated with 1% and 3% Sepropol and compared with the collagen level in healthy skin and wounds treated with dermazin. Granulation and regenerated epithelium formation times were compared, with the 3% Sepropol being by far the most effective. The 3% Sepropol also increased the collagen level to 116% with the control sub-groups scoring between 80% and 98%. The results show the healing process of burn wounds in pigs treated with the Sepropol balm starts earlier and has a faster course than the standard dermazin therapy.

  16. Histological and bacteriological studies of burn wounds treated with boiled potato peel dressings.

    Science.gov (United States)

    Keswani, M H; Vartak, A M; Patil, A; Davies, J W

    1990-04-01

    Histological and clinical studies have been made on comparable burn wounds covered with either boiled potato peels affixed to gauze bandages or gauze dressings alone; both dressings were applied over a thin layer of 5 per cent silver sulphadiazine. Compared with treatment with plain gauze dressings, the application of the potato peel dressing reduced or eliminated dessication, permitted the survival of superficial skin cells and hastened epithelial regeneration. Bacteriological studies showed that the potato peels had no intrinsic antibacterial activity, the wounds beneath both dressings showing either no growth or, on most occasions, the same bacterial species. The easy availability of potato peels and gauze bandages on to which they can be affixed, the simplicity of the preparation of this dressing, the ease of sterilization and its low cost of production make this the dressing of choice for burn wounds in our developing country. PMID:2350410

  17. Efficacy of silver sulfadiazine phonophoresis on wound healing in acute burn patients

    DEFF Research Database (Denmark)

    Omar, Ghada Said Mohammed

    2003-01-01

    The purpose of the current study was to evaluate the efficacy of SSD phonophoresis approaches (continuous and pulsed modes on the rate of healing following acute burn injury . forty female patients with second degree burn in thrir anterior aspect of the dominant foream were divided randomly...... into two groups : patients in group I received pulsed SSD phonophoresis for 15 min with a frequency of 1MHz , intensity of 1 w/ cm2 , and with the pulse ratio was set at 1 : 4 , and the pulsed duration was set at 2 m.s., while pationts in group II received continuous SSD phonophoresis for 5 min...... with a frequency of 1 MHz , and intensity of 1 W/cm2 . the parameters investigated inclding 1.burn surface area measured by tracing the burn wound parameters , and 2.determination of glycosaminoglycan in urine by using cetylpyridinuin chloride turbidity method . both parameters are measured 24 hours post-burn...

  18. Propolis induces chondroitin/dermatan sulphate and hyaluronic Acid accumulation in the skin of burned wound.

    Science.gov (United States)

    Olczyk, Pawel; Komosinska-Vassev, Katarzyna; Winsz-Szczotka, Katarzyna; Stojko, Jerzy; Klimek, Katarzyna; Kozma, Ewa M

    2013-01-01

    Changes in extracellular matrix glycosaminoglycans during the wound repair allowed us to apply the burn model in which therapeutic efficacy of propolis and silver sulfadiazine was compared. Burns were inflicted on four pigs. Glycosaminoglycans isolated from healthy and burned skin were quantified using a hexuronic acid assay, electrophoretic fractionation, and densitometric analyses. Using the reverse-phase HPLC the profile of sulfated disaccharides released by chondroitinase ABC from chondroitin/dermatan sulfates was estimated. Chondroitin/dermatan sulfates and hyaluronic acid were found in all samples. Propolis stimulated significant changes in the content of particular glycosaminoglycan types during burn healing. Glycosaminoglycans alterations after silver sulfadiazine application were less expressed. Propolis maintained high contribution of 4-O-sulfated disaccharides to chondroitin/dermatan sulfates structure and low level of 6-O-sulfated ones throughout the observed period of healing. Propolis led to preservation of significant contribution of disulfated disaccharides especially 2,4-O-disulfated ones to chondroitin sulfates/dermatan sulfates structure throughout the observed period of healing. Our findings demonstrate that propolis accelerates the burned tissue repair by stimulation of the wound bed glycosaminoglycan accumulation needed for granulation, tissue growth, and wound closure. Moreover, propolis accelerates chondroitin/dermatan sulfates structure modification responsible for binding growth factors playing the crucial role in the tissue repair.

  19. Propolis Induces Chondroitin/Dermatan Sulphate and Hyaluronic Acid Accumulation in the Skin of Burned Wound

    Directory of Open Access Journals (Sweden)

    Pawel Olczyk

    2013-01-01

    Full Text Available Changes in extracellular matrix glycosaminoglycans during the wound repair allowed us to apply the burn model in which therapeutic efficacy of propolis and silver sulfadiazine was compared. Burns were inflicted on four pigs. Glycosaminoglycans isolated from healthy and burned skin were quantified using a hexuronic acid assay, electrophoretic fractionation, and densitometric analyses. Using the reverse-phase HPLC the profile of sulfated disaccharides released by chondroitinase ABC from chondroitin/dermatan sulfates was estimated. Chondroitin/dermatan sulfates and hyaluronic acid were found in all samples. Propolis stimulated significant changes in the content of particular glycosaminoglycan types during burn healing. Glycosaminoglycans alterations after silver sulfadiazine application were less expressed. Propolis maintained high contribution of 4-O-sulfated disaccharides to chondroitin/dermatan sulfates structure and low level of 6-O-sulfated ones throughout the observed period of healing. Propolis led to preservation of significant contribution of disulfated disaccharides especially 2,4-O-disulfated ones to chondroitin sulfates/dermatan sulfates structure throughout the observed period of healing. Our findings demonstrate that propolis accelerates the burned tissue repair by stimulation of the wound bed glycosaminoglycan accumulation needed for granulation, tissue growth, and wound closure. Moreover, propolis accelerates chondroitin/dermatan sulfates structure modification responsible for binding growth factors playing the crucial role in the tissue repair.

  20. Two stage study of wound microorganisms affecting burns and plastic surgery inpatients.

    Science.gov (United States)

    Miranda, Benjamin H; Ali, Syed N; Jeffery, Steven L A; Thomas, Sunil S

    2008-01-01

    This study was designed to identify wound microorganisms and the reasons for differing prevalence between the wards, burns unit and intensive care unit (ICU) in a regional centre for burns and plastic surgery. Antibiotic sensitivities of the 10 most prevalent microorganisms cultured from inpatient wound swabs were also investigated. Inpatient wound swab data were collected retrospectively using notes and departmental database information between January and June 2007. Data were analyzed using chi-squared tests and P-values. Eight hundred five positive wound swabs from 204 swab positive inpatients were analyzed. Stage 1 of this study demonstrated 917 positive swab episodes and 30 varieties of organism. The five most prevalent organisms cultured were Staphylococcus (23.9%), Acinetobacter (21.2%), Methicillin Resistant Staphylococcus aureus (MRSA) (20.8%), Pseudomonas (9.7%) and Enterococcus (5.2%). Stage 2 revealed that Acinetobacter baumanni (ABAU) was significantly more prevalent in military over civilian inpatients (P PAER) was significantly more prevalent in military inpatients over civilian inpatients (P PAER were significantly more prevalent in the ICU setting. Furthermore, military inpatient wounds grew more ABAU, MRSA, and PAER than civilians, probably due to the longer inpatient stay, dirty nature of wounds, site and complex mechanism of injury. Finally, this study suggests that ABAU was brought into the unit by military patients.

  1. Molecular Epidemiology and Clinical Impact of Acinetobacter calcoaceticus-baumannii Complex in a Belgian Burn Wound Center

    Science.gov (United States)

    Bilocq, Florence; Jennes, Serge; Verbeken, Gilbert; Rose, Thomas; Keersebilck, Elkana; Bosmans, Petra; Pieters, Thierry; Hing, Mony; Heuninckx, Walter; De Pauw, Frank; Soentjens, Patrick; Merabishvili, Maia; Deschaght, Pieter; Vaneechoutte, Mario; Bogaerts, Pierre; Glupczynski, Youri; Pot, Bruno; van der Reijden, Tanny J.; Dijkshoorn, Lenie

    2016-01-01

    Multidrug resistant Acinetobacter baumannii and its closely related species A. pittii and A. nosocomialis, all members of the Acinetobacter calcoaceticus-baumannii (Acb) complex, are a major cause of hospital acquired infection. In the burn wound center of the Queen Astrid military hospital in Brussels, 48 patients were colonized or infected with Acb complex over a 52-month period. We report the molecular epidemiology of these organisms, their clinical impact and infection control measures taken. A representative set of 157 Acb complex isolates was analyzed using repetitive sequence-based PCR (rep-PCR) (DiversiLab) and a multiplex PCR targeting OXA-51-like and OXA-23-like genes. We identified 31 rep-PCR genotypes (strains). Representatives of each rep-type were identified to species by rpoB sequence analysis: 13 types to A. baumannii, 10 to A. pittii, and 3 to A. nosocomialis. It was assumed that isolates that belonged to the same rep-type also belonged to the same species. Thus, 83.4% of all isolates were identified to A. baumannii, 9.6% to A. pittii and 4.5% to A. nosocomialis. We observed 12 extensively drug resistant Acb strains (10 A. baumannii and 2 A. nosocomialis), all carbapenem-non-susceptible/colistin-susceptible and imported into the burn wound center through patients injured in North Africa. The two most prevalent rep-types 12 and 13 harbored an OXA-23-like gene. Multilocus sequence typing allocated them to clonal complex 1 corresponding to EU (international) clone I. Both strains caused consecutive outbreaks, interspersed with periods of apparent eradication. Patients infected with carbapenem resistant A. baumannii were successfully treated with colistin/rifampicin. Extensive infection control measures were required to eradicate the organisms. Acinetobacter infection and colonization was not associated with increased attributable mortality. PMID:27223476

  2. Toxic shock syndrome toxin level in wound samples of hospitalized children with burn: a case control study

    Directory of Open Access Journals (Sweden)

    Shima Javadinia

    2014-05-01

    Full Text Available Background: Toxic shock syndrome (TSS, a dangerous consequence of Toxic shock syndrome toxin-1 (TSST-1 caused by Staphylococcus aureus. The early detection for infections of Staphylococcus aureus in burned children is very important, also the pre-vention for consequences of TSST-1. Fever is one of the most noticeable sign in burned children. On the other hand, fever is one of the important consequences of TSST-1 pro-duction. Methods: This study aimed to assess the toxic shock syndrome toxin-1 level in the wound’s specimens of two groups febrile and afebrile in the hospitalized burned chil-dren in Motahari hospital Tehran, Iran in the year 2013. In this case-control study, 90 children who admitted to the burn unit, divided in two groups of 45 patients: febrile (cases group and afebrile (control group. All of burned children under went wound biopsy, and then all of wound’s specimens were tested by PCR for specific primer of toxin producing genome. Finally all of data collected and statistically analyzed. This data include group febrile and afebrile, demographic characteristics, percentage of burned surface severity and result of PCR. Results: The positive result for PCR test, production of TSST-1 in febrile burned chil-dren (cases group was 37.7% and in afebrile burned children (control group was 11.1% that this different was statistically significant (P=0.003. The mean and stan-dard deviation for percentage of burned surface (severity in samples with positive re-sult for PCR test was 30.9±16.93 and in samples with negative result for PCR test was 20.09±11.02 that this different was statistically significant (P=0.01. There was no dif-ference between positive PCR result and negative PCR result of age and sex. Conclusion: Direct association was approved between the production of TSST-1 and the occurrence of fever in burned children. Increased surface severity of burns also re-lated to the production of TSST-1. Further research is recommended.

  3. Effects of mesenchymal stem cells transfected with human hepatocyte growth factor gene on healing of burn wounds

    Institute of Scientific and Technical Information of China (English)

    HA Xiao-qin; L(U) Tong-de; HUI Ling; Dong Fang

    2010-01-01

    Objective: To explore the effects of bone marrow-derived mesenchymal stem cells (BMSCs)transfected with adenoviral vector carrying hepatocyte growth factor (HGF, Ad-HGF) on burn wound healing.Methods: BMSCs from male Wistar rats were separated and purified with Percoll separating medium by density gradient centrifugation and cultured with DMEM containing 20% fetal bovine serum (FBS). Then BMSCs were transfected with Ad-HGF at the optimal gene transduction efficiency of 100 multiplicity of infection (MOI). The efficiency of transfection and the expression of HGF in the suspension were detected by flow cytometry and enzyme linked immunosorbent assay (ELISA) respectively. Thirtytwo female rats were subjected to 90℃ water for 12 seconds to induce a partial thickness skin burn. The animals were randomly divided into mesenchymal stem cells (MSCs) treatment group (Group A), Ad-HGF treatment group (Group B),Ad-HGF-modified MSCs treatment group (Group C) and saline control group (Group D). On days 3, 5, 7, 14 and 21 postburn, HE and Sirius red stain were performed to observe the burn wound healing and collagen content. The content of hydroxyproline in wounds was also detected.Transplanted cells and the expression of(sex-determining region Y) SRY gene were detected by in situ hybridization and polymerase chain reaction (PCR), while the expression of HGF in wound tissues was detected by ELISA.Results: The result of flow cytometry showed that the transfection efficiency was 86.41% at 100 MOI. Compared with the control group, the content of HGF in the supernatant after transfection increased time-dependently and peaked at 48 h, showing significant differences at 24 h, 48 h,72 h and 96 h (P<0.01 ). Results of HE stain revealed that the range of re-epidermidalization in Group C was significantly larger than that in other groups in the first week. Three weeks postburn, the epidermis was significantly thicker in Group C than in other groups and the nails of dermis inserted into

  4. Wound healing and infection in surgery

    DEFF Research Database (Denmark)

    Sørensen, Lars Tue

    2012-01-01

    : The aim was to clarify how smoking and nicotine affects wound healing processes and to establish if smoking cessation and nicotine replacement therapy reverse the mechanisms involved.......: The aim was to clarify how smoking and nicotine affects wound healing processes and to establish if smoking cessation and nicotine replacement therapy reverse the mechanisms involved....

  5. Analysis of Secondary Chemistry and Treatment of Burn Wounds with Nonthermal Plasma Induced Effluent

    Science.gov (United States)

    Golkowski, Mark; Plimpton, S. Reed; Golkowski, Czeslaw

    2013-10-01

    Exploitation of non-thermal plasmas in the biomedical setting is a rapidly growing field with a large number of diverse technologies under investigation. Potential applications of such devices range from instrument sterilization to clinical therapy. One of the key hurdles to the implementation of non-thermal plasma technologies in the relatively poor understanding of the chemical processes taking place. Our group has recently completed precise analysis of chemical species created by our indirect exposure non-thermal plasma device with hydrogen peroxide additives. Reactive nitrogen and oxygen species are observed using optical absorption spectroscopy. We report the unique detection of short lived hydroxyl radicals at a significant distance from the discharge using electron paramagnetic spin resonance trapping. The hydroxyl radicals are shown to be generated in secondary ozonide based chemical processes away from the discharge. The plasma device is applied to a porcine model of infected full thickness burn wounds. The bacteria load reduction after treatment with our device is shown to be 10-100 fold improvement over Silvadene which is the main treatment currently used in the clinic. Partially funded by NIH SBIR R43 AI096594.

  6. Effect of Fuchunsan I on healing of remaining wound surface in burn%复春散Ⅰ号对烧伤残余创面愈合的影响

    Institute of Scientific and Technical Information of China (English)

    黄灿全

    2003-01-01

    @@ BACKGROUND: Remaining wound surface in late stage isoften found in patients with big area of deep burn and infection iscomplicated in most cases. There are many causes for remainingwound surface, but local repeated infection is one of the importantreasons. Once infection occurred at wound surface, growth of ep-ithelial cells will be influenced seriously because of large amount ofbacteria and products of metabolism and effect of skin graft isn' tsatisfying. So, an effective method must be adopted to replace skingraft and promote healing of wound surface. Fuchunsan I effectivelyresolved this problem.

  7. Identification of Major Active Ingredients Responsible for Burn Wound Healing of Centella asiatica Herbs

    Directory of Open Access Journals (Sweden)

    Fang Wu

    2012-01-01

    Full Text Available Centella asiatica herbs have been prescribed as a traditional medicine for wound healing in China and Southeast Asia for a long time. They contain many kinds of triterpenoid compounds, mainly including glycosides (asiaticoside and madecassoside and corresponding aglycones (asiatic acid and madecassic acid. To identify which is the major active constituent, a comprehensive and comparative study of these compounds was performed. In vitro, primary human skin fibroblasts, originating from healthy human foreskin samples, were treated with various concentrations of asiaticoside, madecassoside, asiatic acid, and madecassic acid, respectively. Cell proliferation, collagen synthesis, MMP-1/TIMP-1 balance, and TGF-β/Smad signaling pathway were investigated. In vivo, mice were orally administered with the four compounds mentioned above for two weeks after burn injury. The speed and quality of wound healing, as well as TGF-β1 levels in skin tissues, were examined. Interestingly, in contrast to prevalent postulations, asiaticoside and madecassoside themselves, rather than their corresponding metabolites asiatic acid and madecassic acid, are recognized as the main active constituents of C. asiatica herbs responsible for burn wound healing. Furthermore, madecassoside is more effective than asiaticoside (P=0.0446 for procollagen type III synthesis in vitro, P=0.0057 for wound healing speed, and P=0.0491 for wound healing pattern in vivo, correspondingly.

  8. Effect of virtual reality on adolescent pain during burn wound care.

    Science.gov (United States)

    Jeffs, Debra; Dorman, Dona; Brown, Susan; Files, Amber; Graves, Tamara; Kirk, Elizabeth; Meredith-Neve, Sandra; Sanders, Janise; White, Benjamin; Swearingen, Christopher J

    2014-01-01

    The objective of this study was to compare the effect of virtual reality to passive distraction and standard care on burn treatment pain in adolescents.This single-blinded, randomized controlled study enrolled 30 adolescents who were 10 to 17 years of age from the burn clinic of a large children's hospital. After providing informed consent/assent, these participants were randomly assigned to one of three groups during wound care: standard care, passive distraction watching a movie, or virtual reality (VR) using a tripod-arm device rather than an immersive helmet. Before wound care, participants completed the Spielberger's State-Trait Anxiety Inventory for Children and Pre-Procedure Questionnaire while blinded to group assignment. A total of 28 participants completed the study and rated treatment pain after wound care by using the Adolescent Pediatric Pain Tool and completed a Post-Procedure Questionnaire. The VR group reported less pain during wound care than either the passive distraction or standard care group as determined by multivariable linear regression adjusted for age, sex, preprocedure pain, state anxiety, opiate use, and treatment length. The VR group was the only group to have an estimated decrease in pain perception from baseline preprocedure pain to procedural pain reported. Adolescents pretreated with opiate analgesics and female adolescents reported more pain during wound care.This between-subjects clinical study provides further support for VR, even without requiring wearing of an immersive helmet, in lessening burn wound care pain in adolescents. Passive distraction by watching a movie may be less effective in reducing treatment pain. Additional between-subjects randomized controlled trials with larger samples of children and during other healthcare treatments may further support VR's effectiveness in pediatric procedural pain management.

  9. Development of biofilm-targeted antimicrobial wound dressing for the treatment of chronic wound infections.

    Science.gov (United States)

    Ng, Shiow-Fern; Leow, Hon-Lunn

    2015-01-01

    It has been established that microbial biofilms are largely responsible for the recalcitrance of many wound infections to conventional antibiotics. It was proposed that the efficacy of antibiotics could be optimized via the inhibition of bacterial biofilm growth in wounds. The combination of antibiofilm agent and antibiotics into a wound dressing may be a plausible strategy in wound infection management. Xylitol is an antibiofilm agent that has been shown to inhibit the biofilm formation. The purpose of this study was to develop an alginate film containing xylitol and gentamicin for the treatment of wound infection. Three films, i.e. blank alginate film (SA), alginate film with xylitol (F5) and alginate film with xylitol and gentamicin (AG), were prepared. The films were studied for their physical properties, swelling ratio, moisture absorption, moisture vapor transmission rate (MVTR), mechanical and rheology properties, drug content uniformity as well as in vitro drug release properties. Antimicrobial and antibiofilm in vitro studies on Staphylococcus aureus and Pseudomonas aeruginosa were also performed. The results showed that AG demonstrates superior mechanical properties, rheological properties and a higher MVTR compared with SA and F5. The drug flux of AG was higher than that of commercial gentamicin cream. Furthermore, antimicrobial studies showed that AG is effective against both S. aureus and P. aeruginosa, and the antibiofilm assays demonstrated that the combination was effective against biofilm bacteria. In summary, alginate films containing xylitol and gentamicin may potentially be used as new dressings for the treatment of wound infection. PMID:25758412

  10. Innate defense regulator peptide 1018 in wound healing and wound infection.

    Directory of Open Access Journals (Sweden)

    Lars Steinstraesser

    Full Text Available Innate defense regulators (IDRs are synthetic immunomodulatory versions of natural host defense peptides (HDP. IDRs mediate protection against bacterial challenge in the absence of direct antimicrobial activity, representing a novel approach to anti-infective and anti-inflammatory therapy. Previously, we reported that IDR-1018 selectively induced chemokine responses and suppressed pro-inflammatory responses. As there has been an increasing appreciation for the ability of HDPs to modulate complex immune processes, including wound healing, we characterized the wound healing activities of IDR-1018 in vitro. Further, we investigated the efficacy of IDR-1018 in diabetic and non-diabetic wound healing models. In all experiments, IDR-1018 was compared to the human HDP LL-37 and HDP-derived wound healing peptide HB-107. IDR-1018 was significantly less cytotoxic in vitro as compared to either LL-37 or HB-107. Furthermore, administration of IDR-1018 resulted in a dose-dependent increase in fibroblast cellular respiration. In vivo, IDR-1018 demonstrated significantly accelerated wound healing in S. aureus infected porcine and non-diabetic but not in diabetic murine wounds. However, no significant differences in bacterial colonization were observed. Our investigation demonstrates that in addition to previously reported immunomodulatory activities IDR-1018 promotes wound healing independent of direct antibacterial activity. Interestingly, these effects were not observed in diabetic wounds. It is anticipated that the wound healing activities of IDR-1018 can be attributed to modulation of host immune pathways that are suppressed in diabetic wounds and provide further evidence of the multiple immunomodulatory activities of IDR-1018.

  11. Nanohybrids of silver particles immobilized on silicate platelet for infected wound healing.

    Directory of Open Access Journals (Sweden)

    Chia-Yu Chu

    Full Text Available Silver nanoparticles supported on nanoscale silicate platelets (AgNP/NSP possess interesting properties, including a large surface area and high biocide effectiveness. The nanohybrid of AgNP/NSP at a weight ratio 7/93 contains 5-nm Ag particles supported on the surface of platelets with dimensions of approximately 80×80×1 nm(3. The nanohybrid expresses a trend of lower cytotoxicity at the concentration of 8.75 ppm Ag and low genotoxicity. Compared with conventional silver ions and the organically dispersed AgNPs, the nanohybrid promotes wound healing. We investigated overall wound healing by using acute burn and excision wound healing models. Tests on both infected wound models of mice were compared among the AgNP/NSP, polymer-dispersed AgNPs, the commercially available Aquacel, and silver sulfadiazine. The AgNP/NSP nanohybrid was superior for wound appearance, but had similar wound healing rates, vascular endothelial growth factor (VEGF-A levels and transforming growth factor (TGF-β1 expressions to Aquacel and silver sulfadiazine.

  12. Effect of green tea on the second degree burn wounds in rats

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Fatemi

    2014-01-01

    Full Text Available Background: Various studies indicate that the green tea has anti-inflammatory and anti-oxidative properties. Moreover, a few studies have been carried out that demonstrate beneficial effects of green tea on burned patients. Materials and Methods: In this study, green tea, Vaseline, and silver sulfadiazine dressings were used as first-aid treatment to deep dermal contact burns in rats, compared with a control of nothing. After creating second-degree burn on the dorsum of rats, the treatments were applied for 15 min in four groups. Wound dressing changes were daily. Macroscopic study was performed on days 1, 3, 7, and 14 by using a digital camera and software processing of photos. Microscopic examination was done by pathologic evaluation of skin specimens on day 14. Results: We observed that green tea usage significantly decreased burn size in comparison to the control group (P = 0.004. Conclusion: Green tea is effective on healing process of second degree burn wounds.

  13. Flagellin and pilin immunization against multi-drug resistant Pseudomonas aeruginosa protects mice in the burn wound sepsis model.

    Science.gov (United States)

    Korpi, Fatemeh; Hashemi, Farhad B; Irajian, Gholamreza; Fatemi, Mohammad Javad; Laghaei, Parisa; Behrouz, Bahador

    2016-08-01

    Pseudomonas aeruginosa is a formidable pathogen and a major threat to burn patients. Antimicrobial therapy is often unsuccessful because P. aeruginosa can develop multi-drug resistance; thus, immunotherapy and vaccine can be a rational alternative. Flagella and type IV pili have been identified as important virulence factors in the colonization and pathogenesis of P. aeruginosa in burn wound infections. Immunogenicity and efficacy of mixed recombinant full-length type b flagellin (r-b-flagellin) and recombinant PilA (r-PilA) as candidate vaccines were assessed by measuring humoral and cellular responses, using an experimental burned mouse model. Primary immunization with "r-b-flagellin+r-PilA" followed by two booster shots was sufficient to generate a robust humoral response, which was predominantly a Th2 response consisting mainly of subtype IgG1 and low levels of IgG2a. Analysis of the cytokine response among immunized mice showed an increased production of IL-4, INF-γ and IL-17 by splenocytes upon stimulation by "r-b-flagellin+r-PilA". Opsonophagocytosis assays confirmed the enhanced killing of bacteria by anti "r-b-flagellin+r-PilA" immune sera. These antibodies were also able to reduce bacterial load in the site of original infection into the liver and spleen of challenged mice. The reduction of systemic bacterial spread resulted in an increased survival rate of challenged immunized mice. In conclusion, immunization with "r-b-flagellin+r-PilA" proteins provides a better protective response against P. aeruginosa infection in the burn mouse model. PMID:27210422

  14. Clinical Experience with MEBO in Treating Facial Deep Burn Wounds%MEBO治疗面部深度烧伤创面的临床体会

    Institute of Scientific and Technical Information of China (English)

    汪世友

    2001-01-01

    Objective:To observe the efficacy of MEBO in treating facial deep 2nd degree and superficial 3rd degree burn wounds. Method: 15 patients with facial deep 2nd degree and 15 patients with superficial 3rd degree burn wounds were treated with MEBO. Wound infection, pain, healing time and scar formation rate were observed. Result: Deep 2nd degree wounds healed without scar formation, the wounds had good elasticity and pigmentation. superficial 3rd degree wounds healed with scattered scars and poor elasticity. Conclusion: MEBO had the effect of promoting the regeneration and repair of facial deep burn wound. It helped the granulation to grow into confluence and prevented scar formation.%目的:观察 MEBO对面部深Ⅱ度深型和浅Ⅲ度创面的治疗效果.方法:将采用 MEBO治愈面部 30例烧伤病人,选择深Ⅱ度深型 15例,浅Ⅲ度 15例,进一步观察创面感染,疼痛愈合时间及愈合瘢痕生成情况.结果:深Ⅱ度深型创面无瘢痕愈合,弹性尚好,有色素沉着;浅Ⅲ度创面愈合后有散在瘢痕形成,弹性欠佳.结论: MEBO有促进头面部深度烧伤创面、再生、修复、融合漫延的作用,并有良好的止痕效果

  15. Mechanism of Wound-Healing Activity of Hippophae rhamnoides L. Leaf Extract in Experimental Burns

    OpenAIRE

    Nitin K. Upadhyay; Ratan Kumar; Siddiqui, M. S.; Asheesh Gupta

    2011-01-01

    The present investigation was undertaken to evaluate the healing efficacy of lyophilized aqueous leaf extract of Sea buckthorn (Hippophae rhamnoides L., family Elaeagnaceae) (SBT) and to explore its possible mechanism of action on experimental burn wounds in rats. The SBT extract, at various concentrations, was applied topically, twice daily for 7 days. Treatment with silver sulfadiazine (SSD) ointment was used as reference control. The most effective concentration of the extract was found to...

  16. Managing severe burn injuries: challenges and solutions in complex and chronic wound care

    OpenAIRE

    Jeschke, Marc

    2016-01-01

    Alan D Rogers, Marc G Jeschke Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Abstract: Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased lite...

  17. Managing severe burn injuries: challenges and solutions in complex and chronic wound care

    OpenAIRE

    AD Rogers; MG, Jeschke

    2016-01-01

    Alan D Rogers, Marc G Jeschke Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Abstract: Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased literatu...

  18. Randomized controlled trial of the absorbency of four dressings and their effects on the evaporation of burn wounds

    Institute of Scientific and Technical Information of China (English)

    CHEN Jiong; HAN Chun-mao; SU Guo-liang; TANG Zhi-jian; SU Shi-jie; LIN Xiao-wei

    2007-01-01

    Background Wound dressings are divided into traditional and new types. The new dressings are thought to accelerate wound healing. The purpose of this study was to supplement the scanty data on the absorbency of the new dressings and their effects on evaporation from the burn surface.Methods The water absorption rate of four dressings (carbon fiber dressing, hydrogel dressing, silver nanoparticle dressing, and vaseline gauze) were measured by the immersion-weight gain method. A total of 120 inpatients with 10%superficial partial-thickness burn wounds were randomly assigned to four groups, each with 30 participants. Carbon fiber dressing, hydrogel dressing, and silver nanoparticle dressing were used in groups A, B, and C as the primary dressing,and traditional vaseline gauze was used in group D as the control. Multi-spot evaporation from normal skin and naked wound, and from wounds covered with each of the four dressings was measured post-burn on days 1, 3, 5, and 7 by an EP-I evaporimeter under conditions of 21 ℃ -22 ℃ ambient temperature and 74%-78% humidity.Results The absorption rates of the four dressings were 988% with carbon fiber dressing, 96% with silver nanoparticle,41% with vaseline gauze, and 6% with hydrogel. Evaporation from the naked burn wounds was about 1/3 higher than from normal skin (P<0.01). Compared with wounds without applied dressing, evaporation from dressed wounds decreased and was time-dependent (P<0.01). The evaporation of wounds with carbon fiber dressing was the lowest ((13.40±2.82)ml·h-1·m-2,P<0.01) on day 1 post-burn,compared with the other groups.Conclusion All four dressings have water retention capacity while carbon fiber dressing has the highest absorption rate and shows the best containment and evaporation from the burn wound.

  19. 烧伤后期特大未愈创面伴脓毒症患者的救治%Treatment of a patient with massive unhealed wound accompanied by wound sepsis in late stage after burn injury

    Institute of Scientific and Technical Information of China (English)

    李志清; 王甲汉; 吴起; 杨磊

    2012-01-01

    This article analyzed the medical records of a patient with 90% TBSA unhealed wound accompanied with wound sepsis 50 days post burn (PBD) and to discuss the ideal strategies of treatment for such patients in such condition.This was a 24-year-old male patient suffering from flame burn with 95% TBSA wound and severe inhalation injury.Meek skin grafting with autologous scalp was performed once to the thoracic and abdominal regions; intermingled skin grafting of autologous scalp microskin and large sheet of allograft was performed twice to the limbs within PBD 31.The patient was transferred to our hospital on PBD 50 with 90% TBSA wound unhealed,leaving a vast amount of necrotic tissue and allografts.Furthermore,he was complicated by sepsis,pulmonary infection,and gastric ulcer.Debridement and allogenic skin grafting were performed on the first day after hospitalization.When the condition of wounds was improved,transplantation of a large sheet of allogenic skin with inlaid small pieces of autologous skin,intermingled skin grafting of autologous and allogenic skin,and small pieces of autologous skin grafting were performed.Because of the shortage of donor area,the exposed wounds were temporarily covered with allogeneic skin.Epidermal growth factor was used to promote the healing of autologous skin donor site and deep partial-thickness bum wound.Autologous skin grafting was performed whenever source of healthy skin was available.Systemic use of effective antibiotics,nutritional support and therapy,and other comprehensive measures also contributed to the success of treatment of this patient suffering from wound sepsis.The patient was cured and discharged on PBD 145.

  20. Role of Negative-Pressure Wound Therapy in Deep Sternal Wound Infection After Open Heart Surgery

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    Cemalettin Aydın

    2013-08-01

    Full Text Available Introduction: Mediastinitis is a devastating complication in open heart surgery. The most common treatments after debridement are rewiring with antibiotic irrigation. Vacuum assisted closure therapy is a recently introduced technique that promotes the healing of difficult wounds, including post-sternotomy mediastinitis.Patients and Methods: Forty one patients with deep sternal wound infection were divided into two groups based on the treatment method used. Twenty two patients with post-cardio to my deep sternal wound infection were treated primarily by vacuum assisted closure method (group A and 19 patients with deep sternal wound infection who received closed mediastinal irrigation were treated with antibiotics (group B between January 2006 and January 2010.Results: The two groups were compared. Three patients died during treatment in group B. The median healing time was significantly shorter in group A (mean, 13.5 ± 3.2 days compared to 18 days (mean, 21.2 ± 16.4 days in group B (p< 0.001. Deep sternal wound infection showed no recurrences after the vacuum treatment, while 7 (24% patients in group B suffered recurrences. Hospital stay was significantly shorter in group A (median, 30.5 days; mean, 32.2 ± 11.3 days vs. median, 45 days; mean, 49.2 ± 19.3 days (p= 0.001.Conclusion: A significantly shorter healing time was confirmed with vacuum assisted closure. Hospital stay remained significantly shorter in group A (35 vs. 46 days.

  1. The Wound Healing and Antibacterial Activity of Five Ethnomedical Calophyllum inophyllum Oils: An Alternative Therapeutic Strategy to Treat Infected Wounds.

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    Teddy Léguillier

    Full Text Available Calophyllum inophyllum L. (Calophyllaceae is an evergreen tree ethno-medically used along the seashores and islands of the Indian and Pacific Oceans, especially in Polynesia. Oil extracted from the seeds is traditionally used topically to treat a wide range of skin injuries from burn, scar and infected wounds to skin diseases such as dermatosis, urticaria and eczema. However, very few scientific studies reported and quantified the therapeutic properties of Calophyllum inophyllum oil (CIO. In this work, five CIO from Indonesia (CIO1, Tahiti (CIO2, 3, Fiji islands (CIO4 and New Caledonia (CIO5 were studied and their cytotoxic, wound healing, and antibacterial properties were presented in order to provide a scientific support to their traditional use and verify their safety.The safety of the five CIO was ascertained using the Alamar blue assay on human keratinocyte cells. CIO wound healing properties were determined using the scratch test assay on human keratinocyte cells. CIO-stimulated antibacterial innate immune response was evaluated using ELISA by measuring β defensin-2 release in human derivative macrophage cells. CIO antibacterial activity was tested using oilogramme against twenty aerobic Gram- bacteria species, twenty aerobic Gram+ bacteria species, including a multi-drug resistant Staphylococcus aureus strain and two anaerobic Gram+ bacteria species e.g. Propionibacterium acnes and Propionibacterium granulosum. To detect polarity profile of the components responsible of the antibacterial activity, we performed bioautography against a Staphylococcus aureus strain.Based on Alamar Blue assay, we showed that CIO can be safely used on keratinocyte cells between 2.7% and 11.2% depending on CIO origin. Concerning the healing activity, all the CIO tested accelerated in vitro wound closure, the healing factor being 1.3 to 2.1 higher compared to control when keratinocytes were incubated after scratch with CIO at 0.1%. Furthermore, our results

  2. Hybrid wound dressings with controlled release of antibiotics: Structure-release profile effects and in vivo study in a guinea pig burn model.

    Science.gov (United States)

    Zilberman, Meital; Egozi, Dana; Shemesh, Maoz; Keren, Aviad; Mazor, Eytan; Baranes-Zeevi, Maya; Goldstein, Nyra; Berdicevsky, Israela; Gilhar, Amos; Ullmann, Yehuda

    2015-08-01

    Over the last decades, wound dressings have evolved from a crude traditional gauze dressing to tissue-engineered scaffolds. Many types of wound dressing formats are commercially available or have been investigated. We developed and studied hybrid bilayer wound dressings which combine a drug-loaded porous poly(dl-lactic-co-glycolic acid) top layer with a spongy collagen sublayer. Such a structure is very promising because it combines the advantageous properties of both layers. The antibiotic drug gentamicin was incorporated into the top layer for preventing and/or defeating infections. In this study, we examined the effect of the top layer's structure on the gentamicin release profile and on the resulting in vivo wound healing. The latter was tested on a guinea pig burn model, compared to the neutral non-adherent dressing material Melolin® (Smith & Nephew) and Aquacel® Ag (ConvaTec). The release kinetics of gentamicin from the various studied formulations exhibited burst release values between 8% and 38%, followed by a drug elution rate that decreased with time and lasted for at least 7 weeks. The hybrid dressing, with relatively slow gentamicin release, enabled the highest degree of wound healing (28%), which is at least double that obtained by the other dressing formats (8-12%). It resulted in the lowest degree of wound contraction and a relatively low amount of inflammatory cells compared to the controls. This dressing was found to be superior to hybrid wound dressings with fast gentamicin release and to the neat hybrid dressing without drug release. Since this dressing exhibited promising results and does not require frequent bandage changes, it offers a potentially valuable concept for treating large infected burns.

  3. Application of VitaVallis dressing for infected wounds

    Energy Technology Data Exchange (ETDEWEB)

    Kirilova, N. V., E-mail: n.kirilova@vitavallis.com; Fomenko, A. N., E-mail: alserova@ispms.tsc.ru; Korovin, M. S., E-mail: msk@ispms.tsc.ru [Institute of Strength Physics and Materials Science SB RAS, 2/4 Akademicheskii pr., Tomsk, 634055 (Russian Federation)

    2015-11-17

    Today there is a growing demand for safe and efficient antimicrobial dressings for infected wound treatment. The antimicrobial sorption material for VitaVallis dressings was produced by one-stage oxidation of aluminum nanopowder in water in the presence of fibrous acetylcellulose matrix. Scanning electron microscopy revealed that the material is made up of fibers of diameter 1.5–3.0 µm with adhered agglomerated alumina nanosheets. An antimicrobial study revealed a high inhibitory effect of VitaVallis against the growth of gram-negative (E.coli, P. aeruginosa) and gram-positive (S. aureus) strains. The antimicrobial activity of the dressing against microbial pathogens on the wound surface was demonstrated in in vivo experiments on male rats. The dressing was also tested on volunteer patients. The testing showed reduction of the wound healing period, accelerated cleaning of the infected wound and enhanced tissue regeneration in the wound. The results demonstrate that the VitaVallis dressing can be used for the treatment of deep infected wounds.

  4. Application of VitaVallis dressing for infected wounds

    International Nuclear Information System (INIS)

    Today there is a growing demand for safe and efficient antimicrobial dressings for infected wound treatment. The antimicrobial sorption material for VitaVallis dressings was produced by one-stage oxidation of aluminum nanopowder in water in the presence of fibrous acetylcellulose matrix. Scanning electron microscopy revealed that the material is made up of fibers of diameter 1.5–3.0 µm with adhered agglomerated alumina nanosheets. An antimicrobial study revealed a high inhibitory effect of VitaVallis against the growth of gram-negative (E.coli, P. aeruginosa) and gram-positive (S. aureus) strains. The antimicrobial activity of the dressing against microbial pathogens on the wound surface was demonstrated in in vivo experiments on male rats. The dressing was also tested on volunteer patients. The testing showed reduction of the wound healing period, accelerated cleaning of the infected wound and enhanced tissue regeneration in the wound. The results demonstrate that the VitaVallis dressing can be used for the treatment of deep infected wounds

  5. Advances in biomedical imaging using THz technology with applications to burn-wound assessment

    Science.gov (United States)

    Tewari, Priyamvada; Kealey, Colin; Sung, Jun; Maccabi, Ashkan; Bajwa, Neha; Singh, Rahul; Culjat, Martin; Stojadinovic, Alexander; Grundfest, Warren; Taylor, Zachary D.

    2012-02-01

    Terahertz (THz) hydration sensing and image has been a topic of increased interest recently due largely to improvements in source and detector technology and the identification of applications where current hydration sensing techniques are insufficient. THz medical imaging is an expanding field of research and tissue hydration plays a key role in the contrast observed in THz tissue reflectance and absorbance maps. This paper outlines the most recent results in burn and corneal imaging where hydration maps were used to assess tissue status. A 3 day study was carried out in rat models where a THz imaging system was used to assess the severity and extent of burn throughout the first day of injury and at the 24, 48, and 72 hour time points. Marked difference in tissue reflectance were observed between the partial and full thickness burns and image features were identified that may be used as diagnostic markers for burn severity. Companion histological analysis performed on tissue excised on Day 3 confirms hypothesized burn severity. The results of these preliminary animal trials suggest that THz imaging may be useful in burn wound assessment where current clinical modalities have resolution and/or sensitivity insufficient for accurate diagnostics.

  6. The Antimicrobial Activity o f Honey o n Bacterial Isolates From Burns/Wound o f Patients Attending General Hospital, Ankpa, Kogi State. Nigeria

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    Aliyu Aminu Ibrahim

    2016-05-01

    Full Text Available The antimicrobial activity of honey samples from Ankpa, Enjema and Ojoku districts of Ankpa Local Government Area of Kogi State, Nigeria against coagulase negative Staphylococcus species, Pseudomonas aeruginosa, coagulase positive Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli and Proteus speciesobtained from 200 burns/wound patients attending General Hospital, Ankpa were determined. The sensitivity of honey to the test organisms ranges from 16mm to 19mm in diameter. The minimum inhibitory concentration (MIC of the honey samples on the bacterial isolates from Ankpa and Ojoku were 0.16 v/v and 0.32 v/v for honey from Enjema. The results of the study revealed that honey from the area understudy has high antimicrobial activity and it is recommended that pure natural honey should be stocked in hospitals/clinics so as to encourage its application in the treatment of burns/wound infections

  7. Bacterial cellulose membrane produced by Acetobacter sp. A10 for burn wound dressing applications.

    Science.gov (United States)

    Kwak, Moon Hwa; Kim, Ji Eun; Go, Jun; Koh, Eun Kyoung; Song, Sung Hwa; Son, Hong Joo; Kim, Hye Sung; Yun, Young Hyun; Jung, Young Jin; Hwang, Dae Youn

    2015-05-20

    Bacteria cellulose membranes (BCM) are used for wound dressings, bone grafts, tissue engineering, artificial vessels, and dental implants because of their high tensile strength, crystallinity and water holding ability. In this study, the effects of BCM application for 15 days on healing of burn wounds were investigated based on evaluation of skin regeneration and angiogenesis in burn injury skin of Sprague-Dawley (SD) rats. BCM showed a randomly organized fibrils network, 12.13 MPa tensile strength, 12.53% strain, 17.63% crystallinity, 90.2% gel fraction and 112.14 g × m(2)/h highest water vapor transmission rate (WVTR) although their swelling ratio was enhanced to 350% within 24h. In SD rats with burned skin, the skin severity score was lower in the BCM treated group than the gauze (GZ) group at all time points, while the epidermis and dermis thickness and number of blood vessels was greater in the BCM treated group. Furthermore, a significant decrease in the number of infiltrated mast cells and in vascular endothelial growth factor (VEGF) and angiopoietin-1 (Ang-1) expression was observed in the BCM treated group at day 10 and 15. Moreover, a significant high level in collagen expression was observed in the BCM treated group at day 5 compared with GZ treated group, while low level was detected in the same group at day 10 and 15. However, the level of metabolic enzymes representing liver and kidney toxicity in the serum of BCM treated rats was maintained at levels consistent with GZ treated rats. Overall, BCM may accelerate the process of wound healing in burn injury skin of SD rats through regulation of angiogenesis and connective tissue formation as well as not induce any specific toxicity against the liver and kidney. PMID:25817683

  8. Honey ointment': a natural remedy of skin wound infections

    International Nuclear Information System (INIS)

    Background: Honey is a gift of nature, principally identified and valued to possess antimicrobial and anti-inflammatory activity and has been used as a natural remedy of wounds since ancient times. The objectives of this study were to evaluate the antimicrobial activity of honey against micro-organisms, to formulate a honey ointment and to evaluate the efficacy of such ointment by conducting clinical trials on skin wound infection. Methods: This experimental study was conducted at Department of Pharmaceutics, Faculty of Pharmacy, University of Karachi and Out-patient Department of Dermatology, Fauji Foundation Hospital, Rawalpindi from November 2009 to October 2010. The antimicrobial activity of Pakistani floral sources (Trachysperm copticum, Acacia nilotica species indica, Zizyphus) honey samples was investigated by disc diffusion method against freshly isolated wound infecting bacteria (Staphylococci aureus, Staphylococci epidermidis, Streptococcus faecalis, Pseudomonas aeruginosa, Klebsiella pneumonia, Escherichia coli, Proteus vulgaris and Candida albicans), and Staphylococci aureus ATCC 6538, Pseudomonas aeruginosa ATCC 9022, Escherichia coli ATCC 25922, Candida albican ATCC 15146. An ointment containing 20% active antimicrobial honey was formulated. The efficacy of such ointment was evaluated by passing thought clinical trials. A total number of 27 patients (23 skin wound infection, and 4 diabetic foot ulcer) were involved in the study. Thin layer of newly formulated honey ointment on gauze were applied two to three times per day till complete healing. Results: In microbiological assay the honey samples were found to exhibit a very promising antimicrobial activity against all the micro-organisms tested. In clinical trial very significant results (99.15%) healing was observed in skin wound infections cases with mean healing time of 5.86 (2-20) days, and 95% diabetic foot ulcers healed with the mean healing time of 20 (8-40) days. Conclusion: Newly formulated

  9. Negative Pressure Wound Therapy in Infected Wound following Posterior Spinal Instrumentation using Simple Self-assembled System: A Case Report

    OpenAIRE

    Chang, CW; Chan, HZ; Lim, SW; Khoo, EH; Zulkiflee, O

    2014-01-01

    Abstract Postoperative wound infection in an instrumented spine patient is often disastrous. Management includes implant removal leading to spine instability. Negative pressure wound therapy (NPWT) applied to the spine surgical wound is one of the wound care technique with successful results. We report a case of a man who sustained Chance fracture of Lumbar 1 (L1) vertebra treated with long segment posterior instrumentation, who unfortunately developed Extended-spectrum beta-lactamase (ESBL) ...

  10. Cryopreserved cadaveric skin allograft for cover of excised burns wounds: early clinical experience in Singapore

    International Nuclear Information System (INIS)

    Human cadaveric skin allograft is widely and effectively used in the treatment of extensive burns. A Skin Bank was established in Singapore National Burns Centre in late 1992 to cater to this need. Due to the shortage of skin donors, it was not until early 1998 that the Skin Bank began to store cadaveric skin harvested from consent donors under the Medical Therapy, Education and Research Act. Cadaveric skin has significant clinical usefulness particularly in the treatment of severe burns. The National Burns Centre admits on the average 300 patients a year, and about 25% of which have sustained major burns (total bum area in excess of 30% BSA or full thickness in excess of 20% BSA). In many cases, the bums are too extensive for autologous skin grafts. The pivotal role of the Skin Bank allows temporary coverage of the entire open bum wound following desloughing or bum wound excision. To date six skin donations have been dealt with. The national tissue transplant team coordinated the selection and screening of these donors. The skin harvested is cryopreserved with 10% dimethyl sulphoxide (DMSO) or glycerol in DMEM. Supplementation with antibiotics is important. Storage temperature is set at -150 degree C. The procurement, processing, preservation and storage of skin allografts were according to guidelines issued by the American Association of Tissue Banks.Three patients with extensive bums (45% mean body surface area) have benefited from this stored cadaveric skin as temporary biological dressings. The technique is by no means novel but the usage of cadaveric skin represents a further treatment milestone for the severe bum injury patients at our centre

  11. WOUND INFECTION AFTER SCOLIOSIS SURGERY: AN ANALYSIS OF 15 CASES

    Institute of Scientific and Technical Information of China (English)

    李书纲; 仉建国; 李军伟; 林进; 田野; 翁习生; 邱贵兴

    2002-01-01

    Objective. To discuss the causes and treatments of wound infections after scoliosis surgery. Methods. Nine hundred and twenty-four cases of scoliosis were reviewed, and the clinical data of 15 cases of postoperative infection were analysed retrospectively. Results. All 15 cases underwent spinal posterior fusion with autologous bone graft using instrumentations. Seven were diagnosed as early infection, and 8 were delayed infection. Radical debridement was performed in all 15 cases. The duration of antibiotics administration was 10 to 34 days with continuous closed irrigation for 2~ 4 weeks and primary closure for the wounds. All patients were followed up for an average of 3.5 years (2 to 7.5 years) with good outcomes and no recurrence. Conclusion. Wound infection following surgical correction of scoliosis primarily results from intraoperative seeding, although host-related and operation-related factors may contribute to its development. Once the infections are diagnosed, good results can be achieved by prompt surgical debridement, irrigation and reasonably administered antibiotics. Removal of hardware may be necessary in deep infections.

  12. 288例烧伤患者早期创面感染病原菌种类及主要致病菌耐药性分析%Analysis on the Bacterium Species and Drug Resistance of the Main Pathogenic Bacteria Isolated from 288 Patients with Earlier Period Infected Burn Wound

    Institute of Scientific and Technical Information of China (English)

    董华丽; 张传领; 沈丽蒙; 郭远瑜; 张国祥

    2013-01-01

    Objective To investigate the bacteria species and drug resistance characteristics of the main pathogenic bacteria isolated from earlier period infected burn wound patients,and to provide evidence for reasonable clinical treatment with antibiotics.Methods We collected the earlier period infected secretion specimens and clinical and epidemiological data of the bum wound cases from January 2008 to December 2011.The pathogenic bacteria were isolated,cultured and identified,and the drug sensitivity test (DST) was conducted on the main species of the pathogenic bacteria to antibiotics by means of conventional methods.Results A total of 288 bacteria strains were isolated from 288 earlier period infected bum wound patients' secretion samples.There were more than 10 bacteria species identified from these strains,including Staphylococcus aureus (116/288,40.3 %),Staphylococcus epidermidis (36/288,12.5 %),Staphylococcus haemolyticus (27/288,9.4 %),Pseudomonas aeruginosa (35/288,12.2%),Enterobacter cloacae (15/288,5.2%),Escherichia coli (9/288,3.1%),and the other bacteria strains (50/288,17.4%).The results of DST showed that S.aureus and S.epidermidis were highly resistant to penicillin (with the resistant rates of 93.1% and 100%,respectively),but highly sensitive to nitrofurantoin,linezolid,and rifampicin,and in which no vancomycin-resistant strains were found.The resistant rates of P.aeruginosa to ampicillin,cefozolin,cefuroxime and cefoxitin were all of 100 %,but to ceftazidime,cefepime,piperacillin/tazobactam,levofloxacin,gentamycin and kanamycin were all less than 10 %.Conclusions The results of this study show that bacteria species and their drug resistance in earlier period infected burn wound patients are multiple and complex.The main pathogenic bacteria are S.aureus,S.epidermidis,S.haemolyticus and P.aeruginosa.Clinicians should pay attention to the types of pathogenic bacteria which cause earlier period surface infections and the resistance to

  13. BACTERIOLOGY OF WOUNDS INFECTIONS IN A TERTIARY CARE HOSPITAL

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    Suguneswari Giddi

    2016-07-01

    Full Text Available Wound infections are one of the leading causes of patient’s morbidity, which ends in financial loss to both patient and hospital. Delayed treatment drug resistance due to indiscriminate use of antibiotics is implicated as the cause of chronicity of wounds. Empirical treatment without culturing the causative agent somehow lessens the delay of treatment, but actually is leading to the rise of resistant strains in the community. It is obligatory to know the prevalence of causative agents to implicate the early treatments without wait for the culture reports. MATERIAL AND METHODS This study was done to identify the prevalent organisms of wounds and its susceptibility to antimicrobials. 100 pus samples from different wounds of 100 patients, both inpatients and outpatients attending Viswabharathi Medical College at Kurnool were collected. All the pus samples were processed by gram staining of the direct smear, inoculating on to nutrient agar, blood agar, and MacConkey agar and incubated overnight at 370c. Culture morphology and gram staining was done from the positive growth. Confirmation was done by biochemical reactions and necessary special tests. Results: 100 wound samples yielded 105 isolates. Among the total 105 isolates, the gram negative isolates were dominating and accounted for 53.33% and gram positive accounted for 46.66% only. In the overall study, Staphylococcus remained as predominant isolate and is 100% sensitive to vancomycin, Linezolid. CONCLUSION The accurate identification of culture isolates may be a useful tool to provide appropriate antibiotic and help in reducing the drug-resistant strains in wound infections. This study provides better guidance for the clinicians to cure wounds without delay and much waste of antibiotics that ultimately prevents the resistant strains and saves the economy of both patient as well as hospital.

  14. Antibacterial properties of tualang honey and its effect in burn wound management: a comparative study

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    Nasir Nur-Azida

    2010-06-01

    Full Text Available Abstract Background The use of honey as a natural product of Apis spp. for burn treatment has been widely applied for centuries. Tualang honey has been reported to have antibacterial properties against various microorganisms, including those from burn-related diagnoses, and is cheaper and easier to be absorbed by Aquacel dressing. The aim of this study is to evaluate the potential antibacterial properties of tualang honey dressing and to determine its effectiveness as a partial thickness burn wound dressing. Methods In order to quantitate the bioburden of the swabs, pour plates were performed to obtain the colony count (CFU/ml. Swabs obtained from burn wounds were streaked on blood agar and MacConkey agar for bacterial isolation and identification. Later, antibacterial activity of Aquacel-tualang honey, Aquacel-Manuka honey, Aquacel-Ag and Aquacel- plain dressings against bacteria isolated from patients were tested (in-vitro to see the effectiveness of those dressings by zone of inhibition assays. Results Seven organisms were isolated. Four types of Gram-negative bacteria, namely Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas spp. and Acinetobacter spp., and three Gram-positive bacteria, namely Staphylococcus aureus, coagulase-negative Staphylococcus aureus (CONS and Streptococcus spp., were isolated. Total bacterial count decreased on day 6 and onwards. In the in-vitro antibacterial study, Aquacel-Ag and Aquacel-Manuka honey dressings gave better zone of inhibition for Gram positive bacteria compared to Aquacel-Tualang honey dressing. However, comparable results were obtained against Gram negative bacteria tested with Aquacel-Manuka honey and Aquacel-Tualang honey dressing. Conclusions Tualang honey has a bactericidal as well as bacteriostatic effect. It is useful as a dressing, as it is easier to apply and is less sticky compared to Manuka honey. However, for Gram positive bacteria, tualang honey is not as effective as usual care

  15. Nosocomial Infections in Burned Patients in Motahari Hospital, Tehran, Iran

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    Leila Azimi

    2011-01-01

    Full Text Available Burn patients are at high risk of developing nosocomial infection because of their destroyed skin barrier and suppressed immune system, compounded by prolonged hospitalization and invasive therapeutic and diagnostic procedures. Studies on nosocomial infection in burn patients are not well described. The objective of the present study was to identify the causative bacterial of nosocomial infection and to determine the incidence of nosocomial infection and their changing during hospitalization in burned patients admitted to in the Motahari Hospital, Tehran, Iran. During the second part of 2010, 164 patients were included in this study. Samples were taken the first 48 hours and the fourth week after admission to Motahari Burn hospital. Isolation and identification of microorganisms was performed using the standard procedure. Of the 164 patients, 717 samples were taken and 812 bacteria were identified, 610 patients were culture positive on day 7 while 24 (17.2% on 14 days after admission. The bacteria causing infections were 325 Pseudomonas, 140 Acinetobacter, 132 Staphylococcus aureus, and 215 others. The percentage of mortality was 12%. All of patients had at least 1 positive culture with Pseudomonas and/or with Acinetobacter. Hospitals suggest continuous observationof burn infections and increase strategies for antimicrobial resistance control and treatment of infectious complications.

  16. Rapidly developed squamous cell carcinoma after laser therapy used to treat chemical burn wound: a case report

    OpenAIRE

    Cho, Hyung-Rok; Kwon, Soon-Sung; Chung, Seum; Kie, Jeong-Hae

    2015-01-01

    Background In chronic wounds, especially burn scars, malignant tumors can arise. However, it is rare for a subacute burn injury to change to a malignant lesion within one month. Moreover, a case of squamous cell carcinoma arising from HeNe laser therapy after a chemical burn has never been reported. Case report In this report, we examine a rare case of squamous cell carcinoma arising from HeNe laser therapy after a chemical burn. Because pathologic investigations were made from the first oper...

  17. HOSPITAL OUTBREAK OF POST CAESAREAN WOUND INFECTION WITH ATYPICAL MYCOBACTERIA

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    Battu

    2016-06-01

    Full Text Available Study of 18 cases of post-operative CS wound infection due to Atypical Mycobacterium (M. chelonae were found in a single hospital over a six-month period. Though the contaminating source could not be identified, remedial control measures taken includes changing all the operative equipment, autoclave machine, air conditioners, exhaust fans of OT, linen and mattresses and solutions like betadine, savlon, spirit and also suture material replaced with new ones. Antibiotic protocols are changed and daily cleaning of OT with cetrimide solution and daily fumigation for one month. No further Atypical MB infective episode have occurred in the one and a half year since the study. Awareness of this ubiquitous opportunistic organism that is not easily eradicated from the hospital environment and strong suspicion of chronic post-operative wound infection, careful surveillance, detailed attention to disinfectant methods of medical devices and appropriate control measures are essential to prevent potential outbreaks.

  18. Study of Bacteriology of Post-Operative Wound Infection

    Directory of Open Access Journals (Sweden)

    Neelam Abdulrauf Bagwan

    2014-07-01

    Full Text Available Background: While many patients are admitted to hospital for treatment of infections, some acquire infection during their stay in the hospital. These infections are called as nosocomial infections. Surgical site infection or post operative wound infection is one of them. It is defined as infection of previously sterile tissue incised to gain exposure for operating deeper spaces operatively exposed or organs manipulated by a surgeon. It is one of the feared complications of surgery as it increases morbidity as well as cost of medical care. Aims and Objectives: Study was conducted to find out incidence of surgical site infection rate in surgical ward, evaluate various factors contributing to infection and to identify causative pathogens and their antibiogram patterns. Material and Methods: All clean and clean contaminated operative cases admitted in surgery ward in study period of 18 months were included. Preoperative, operative and postoperative management protocols of the cases were recorded in detail. Results: A total of 1082 operated cases were studied among which 59 infected cases were found. Surgical Site Infection (SSI rate was 5.45%. E. coli and Staphylococcus aureus were the commonest pathogen isolated from the infected wound. 50 % were Methicillin Resistant Staphylococcus Aureus (MRSA among them and 50% of rd Enterobacteriaceae group were resistant to 3 generation Cephalosporins. Conclusion: Surgical site infection rate of a hospital can be reduced easily by following proper pre-operative protocol for the patients. Those patients with surgical site infection can be treated effectively by following the antibiotic policy as provided by the Department of Microbiology.

  19. Management of wound infection after lumbar arthrodesis maintaining the instrumentation

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    Asdrubal Falavigna

    2015-06-01

    Full Text Available OBJECTIVE: To determinate whether a surgical protocol with immediate extensive debridement, closed irrigation system and antibiotic therapy would be effective to achieve healing of deep wound infection without removing the instrumentation.METHODS: Prospective cohort study with 19 patients presenting degenerative spinal stenosis or degenerative spondylolisthesis, who developed infection after posterior lumbar arthrodesis. The diagnosis was confirmed by a microbial culture from subfascial lumbar fluid and/or blood. Patients were treated with a protocol of wound exploration, extensive flushing and debridement, placement of a closed irrigation system that was maintained for five days and intravenous antibiotics. The instrumentation system was not removed.RESULTS: Mean age was 59.31 (±13.17 years old and most patients were female (94.7%; 18/19. The mean period for the identification of the infection was 2 weeks and 57.9% underwent a single wound exploration. White blood count, erythrocyte sedimentation rate and C-reactive protein showed a significant decrease post-treatment when compared to pre-treatment values. A significant reduction of erythrocyte sedimentation rate and C-reactive protein was also observed at the final evaluation. No laboratory test was useful to predict the need for more than one debridement.CONCLUSION: Patients with wound infection after instrumentation can be treated without removal of the instrumentation through wound exploration, extensive flushing, debridement of necrotic tissue, closed irrigation system during 5 days and proper antibiotic therapy. The blood tests were not useful to predict surgical re-interventions.

  20. A comparative study to evaluate the effect of honey dressing and silver sulfadiazene dressing on wound healing in burn patients

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    Baghel P

    2009-01-01

    Full Text Available To compare the effect of honey dressing and silver-sulfadiazene (SSD dressing on wound healing in burn patients. Patients (n=78 of both sexes, with age group between 10 and 50 years and with first and second degree of burn of less than 50% of TBSA (Total body surface area were included in the study, over a period of 2 years (2006-08. After stabilization, patients were randomly attributed into two groups: ′honey group′ and ′SSD group′. Time elapsed since burn was recorded. After washing with normal saline, undiluted pure honey was applied over the wounds of patients in the honey group (n=37 and SSD cream over the wounds of patients in SSD group (n=41, everyday. Wound was dressed with sterile gauze, cotton pads and bandaged. Status of the wound was assessed every third and seventh day and on the day of completion of study. Patients were followed up every fortnight till epithelialization. The bacteriological examination of the wound was done every seventh day. The mean age for case (honey group and control (SSD group was 34.5 years and 28.5 years, respectively. Wound swab culture was positive in 29 out of 36 patients who came within 8 hours of burn and in all patients who came after 24 hours. The average duration of healing in patients treated with honey and SSD dressing at any time of admission was 18.16 and 32.68 days, respectively. Wound of all those patients (100% who reported within 1 hour became sterile with honey dressing in less than 7 days while none with SSD. All of the wounds became sterile in less than 21 days with honey, while tthis was so in only 36.5% with SSD treated wounds. The honey group included 33 patients reported within 24 hour of injury, and 26 out of them had complete outcome at 2 months of follow-up, while numbers for the SSD group were 32 and 12. Complete outcome for any admission point of time after 2 months was noted in 81% and 37% of patients in the honey group and the SSD group. Honey dressing improves wound

  1. Transdermal treatment of the surgical and burned wound skin via phytochemical-capped gold nanoparticles.

    Science.gov (United States)

    Lee, Jaewook; Kim, JiEun; Go, Jun; Lee, Jong Ho; Han, Dong-Wook; Hwang, DaeYoun; Lee, Jaebeom

    2015-11-01

    The biological activities and therapeutic potential of phytochemical-decorated Au nanoparticles (Phyto-AuNPs) were investigated through the treatment of Phyto-AuNPs on the dorsal skin of rats via transdermal drug delivery process in order to regenerate surgical wounded and burned skin. Two different Phyto-AuNPs were applied to the dorsal skin: gallic acid-isoflavone--covered AuNPs (GI-AuNPs) and protocatechuic acid-isoflavone--covered AuNPs (PI-AuNPs). From the biological activity monitoring, it has been resulted that 5-fold thicker epidermis (ER), 50% reduction of metalloproteinase-1 (MMP-1) level, 3-fold higher superoxide dismutase (SOD) activity were obtained in the Phyto-AuNP-treated group, compared with a vehicle group (deionized water (DI-water) treatment). Moreover, the Phyto-AuNPs treatment on the surgical and burn damaged Sprague-Dawley (SD) rats induced higher expression of vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang-2). It would be plausible that antioxidant property of Phyto-AuNPs assist the acceleration and activation of biomolecules in the healing mechanism, where Phyto-AuNPs can be potential candidates for skin regeneration and wound healing.

  2. Postoperative wound infections after a proctectomy—Patient experiences

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    Karin Hassel

    2016-02-01

    Full Text Available Poor perineal wound healing and infections after proctectomy surgery cause a significant proportion of physical and psychological morbidities, such as pain, leakage, and abscesses. In the long run, some of these symptoms will lead to extended periods of hospitalization. These kinds of postoperative complications are also associated with delays in possible chemotherapy treatment. The aim of this study was to describe patient experiences of perineal wound infections following proctectomy due to rectal cancer, and the importance of the communication with and the self-care support from the nurse for these patients. Five women and five men (61–87 years, median age 71 years were included and interviewed. A qualitative content analysis of the interviews was carried out and the following main categories emerged: “Managing postoperative complications,” “Being independent,” “Feeling safe,” and “Accepting the situation.” A perineal wound infection after a proctectomy is devastating for the individual patient. The limitations and changes to the patients’ lives turn into new daily routines, which force them to find new ways to live and to accept the situation. For many of them, the infections remained for several months and, sometimes, for years. The ability to lead an independent life is drastically reduced, but through continuity in care it is possible to create a feeling of safety. Information, communication, and self-care support are all important and valuable factors for recovery. Specialized care containing an action plan is therefore needed in clinical practice to reduce the number of perineal wound infections postoperatively and should be initiated when the patient is discharged from the ward and continue until recovery.

  3. MEBT/MEBO在烧伤治疗中的疗效分析%Clinical analysis of the efficacy of MEBT/MEBO in treating burn wounds

    Institute of Scientific and Technical Information of China (English)

    曾光伟

    2012-01-01

    目的探讨MEBT/MEBO治疗各种原因引起的烧伤创面的临床疗效。方法将2010年7月一2012年6月期间烧伤整形美容科收治的112例患者患病全程采用MEBT/MEBO治疗,观察烧伤创面的疼痛程度、愈合情况、炎性反应和瘢痕形成等。结果112例浅I 度、深I 度烧伤患者应用MEBT/MEBO治疗后烧伤创面均在不同时间段内自行愈合、疼痛减轻或消失、局部感染和瘢痕形成轻等。结论 MEBT/MEBO能减轻烧伤创面疼痛,促进创面愈合,减少创面感染率,减少瘢痕形成。%Objective: To analyze the clinical effect of MEBT/MEBO in treating 112 cases burned patients resulted from various causes. Method: Treating wounds with MEBT/MEBO all the time. Result:112 patients of deep II degree, shallow III degree burn were treated by MEBO at different times with self-healing, pain relieved or disappeared, infection and scar rare, and did not have any dysfunction. After wounds healing, no obvious infection and scar formation. Conclusion:MEBT/MEBO has special efficacy in promoting the healing of burn wounds and reducing infection and scar formation.

  4. Examination of the Early Diagnostic Applicability of Active Dynamic Thermography for Burn Wound Depth Assessment and Concept Analysis.

    Science.gov (United States)

    Prindeze, Nicholas J; Fathi, Payam; Mino, Matthew J; Mauskar, Neil A; Travis, Taryn E; Paul, Dereck W; Moffatt, Lauren T; Shupp, Jeffrey W

    2015-01-01

    Despite advances in perfusion imaging, burn wound imaging technology continues to lag behind that of other fields. Quantification of blood flow is able to predict time for healing, but clear assessment of burn depth is still questionable. Active dynamic thermography (ADT) is a noncontact imaging modality capable of distinguishing tissue of different thermal conductivities. Utilizing the abnormal heat transfer properties of the burn zones, we examined whether ADT was useful in the determination of burn depth in a model of early burn wound evaluation. Duroc pigs (castrated male; n = 3) were anesthetized, and two burns were created with an aluminum billet at 3 and 12 seconds. These contact times resulted in superficial partial and deep partial thickness burn wounds, respectively. ADT and laser Doppler imaging (LDI) imaging were performed every 30 minutes postburn for a total of five imaging sessions ending 150 minutes postburn. For ADT, imaging excitation was performed for 42-120 seconds with dual quartz-infrared lamps, and subsequent infrared image capture was performed for 300 seconds. MATLAB-assisted image analysis was performed to determine burn zone region of interest thermal relaxation and characteristic patterns. LDI was performed with a moorLDI system, and biopsies were captured for histology following the 150-minute imaging session. Both ADT and LDI imaging modalities are able to detect different physical properties at 30, 60, 90 120, and 150 minutes postburn with statistical significance (P < 0.05). Resultant ADT cooling curves characterize greater differences with greater stimulation and a potentially more identifiable differential cooling characteristic. Histological analysis confirmed burn depth. This preliminary work confirms that ADT can measure burn depth and is deserving of further research either as a stand-alone imaging technology or in combination with a device to assess perfusion. PMID:25412050

  5. Role of mesenchymal stem cells on cornea wound healing induced by acute alkali burn.

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    Lin Yao

    Full Text Available The aim of this study was to investigate the effects of subconjunctivally administered mesenchymal stem cells (MSCs on corneal wound healing in the acute stage of an alkali burn. A corneal alkali burn model was generated by placing a piece of 3-mm diameter filter paper soaked in NaOH on the right eye of 48 Sprague-Dawley female rats. 24 rats were administered a subconjunctival injection of a suspension of 2×10(6 MSCs in 0.1 ml phosphate-buffered saline (PBS on day 0 and day 3 after the corneal alkali burn. The other 24 rats were administered a subconjunctival injection of an equal amount of PBS as a control. Deficiencies of the corneal epithelium and the area of corneal neovascularization (CNV were evaluated on days 3 and 7 after the corneal alkali burn. Infiltrated CD68(+ cells were detected by immunofluorescence staining. The mRNA expression levels of macrophage inflammatory protein-1 alpha (MIP-1α, tumor necrosis factor-alpha (TNF-α, monocyte chemotactic protein-1 (MCP-1 and vascular endothelial growth factor (VEGF were analyzed using real-time polymerase chain reaction (real-time PCR. In addition, VEGF protein levels were analyzed using an enzyme-linked immunosorbent assay (ELISA. MSCs significantly enhanced the recovery of the corneal epithelium and decreased the CNV area compared with the control group. On day 7, the quantity of infiltrated CD68(+ cells was significantly lower in the MSC group and the mRNA levels of MIP-1α, TNF-α, and VEGF and the protein levels of VEGF were also down-regulated. However, the expression of MCP-1 was not different between the two groups. Our results suggest that subconjunctival injection of MSCs significantly accelerates corneal wound healing, attenuates inflammation and reduces CNV in alkaline-burned corneas; these effects were found to be related to a reduction of infiltrated CD68(+ cells and the down-regulation of MIP-1α, TNF-α and VEGF.

  6. Combined use of negative pressure wound therapy and Integra® to treat complex defects in lower extremities after burns

    OpenAIRE

    González Alaña, I.; J.V. Torrero López; Martín Playá, P.; F.J. Gabilondo Zubizarreta

    2013-01-01

    Deep and extensive burns of lower extremities present a difficult challenge to healthcare professionals. After debridement, bones, tendons or joints are frequently exposed and cannot be covered by simple autografts. Moreover, in the case of major burns, damage to the surrounding areas of skin and the severity of the patient’s overall condition, often count against using pedicled or microsurgical flaps. In dealing with such complex wounds, which are difficult to treat, several authors have rec...

  7. Local Collagen-Gentamicin for Prevention of Sternal Wound Infections

    OpenAIRE

    Friberg, Örjan

    2006-01-01

    In cardiac surgery, sternal wound infection (SWI) continues to be one of the most serious postoperative complications. Coagulase-negative staphylococci (CoNS) have become the most common causative agents of SWI. Prophylaxis with intravenous beta-lactam antibiotics (cephalosporins or in Sweden most commonly isoxazolyl penicillins) is routinely practised. However, many CoNS species are resistant to beta-lactam antibiotics. Vancomycin is often the only effective antibiotic available for treatmen...

  8. 加强烧伤创面处理是防治并发症的重要措施%Enhancing treatment of burn wounds is an important measure for prevention and treatment of complications

    Institute of Scientific and Technical Information of China (English)

    黄跃生

    2014-01-01

    Burn wound repair is an eternal issue for burn treatment.Ischemia and hypoxia caused by stress and wound inflammatory reactions to burn injuries are key factors of sepsis and organ complications.Therefore,the treatment of burn wound is not only relevant to repair of burn wound itself; early extensive escharectomy and wound coverage are also important measures for prevention and treatment of complications,such as sepsis and organ dysfunction.Besides the good vital supportive treatment such as circulation maintenance,coverage of open wounds with reliable skin substitutes is also the key point to ensure success of early extensive escharectomy.

  9. Pirfenidone nanoparticles improve corneal wound healing and prevent scarring following alkali burn.

    Directory of Open Access Journals (Sweden)

    Sushovan Chowdhury

    Full Text Available PURPOSE: To evaluate the effects of pirfenidone nanoparticles on corneal re-epithelialization and scarring, major clinical challenges after alkali burn. METHODS: Effect of pirfenidone on collagen I and α-smooth muscle actin (α-SMA synthesis by TGFβ induced primary corneal fibroblast cells was evaluated by immunoblotting and immunocytochemistry. Pirfenidone loaded poly (lactide-co-glycolide (PLGA nanoparticles were prepared, characterized and their cellular entry was examined in primary corneal fibroblast cells by fluorescence microscopy. Alkali burn was induced in one eye of Sprague Dawley rats followed by daily topical treatment with free pirfenidone, pirfenidone nanoparticles or vehicle. Corneal re-epithelialization was assessed daily by flourescein dye test; absence of stained area indicated complete re-epithelialization and the time for complete re-epithelialization was determined. Corneal haze was assessed daily for 7 days under slit lamp microscope and graded using a standard method. After 7 days, collagen I deposition in the superficial layer of cornea was examined by immunohistochemistry. RESULTS: Pirfenidone prevented (P<0.05 increase in TGF β induced collagen I and α-SMA synthesis by corneal fibroblasts in a dose dependent manner. Pirfenidone could be loaded successfully within PLGA nanoparticles, which entered the corneal fibroblasts within 5 minutes. Pirfenidone nanoparticles but not free pirfenidone significantly (P<0.05 reduced collagen I level, corneal haze and the time for corneal re-epithelialization following alkali burn. CONCLUSION: Pirfenidone decreases collagen synthesis and prevents myofibroblast formation. Pirfenidone nanoparticles improve corneal wound healing and prevent fibrosis. Pirfenidone nanoparticles are of potential value in treating corneal chemical burns and other corneal fibrotic diseases.

  10. Wound botulism presenting as a deep neck space infection.

    Science.gov (United States)

    Gouveia, Christopher; Mookherjee, Somnath; Russell, Matthew S

    2012-12-01

    Otolaryngologists commonly evaluate patients with findings suspicious for deep space soft tissue infections of the neck. In this case, a woman with a history of injection drug use (IDU) presented with dysphagia, odynophagia, and neck pain. Multiple neck abscesses, too small to drain, were seen on imaging. Despite broad-spectrum intravenous antibiotics, she unexpectedly and rapidly developed respiratory failure requiring intubation. Further work-up diagnosed wound botulism (WB). To our knowledge, this is the first report of WB presenting as a deep neck space infection, and illustrates the importance of considering this deadly diagnosis in patients with IDU history and bulbar symptoms.

  11. In vivo time-lapse imaging of skin burn wound healing using second-harmonic generation microscopy

    Science.gov (United States)

    Yasui, Takeshi; Tanaka, Ryosuke; Hase, Eiji; Fukushima, Shu-ichiro; Araki, Tsutomu

    2014-02-01

    Wound healing is a process to repair the damaged tissue caused by thermal burn, incised wound, or stab wound. Although the wound healing has many aspects, it is common for dynamics of collagen fiber, such as decomposition, production, or growth, to be closely related with wound healing. If such the healing process can be visualized as a timelapse image of the collagen fiber in the same subject, one may obtain new findings regarding biological repairing mechanisms in the healing process. In this article, to investigate the temporal modoification of dermal collagen fiber in the burn wound healing, we used second-harmonic-generation (SHG) microscopy, showing high selectivity and good image contrast to collagen molecules as well as high spatial resolution, optical three-dimensional sectioning, minimal invasiveness, deep penetration, the absence of interference from background light, and in vivo measurement without additional staining. Since SHG light arises from a non-centrosymmetric triple helix of three polypeptide chains in the collagen molecule, SHG intensity sensitively reflects the structure maturity of collagen molecule and its aggregates. A series of time-lapse SHG images during the wound healing process of 2 weeks clearly indicated that condensation and melting of dermal collagen fibers by the deep dermal burn, decomposition of the damaged collagen fibers in the inflammation phase, production of new collagen fibers in the proliferation phase, and the growth of the new collagen fibers in the remodeling phase. These results show a high potential of SHG microscopy for optical assessment of the wound healing process in vivo.

  12. Electrospun Gelatin Fibers with a Multiple Release of Antibiotics Accelerate Dermal Regeneration in Infected Deep Burns.

    Science.gov (United States)

    Chen, Jianmei; Liu, Zongguang; Chen, Maohua; Zhang, Hong; Li, Xiaohong

    2016-09-01

    Electrospun fibers of hydrophilic polymers meet challenges in a rapid degradation of fiber matrices and discharge of antibiotics to comply with requirements of infection control as a dermal regeneration template. In the current study, a pH conversion process is initially developed to ensure fluent electrospinning, an efficient in situ cross-linking of electrospun gelatin fibers with oxidized alginate and simultaneous loading of gentamicin sulfate (GS) and hydrophobic ciprofloxacin into fibers. The dual drug-loaded fibers indicate a complete release of GS during 6 d and a sustained release of ciprofloxacin for over three weeks, and the antibiotics release indicates significant growth inhibitions on Pseudomonas aeruginosa and Staphylococcus epidermidis. The wound healing efficacy is evaluated on a deep burn model infected with 10(8) CFU of P. aeruginosa. Compared with fibers with loaded individual drugs, the concomitant release of GS and ciprofloxacin significantly reduces the bacteria numbers in wound and livers, at around 2.30 × 10(5) and 1.25 × 10(3) CFU after 3 d, respectively. The wound re-epithelization, blood vessel formation, collagen deposition, and tissue remodeling process are accelerated with a complete healing observed after 21 d. This study provides a feasible strategy to design cross-linked hydrophilic fibers with an extended drug release for biomedical applications. PMID:27276339

  13. Wound infections secondary to snakebite in central Taiwan

    Directory of Open Access Journals (Sweden)

    Li-Wen Huang

    2012-01-01

    Full Text Available There are very few microbiological data on wound infections following snakebites. The objective of this study was to investigate the treatment of secondary infection following snakebites in central Taiwan. Microbiological data and antibiotic sensitivity of wound cultures were retrospectively analyzed from December 2005 to October 2007 in a medical center in central Taiwan. A total of 121 snakebite patients participated in the study. Forty-nine (40.5% subjects were bitten by cobra (Naja atra; 34 of them had secondary infection, and 24 of them (70.6% needed surgical intervention. Cobra bites caused more severe bacterial infection than other snakebites. Morganella morganii was the most common pathogen, followed by Aeromonas hydrophila and Enterococcus. Gram-negative bacteria were susceptible to amikacin, trimethoprim/sulfamethoxazole, cefotaxime, cefepime, ciprofloxacin, and piperacillin/tazobactam. Enterococcus were susceptible to ampicillin, gentamicin, penicillin and vancomycin. It is reasonable to choose piperacillin/tazobactam, quinolone, second- or third-generation cephalosporin for empirical therapy following snakebite. Surgical intervention should be considered for invasive soft tissue infections.

  14. Common questions about wound care.

    Science.gov (United States)

    Worster, Brooke; Zawora, Michelle Q; Hsieh, Christine

    2015-01-15

    Lacerations, abrasions, burns, and puncture wounds are common in the outpatient setting. Because wounds can quickly become infected, the most important aspect of treating a minor wound is irrigation and cleaning. There is no evidence that antiseptic irrigation is superior to sterile saline or tap water. Occlusion of the wound is key to preventing contamination. Suturing, if required, can be completed up to 24 hours after the trauma occurs, depending on the wound site. Tissue adhesives are equally effective for low-tension wounds with linear edges that can be evenly approximated. Although patients are often instructed to keep their wounds covered and dry after suturing, they can get wet within the first 24 to 48 hours without increasing the risk of infection. There is no evidence that prophylactic antibiotics improve outcomes for most simple wounds. Tetanus toxoid should be administered as soon as possible to patients who have not received a booster in the past 10 years. Superficial mild wound infections can be treated with topical agents, whereas deeper mild and moderate infections should be treated with oral antibiotics. Most severe infections, and moderate infections in high-risk patients, require initial parenteral antibiotics. Severe burns and wounds that cover large areas of the body or involve the face, joints, bone, tendons, or nerves should generally be referred to wound care specialists. PMID:25591209

  15. Common questions about wound care.

    Science.gov (United States)

    Worster, Brooke; Zawora, Michelle Q; Hsieh, Christine

    2015-01-15

    Lacerations, abrasions, burns, and puncture wounds are common in the outpatient setting. Because wounds can quickly become infected, the most important aspect of treating a minor wound is irrigation and cleaning. There is no evidence that antiseptic irrigation is superior to sterile saline or tap water. Occlusion of the wound is key to preventing contamination. Suturing, if required, can be completed up to 24 hours after the trauma occurs, depending on the wound site. Tissue adhesives are equally effective for low-tension wounds with linear edges that can be evenly approximated. Although patients are often instructed to keep their wounds covered and dry after suturing, they can get wet within the first 24 to 48 hours without increasing the risk of infection. There is no evidence that prophylactic antibiotics improve outcomes for most simple wounds. Tetanus toxoid should be administered as soon as possible to patients who have not received a booster in the past 10 years. Superficial mild wound infections can be treated with topical agents, whereas deeper mild and moderate infections should be treated with oral antibiotics. Most severe infections, and moderate infections in high-risk patients, require initial parenteral antibiotics. Severe burns and wounds that cover large areas of the body or involve the face, joints, bone, tendons, or nerves should generally be referred to wound care specialists.

  16. Guideline for diagnosis, prophylaxis and treatment of invasive fungal infection post burn injury in China 2013

    Directory of Open Access Journals (Sweden)

    Gaoxing Luo

    2014-04-01

    Full Text Available Invasive fungal infection is one of the major complication of severe burns which can induce local or systemic inflammatory response and cause serious substantial damage to the patient. The incidence of fungal infection for burn victims is increasing dramatically during recent years. This guideline, organized by Chinese Society of Burn Surgeons, aims to standardize the diagnosis, prevention and treatment of burn invasive fungal infection. It can be used as one of the tools for treatment of major burn patients.

  17. Evaluation of burn wound healing property of ocimum sanctum by monitoring of period of re-epithelization in rabbits

    Directory of Open Access Journals (Sweden)

    Vaibhav K. Gupta

    2016-02-01

    Conclusions: Group treated with ointment silver sulfadiazine + O. sanctum showed minimum re-epithelization period. So, the most effective treatment for burn wound healing in this study was ointment silver sulfadiazine + O. sanctum. [Int J Basic Clin Pharmacol 2016; 5(1.000: 146-148

  18. 干细胞与烧伤创面修复%Stem cells and wound repair in burns

    Institute of Scientific and Technical Information of China (English)

    付小兵; 盛志勇

    2008-01-01

    The use of stem cells to replace lost tissues is one of the very important treatment measures used in the field of burn management in recent years.Clinical results show that the use of stem cells therapies has brought new hope for accelerating wound healing with improvement in quality, inducing sweat gland regeneration,and constructing tissue engineering skin,etc.

  19. In vitro and in vivo investigation of bacterial cellulose dressing containing uniform silver sulfadiazine nanoparticles for burn wound healing

    Institute of Scientific and Technical Information of China (English)

    Xiaoxiao Wen; Yudong Zheng; Jian Wu; Lina Yue; Cai Wang; Jiabin Lua; Zhigu Wu; Kaisheng Wang

    2015-01-01

    Silver sulfadiazine (SSD) particles in homogeneous dispersion state were prepared by an ultrasonic method and then nano-and microparticles were separated using centrifugation. SSD particles with narrow size distribution were impregnated with bacterial cellulose (BC) to produce BC–SSD composite membrane used as burn wound dressing. A scanning electron microscope (SEM) was used to examine the surface morphology of BC–SSD membranes. The incorporation of SSD in BC–SSD was confirmed by X-ray diffraction (XRD). Antimicrobial tests in vitro indicated that BC–SSD showed excellent antibacterial activity against Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli. The effects of BC–SSD on burn wound healing were assessed by rat models. The comparative study confirmed that the wound treated with BC–SSD showed high healing rate. The bacteria count in BC–SSD group was far less than control group. Histological analysis showed that epithelialization progressed better in wound treated with BC–SSD. These values demonstrated that the BC–SSD composite membrane could be a promising wound dressing for burn.

  20. In vitro and in vivo investigation of bacterial cellulose dressing containing uniform silver sulfadiazine nanoparticles for burn wound healing

    Directory of Open Access Journals (Sweden)

    Xiaoxiao Wen

    2015-06-01

    Full Text Available Silver sulfadiazine (SSD particles in homogeneous dispersion state were prepared by an ultrasonic method and then nano- and microparticles were separated using centrifugation. SSD particles with narrow size distribution were impregnated with bacterial cellulose (BC to produce BC–SSD composite membrane used as burn wound dressing. A scanning electron microscope (SEM was used to examine the surface morphology of BC–SSD membranes. The incorporation of SSD in BC–SSD was confirmed by X-ray diffraction (XRD. Antimicrobial tests in vitro indicated that BC–SSD showed excellent antibacterial activity against Staphylococcus aureus, Pseudomonas aeruginosa and Escherichia coli. The effects of BC–SSD on burn wound healing were assessed by rat models. The comparative study confirmed that the wound treated with BC–SSD showed high healing rate. The bacteria count in BC–SSD group was far less than control group. Histological analysis showed that epithelialization progressed better in wound treated with BC–SSD. These values demonstrated that the BC–SSD composite membrane could be a promising wound dressing for burn.

  1. Superiority of terahertz over infrared transmission through bandages and burn wound ointments

    Science.gov (United States)

    Suen, Jonathan Y.; Padilla, Willie J.

    2016-06-01

    Terahertz electromagnetic waves have long been proposed to be ideal for spectroscopy and imaging through non-polar dielectric materials that contain no water. Terahertz radiation may thus be useful for monitoring burn and wound injury recovery, as common care treatments involve application of both a clinical dressing and topical ointment. Here, we investigate the optical properties of typical care treatments in the millimeter wave (150-300 GHz), terahertz (0.3-3 THz), and infrared (14.5-0.67 μm) ranges of the electromagnetic spectrum. We find that THz radiation realizes low absorption coefficients and high levels of transmission compared to infrared wavelengths, which were strongly attenuated. Terahertz imaging can enable safe, non-ionizing, noninvasive monitoring of the healing process directly through clinical dressings and recovery ointments, minimizing the frequency of dressing changes and thus increasing the rate of the healing process.

  2. Antiseptic wick: does it reduce the incidence of wound infection following appendectomy?

    LENUS (Irish Health Repository)

    McGreal, Gerald T

    2012-02-03

    The role of prophylactic antibiotics is well established for contaminated wounds, but the use of antiseptic wound wicks is controversial. The aim of this work was to study the potential use of wound wicks to reduce the rate of infection following appendectomy. This prospective randomized controlled clinical trial was conducted at a university hospital in the department of surgery. The subjects were patients undergoing appendectomy for definite acute appendicitis. They were randomized by computer to primary subcuticular wound closure or use of an antiseptic wound wick. For the latter, ribbon gauze soaked in povidone-iodine was placed between interrupted nylon skin sutures. Wicks were soaked daily and removed on the fourth postoperative day. All patients received antibiotic prophylaxis. They were reviewed while in hospital and 4 weeks following operation for evidence of wound infection. The main outcome measures were wound infection, wound discomfort, and cosmetic result. The overall wound infection rate was 8.6% (15\\/174). In patients with wound wicks it was 11.6% (10\\/86) compared to 5.6% (5\\/88) in those whose wounds were closed by subcuticular sutures (p = NS). We concluded that the use of wound wicks was not associated with decreased wound infection rates following appendectomy. Subcuticular closure is therefore appropriate in view of its greater convenience and safety.

  3. Xenogeneic Mesenchymal Stromal Cells Improve Wound Healing and Modulate the Immune Response in an Extensive Burn Model.

    Science.gov (United States)

    Caliari-Oliveira, Carolina; Yaochite, Juliana Navarro Ueda; Ramalho, Leandra Náira Zambelli; Palma, Patrícia Vianna Bonini; Carlos, Daniela; Cunha, Fernando de Queiróz; De Souza, Daurea Abadia; Frade, Marco Andrey Cipriani; Covas, Dimas Tadeu; Malmegrim, Kelen Cristina Ribeiro; Oliveira, Maria Carolina; Voltarelli, Julio César

    2016-01-01

    Major skin burns are difficult to treat. Patients often require special care and long-term hospitalization. Besides specific complications associated with the wounds themselves, there may be impairment of the immune system and of other organs. Mesenchymal stromal cells (MSCs) are a recent therapeutic alternative to treat burns, mainly aiming to accelerate the healing process. Several MSC properties favor their use as therapeutic approach, as they promote angiogenesis, stimulate regeneration, and enhance the immunoregulatory function. Moreover, since patients with extensive burns require urgent treatment and because the expansion of autologous MSCs is a time-consuming process, in this present study we chose to evaluate the therapeutic potential of xenogeneic MSCs in the treatment of severe burns in rats. MSCs were isolated from mouse bone marrow, expanded in vitro, and intradermally injected in the periphery of burn wounds. MSC-treated rats presented higher survival rates (76.19%) than control animals treated with PBS (60.86%, p injected GFP(+) MSCs progressively decreased over time, and 60 days after injection, few MSCs were still detected in the skin of treated animals. This study demonstrates the therapeutic effectiveness of intradermal application of MSCs in a rat model of deep burns, providing basis for future regenerative therapies in patients suffering from deep burn injuries. PMID:25955320

  4. The therapeutic strategy for burn wounds%烧伤创面治疗策略

    Institute of Scientific and Technical Information of China (English)

    吴军; 谭江琳

    2011-01-01

    创面修复是烧伤治疗的根本问题,它贯穿于整个救治过程,是烧伤领域最富挑战性、最重要和最基础的课题之一。每年我国烧伤发生率约占总人口的0.5% ~1.0%,即每年600万~1200万例,大面积烧伤的致残率达48%,其中青壮年致残率约为78.1%[1]。近年来,治疗手段的提高和高新生物技术的应用,使得烧伤临床治疗有了突破性发展,极大地推动了该学科的进步。但如何再进一步降低患者病死率和伤残率,仍然是我们面临的重大问题。目前,烧伤创面修复的策略主要是皮肤移植、促进创面再生和减少愈后瘢痕形成,最终实现挽救患者生命,改善其生理、心理障碍,使其回归社会。%Wound repair is the critical issue in burn injury management. Optimal coverage or regeneration of skin tissue is still a great challenge. In this review, we summarize the current achievements in the fields of immune tolerance induction, skin tissue regeneration, and hypertrophic scar control,which might provide new viewpoints and research direction for diagnosis and treatment of burn wounds.

  5. Nosocomial Infections in Iranian Pediatric Patients With Burn Injuries: A Review

    Directory of Open Access Journals (Sweden)

    Mohammad Sadegh Rezai

    2015-07-01

    Full Text Available Context: Nosocomial infections (NIs are the most common life-threatening complications and leading cause of morbidity and mortality in pediatric patients with burn injuries. It is estimated that annually two million infections, 90000 deaths, and 4.5 billion USD in excess healthcare costs are imposed by NIs. Herein, we reviewed the articles related to NIs in Iranian pediatric patients with burn injuries. Evidence Acquisition: A review of epidemiologic studies on NI in pediatric patients with burn injuries in Iran was performed by searching studies indexed in PubMed, Google scholar, Iranmedex, Magiran, SID databases, published in English language in 2014. Keywords for searching included “Nosocomial Infections”, “Hospital- acquired infection”, “Healthcare- associated infections”, “burn”, “children”, “pediatric”, and “Iran”. All articles related to NIs in pediatric patients with burn injuries or about general population with burn injuries, which included pediatric population up to the age 18 years in Iran, were included. Articles out of the definition for age group or lack of significant data, outpatients, and patients selected for reconstructive surgeries were excluded. Results: Of 43 reviewed articles, nine eligible articles were selected. The male to female ratio was 1.6:1. The age ranged from birth to 18 years with the mean of 3.4 years. Overall incidence of NIs was 20.94%. Pseudomonas aeruginosa (30.39%, Klebsiella pneumonia (17.54%, Acinetobacter (17.47%, and Staphylococcus aureus (14.98% were the most common prominent isolates with high antibiotic resistance isolated from the cultures of different sites of infections including burn wound. Vancomycin was highly specific antibiotic against Gram-positive bacteria isolates. All spices of Acinetobacter were multidrug resistant. The mean of mortality rate was 8.75%. Conclusions: In spite of higher incidence of NIs in children with burn injuries, there are no well

  6. Intensive Care Unit Infections and Antibiotic Use

    OpenAIRE

    Ayşegül Yeşilkaya; Hande Arslan

    2011-01-01

    Burn wound infections is the leading cause of morbidity and mortality in burn trauma patients. Although burn wound is sterile at the beginning, because of risk factors such as prolonged hospital stay, immunesuppression and burn affecting large body surface area, colonisation firstly with Staphylococcus aureus and then Pseudomonas aeruginosa will occur later. Delay in wound closure and treatment with broad-spectrum antibiotic will result wound colonisation with antibiotic-resistant bacteria. T...

  7. Body protective compound-157 enhances alkali-burn wound healing in vivo and promotes proliferation, migration, and angiogenesis in vitro

    Directory of Open Access Journals (Sweden)

    Huang T

    2015-04-01

    Full Text Available Tonglie Huang,1,* Kuo Zhang,2,* Lijuan Sun,3 Xiaochang Xue,1 Cun Zhang,1 Zhen Shu,1 Nan Mu,1 Jintao Gu,1 Wangqian Zhang,1 Yukun Wang,1 Yingqi Zhang,1 Wei Zhang1 1State Key Laboratory of Cancer Biology, Department of Biopharmaceutics, School of Pharmacy, The Fourth Military Medical University, 2National Engineering Research Center for Miniaturized Detection Systems, School of Life Sciences, Northwest University, 3Department of Ophthalmology, Xijing Hospital, The Fourth Military Medical University, Xi’an, People’s Republic of China *These authors contributed equally to this work Abstract: Chemical burns take up a high proportion of burns admissions and can penetrate deep into tissues. Various reagents have been applied in the treatment of skin chemical burns; however, no optimal reagent for skin chemical burns currently exists. The present study investigated the effect of topical body protective compound (BPC-157 treatment on skin wound healing, using an alkali burn rat model. Topical treatment with BPC-157 was shown to accelerate wound closure following an alkali burn. Histological examination of skin sections with hematoxylin–eosin and Masson staining showed better granulation tissue formation, reepithelialization, dermal remodeling, and a higher extent of collagen deposition when compared to the model control group on the 18th day postwounding. BPC-157 could promote vascular endothelial growth factor expression in wounded skin tissues. Furthermore, 3-(4,5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide and cell cycle analysis demonstrated that BPC-157 enhanced the proliferation of human umbilical vein endothelial cells (HUVECs. Transwell assay and wound healing assay showed that BPC-157 significantly promoted migration of HUVECs. We also observed that BPC-157 upregulated the expression of VEGF-a and accelerated vascular tube formation in vitro. Moreover, further studies suggested that BPC-157 regulated the phosphorylation level of

  8. Use of negative pressure wound therapy in the management of infected abdominal wounds containing mesh: an analysis of outcomes.

    Science.gov (United States)

    Baharestani, Mona Mylene; Gabriel, Allen

    2011-04-01

    The purpose of this study was to examine the clinical outcomes of negative pressure wound therapy (NPWT) using reticulated open-cell foam (ROCF) in the adjunctive management of abdominal wounds with exposed and known infected synthetic mesh. A non randomised, retrospective review of medical records for 21 consecutive patients with infected abdominal wounds treated with NPWT was conducted. All abdominal wounds contained exposed synthetic mesh [composite, polypropylene (PP), or knitted polyglactin 910 (PG) mesh]. Demographic and bacteriological data, wound history, pre-NPWT and comparative post-NPWT, operative procedures and complications, hospital length of stay (LOS) and wound healing outcomes were all analysed. Primary endpoints measured were (1) hospital LOS prior to initiation of NPWT, (2) total time on NPWT, (3) hospital LOS from NPWT initiation to discharge and (4) wound closure status at discharge. A total of 21 patients with abdominal wounds with exposed, infected mesh were treated with NPWT. Aetiology of the wounds was ventral hernia repair (n = 11) and acute abdominal wall defect (n = 10). Prior to NPWT initiation, the mean hospital LOS for the composite, PP and PG meshes were 76 days (range: 21-171 days), 51 days (range: 32-62 days) and 19 days (range: 12-39 days), respectively. The mean hospital LOS following initiation of NPWT for wounds with exposed composite, PP and PG mesh were 28, 31 and 32 days, respectively. Eighteen of the 21 wounds (86%) reached full closure after a mean time of 26 days of NPWT and a mean hospital LOS of 30 days postinitiation of NPWT. Three wounds, all with composite mesh left in situ, did not reach full closure, although all exhibited decreased wound dimensions, granulating beds and decreased surface area exposure of mesh. During NPWT/ROCF, one hypoalbuminemic patient with exposed PP mesh developed an enterocutaneous fistula over a prior enterotomy site. This patient subsequently underwent total mesh extraction, takedown of

  9. Negative Pressure Wound Therapy (NPWT) to Treat Complex Defect of the Leg after Electrical Burn.

    Science.gov (United States)

    Tevanov, Iulia; Enescu, Dan M; Bălănescu, Radu; Sterian, G; Ulici, Alexandru

    2016-01-01

    Negative pressure wound therapy is a non-invasive treatment that uses under atmospheric pressure to increase blood supply to the wound, stimulating the formation of granulation tissue, angiogenesis, proliferation of fibroblasts and endothelial cells. Negative pressure therapy has also the ability to decrease the bacterial load, reduce swelling and decrease exudate while maintaining a moist environment that facilitates healing. Our patient, a 17 year old male, suffered major third and fourth-degree high voltage electrical burns on 60% of the body surface, in November 2011. After the excision of the necrotic tissue (muscles and tendons), the lower extremity of the right leg- the tibial bone, the fibula, external and internal malleoli became exposed circularly. The soft-tissue defect was partially covered by using an internal twin muscle flap and free split skin. Then, a cross leg flap technique has been used, partially covering the defect with a contralateral thigh flap. Surface swab cultures were positive for Pseudomonas aeruginosa. In October 2013 the patient was transferred to our department. The clinical examination of the right leg showed that the tibial bone had been exposed on an area of 15/3 cm in the lower half. The peroneal malleolus had also been exposed. The resection of the devitalized, exposed tibia and the avivement of the wound edges were performed. Then the NPWT was started and performed by intermittent suction. Local cleansing, soft-tissue avivement and dressing changes were performed twice a week for 6 weeks. After six weeks of NPWT and eleven dressing changes under general anaesthesia, the wounds were ready for skin grafting. Granulation tissue was formed, covering the entire surface of both the tibia bone and the peroneal malleolus. Both receptor beds were covered with free skin graft harvested from the ipsilateral thigh. The mechanical suture of the skin grafts was performed and the grafts were covered with damp dressing. By using the NPWT it

  10. Risk analysis and outcome of mediastinal wound and deep mediastinal wound infections with specific emphasis to omental transposition

    LENUS (Irish Health Repository)

    Parissis, Haralabos

    2011-09-19

    Abstract Background To report our experience, with Deep mediastinal wound infections (DMWI). Emphasis was given to the management of deep infections with omental flaps Methods From February 2000 to October 2007, out of 3896 cardiac surgery patients (prospective data collection) 120 pts (3.02%) developed sternal wound infections. There were 104 males & 16 females; (73.7%) CABG, (13.5%) Valves & (9.32%) CABG and Valve. Results Superficial sternal wound infection detected in 68 patients (1.75%) and fifty-two patients (1.34%) developed DMWI. The incremental risk factors for development of DMWI were: Diabetes (OR = 3.62, CI = 1.2-10.98), Pre Op Creatinine > 200 μmol\\/l (OR = 3.33, CI = 1.14-9.7) and Prolong ventilation (OR = 4.16, CI = 1.73-9.98). Overall mortality for the DMWI was 9.3% and the specific mortality of the omental flap group was 8.3%. 19% of the "DMWI group", developed complications: hematoma 6%, partial flap loss 3.0%, wound dehiscence 5.3%. Mean Hospital Stay: 59 ± 21.5 days. Conclusion Post cardiac surgery sternal wound complications remain challenging. The role of multidisciplinary approach is fundamental, as is the importance of an aggressive early wound exploration especially for deep sternal infections.

  11. Polyvinyl alcohol nanofiber formulation of the designer antimicrobial peptide APO sterilizes Acinetobacter baumannii-infected skin wounds in mice.

    Science.gov (United States)

    Sebe, Istvan; Ostorhazi, Eszter; Fekete, Aron; Kovacs, Krisztian N; Zelko, Romana; Kovalszky, Ilona; Li, Wenyi; Wade, John D; Szabo, Dora; Otvos, Laszlo

    2016-01-01

    Native and designer cationic antimicrobial peptides are increasingly acknowledged as host defense molecules rather than true antimicrobials. Due to their ability to activate the innate immune system, these structures are used to treat uninfected and bacterially-infected wounds, including those harboring Acinetobacter baumannii. Previously we documented that when administered intramuscularly or topically in liquid formulations, the proline-rich host defense peptide dimer A3-APO accelerates uninfected wound re-epithelization and eliminates systemic and local A. baumannii, methicillin-resistant Staphylococcus aureus and other pathogen load from infected lesions better than conventional antibiotics. In the current study we sought to produce and characterize a novel delivery system, suitable for immediate and convenient application in non-hospital environments. The APO monomer was incorporated into polyvinyl alcohol nanofibers and the complex was polymerized into a solid patch dressing. Mice were subjected to skin abrasion where the wounds were either left uninfected or were inoculated with a near lethal dose of multidrug resistant A. baumannii strain. Analyzed after 3 days, APO monomer-containing patches improved wound appearance significantly better than polymer patches without antibiotics. When compared to colistin, the APO patches accelerated wound healing, and statistically significantly reduced wound size and wound bacterial load. The in vivo antimicrobial effect was more extensive than after intramuscular administration of the peptide drug, by using only one tenth of the active pharmaceutical ingredient. These data suggest that the APO monomer-impregnated nanofiber dressing can be developed as an economical first-line treatment option to skin injuries in general and battlefield burn and blast injuries in particular. PMID:26319645

  12. Emphasize the diagnosis and treatment of infective endocarditis in patients with severe burn%重视严重烧伤患者感染性心内膜炎的诊断和治疗

    Institute of Scientific and Technical Information of China (English)

    郇京宁

    2016-01-01

    The incidence and mortality of infective endocarditis (IE) in patients with severe burn remain high,which are attributed to invasive procedures,bacteremia,and wound infection after burns.Clinical clues for IE in burns are usually masked by burn-related manifestations,so the diagnosis of IE may be delayed or missed.For burned patients with persistent bacteremia of unknown source,especially Staphylococcus aureus -induced bacteremia,the diagnosis of IE should be considered according to the Duke criteria,and early echocardiography performance is particularly important.Antibiotic therapy is the mainstay initial management,and early surgical intervention is strongly recommended once IE is clearly diagnosed in patients with burns.In order to lower the incidence and mortality of IE in burns,it is very important to take prophylactic procedures along with the whole course of burn management.

  13. Deep sternal wound infection after cardiac surgery: Evidences and controversies.

    Science.gov (United States)

    Cotogni, Paolo; Barbero, Cristina; Rinaldi, Mauro

    2015-11-01

    Despite many advances in prevention and perioperative care, deep sternal wound infection (DSWI) remains a pressing concern in cardiac surgery, with a still relevant incidence and with a considerable impact on in-hospital mortality and also on mid- and long-term survival. The permanent high impact of this complication is partially related to the increasing proportion of patients at high-risk for infection, as well as to the many patient and surgical risk factors involved in the pathogenesis of DSWI. The prophylactic antibiotic therapy is one of the most important tools in the prevention of DSWI. However, the choice of antibiotic, the dose, the duration, the adequate levels in serum and tissue, and the timing of antimicrobial prophylaxis are still controversial. The treatment of DSWI ranges from surgical revision with primary closure to surgical revision with open dressings or closed irrigation, from reconstruction with soft tissue flaps to negative pressure wound therapy (NPWT). However, to date, there have been no accepted recommendations regarding the best management of DSWI. Emerging evidence in the literature has validated the efficacy and safety of NPWT either as a single-line therapy, or as a "bridge" prior to final surgical closure. In conclusion, the careful control of patient and surgical risk factors - when possible, the proper antimicrobial prophylaxis, and the choice of validated techniques of treatment could contribute to keep DSWIs at a minimal rate. PMID:26557476

  14. Factors predisposing to wound infection in cardiac surgery. A prospective study of 517 patients.

    Science.gov (United States)

    Wilson, A P; Livesey, S A; Treasure, T; Grüneberg, R N; Sturridge, M F

    1987-01-01

    Postoperative wound infection can greatly prolong hospital stay after cardiac surgery, so the identification of predisposing factors may help in prevention or early institution of treatment. Transfer of organisms from the leg to the sternum during coronary artery surgery has been proposed as a major additional cause of sepsis. The definition of wound infection is not standardised and therefore makes comparison between centres difficult. In a prospective study of 517 patients, a wound scoring method (ASEPSIS) has been used to register all abnormal wounds to maximise the chances of identifying factors predisposing to infection. Abnormal healing was noted in 99 (19%) sternal wounds and 29 (8%) leg wounds. Obesity was the principal risk factor (P less than 0.005). Diabetes, reoperation, length of preoperative hospital stay, age, sex, or previous cardiac surgery had little effect on wound healing. The range of bacteria isolated from chest wounds after coronary artery surgery was similar to that after valvular surgery, but the rate of isolation was significantly greater. With careful attention to technique, leg wound infection rarely presented a clinical problem and did not appear to be a source of bacteria infecting the chest wound.

  15. Response of Kalanchoe daigremontiana to wounding and infection with Agrobacterium tumefaciens

    OpenAIRE

    Tkalec, Mirta; Car, Diana; GOSPOČIĆ, JANKO; KRIŽAIĆ, IVA; DUŽ, KAROLINA; VIDAKOVIĆ-CIFREK, ŽELJKA

    2012-01-01

    Background and Purpose: Transformation of plant tissue with Agrobacterium tumefaciens includes wounding of plant and subsequent infection by bacteria. Polyphenol oxidase activity and oxidative stress parameters – the content of H2O2, as well as activity and isoenzymes of antioxidative enzymes catalase, pyrogallol and guaiacol peroxidase were investigated as markers of plant response to wounding and infection. Materials and Methods: Five tissue types – healthy tissue, wounded tissue, tissue in...

  16. A Rat Model of Diabetic Wound Infection for the Evaluation of Topical Antimicrobial Therapies

    OpenAIRE

    Mendes, JJ; Leandro, C; Bonaparte, D; Pinto, A.

    2012-01-01

    Diabetes mellitus is an epidemic multisystemic chronic disease that frequently is complicated by complex wound infections. Innovative topical antimicrobial therapy agents are potentially useful for multimodal treatment of these infections. However, an appropriately standardized in vivo model is currently not available to facilitate the screening of these emerging products and their effect on wound healing. To develop such a model, we analyzed, tested, and modified published models of wound he...

  17. The interrelationships between wound management, thermal stress, energy metabolism, and temperature profiles of patients with burns.

    Science.gov (United States)

    Wallace, B H; Caldwell, F T; Cone, J B

    1994-01-01

    This prospective randomized study was performed to evaluate the metabolic and thermal responsiveness of patients with burns to thermal stress with three protocols of wound care: group I (n = 7) treated with dressings and variable ambient temperature selected for patients subjective comfort; group II (n = 7) treated without dressings and variable ambient temperature for patient comfort; group III (n = 6) treated without dressings and ambient temperature of 25 degrees C, electromagnetic heaters were set to achieve patient subjective comfort; and group IV (n = 6) healthy volunteers. After baseline partitional calorimetry was performed, individual patients were cold-challenged while subjectively comfortable by sequentially lowering either the ambient temperature or the output from the electromagnetic heaters. Heat balance and temperatures were obtained after each perturbation in external energy support. For patients in groups I and II, subjective perception of thermal comfort (warm, neutral, neutral and fed, cool, or cold) was more strongly correlated (p temperature. For patients treated with electromagnetic heaters, changes in heat production were most strongly correlated with the energy output from the electromagnetic heaters. Even though the environmental conditions required to achieve a particular level of comfort are quite different between treatment groups, the difference in temperature between the patient's surface and ambient is approximately the same for groups I, II, and IV for each subjective state.(ABSTRACT TRUNCATED AT 250 WORDS)

  18. Moist Exposed Burn Ointment in the Management of Burn Wound%湿润烧伤膏在烧伤创面治疗中的作用

    Institute of Scientific and Technical Information of China (English)

    V·贾亚拉曼

    2012-01-01

      Management of burns remains one of the greatest challenges in burn care. Local management of a burn wound requires early wound debridement and an optimum environment to stimulate epithelialisation and cellular prolifera-tion. Protocol was developed as early as 30 years ago for the management of burns that includes early excision and SSG cov-erage. The results were not perfect. The quality of healed skin as well as the prominence of hypertrophic scar needs to ex-plore the novel approaches. Wound healing assessment was made in burn wounds in 100 patients treated with MEBO cream and in 100 patients with Silver Sulpha Diazine Cream at the Kilpauk Medical College Hospital, Burns Unit. The comparative analysis is presented to assess the wound healing pattern in both the groups. Moist exposed burn ointment has been used with success in the management of deep superficial partial thickness and deep partial thickness burns in our department. The MEBO cream creates a physiological moist environment over the wound inducing an anti-inflammatory effect. It provides a nutritive base for the wound and debrides the wound eschar and expedites wound epithelialisation. The purpose of this study was to prospectively evaluate the outcome of the use of MEBO for second degree burns. Between August 2010 to May 2011 period 100 patients with second degree burns underwent MEBO cream application and were compared with 100 patients who had silver sulphadiazine cream . The result was analysed for the nature of wound debridement, reduction of inflammation, healing pattern, scar and pigmentation, MEBO provides excellent skin pigmentation and minimal visible scar.%  烧伤治疗一直是烧伤领域中的一大难题.烧伤创面的局部治疗要求早期清创,并为创面提供一个适宜的环境刺激上皮形成和细胞的分化.早在30年前,烧伤的标准化治疗方案就已经形成,包括早期切痂及韧厚皮移植,但治疗效果不尽人意.为了改善愈合后的皮

  19. Topical application of docosanol- or stearic acid-containing creams reduces severity of phenol burn wounds in mice.

    Science.gov (United States)

    Khalil, M H; Marcelletti, J F; Katz, L R; Katz, D H; Pope, L E

    2000-08-01

    Because of their reported antiviral and anti-inflammatory activities, cream formulations containing n-docosanol (docosanol) or stearic acid were tested for effects on chemically-induced burns in mice. In this model, injury was induced by painting the abdomens of mice with a chloroform solution of phenol. This was followed by the topical application of test substances 0.5, 3, and 6 h later. Progression of the wounds was assessed by a single evaluator after 8 h, using a numerical score of gross morphology. Docosanol- and stearic acid-containing creams substantially and reproducibly lessened the severity and progression of skin lesions compared to untreated sites with a 76% and 57% reduction in mean lesion scores, respectively. Untreated wounds appeared red and ulcerated; docosanol cream-treated wounds showed only slight erythema.

  20. Multispectral imaging burn wound tissue classification system: a comparison of test accuracies between several common machine learning algorithms

    Science.gov (United States)

    Squiers, John J.; Li, Weizhi; King, Darlene R.; Mo, Weirong; Zhang, Xu; Lu, Yang; Sellke, Eric W.; Fan, Wensheng; DiMaio, J. Michael; Thatcher, Jeffrey E.

    2016-03-01

    The clinical judgment of expert burn surgeons is currently the standard on which diagnostic and therapeutic decisionmaking regarding burn injuries is based. Multispectral imaging (MSI) has the potential to increase the accuracy of burn depth assessment and the intraoperative identification of viable wound bed during surgical debridement of burn injuries. A highly accurate classification model must be developed using machine-learning techniques in order to translate MSI data into clinically-relevant information. An animal burn model was developed to build an MSI training database and to study the burn tissue classification ability of several models trained via common machine-learning algorithms. The algorithms tested, from least to most complex, were: K-nearest neighbors (KNN), decision tree (DT), linear discriminant analysis (LDA), weighted linear discriminant analysis (W-LDA), quadratic discriminant analysis (QDA), ensemble linear discriminant analysis (EN-LDA), ensemble K-nearest neighbors (EN-KNN), and ensemble decision tree (EN-DT). After the ground-truth database of six tissue types (healthy skin, wound bed, blood, hyperemia, partial injury, full injury) was generated by histopathological analysis, we used 10-fold cross validation to compare the algorithms' performances based on their accuracies in classifying data against the ground truth, and each algorithm was tested 100 times. The mean test accuracy of the algorithms were KNN 68.3%, DT 61.5%, LDA 70.5%, W-LDA 68.1%, QDA 68.9%, EN-LDA 56.8%, EN-KNN 49.7%, and EN-DT 36.5%. LDA had the highest test accuracy, reflecting the bias-variance tradeoff over the range of complexities inherent to the algorithms tested. Several algorithms were able to match the current standard in burn tissue classification, the clinical judgment of expert burn surgeons. These results will guide further development of an MSI burn tissue classification system. Given that there are few surgeons and facilities specializing in burn care

  1. The Incidence of Infection After Early Closure of Evulsive Facial Wounds

    Directory of Open Access Journals (Sweden)

    Hosseini-e- Todashki H

    2000-06-01

    Full Text Available The aim of this study was to evaluate the incidence of postoperative wound dehiscence and"ninfection after early closure of evulsive facial wounds. This treatment was conducted on 28 male patients"nwith evulsive facial wounds. The formation of these evulsive wounds was due to the rupture of"ntemporary cavitation caused by high and extra high velocity messiles. All patients with average age of 18"nyears old were treated 24-48 hrs afire accidents at base hospitals (1988-1990."nPrimary healing was achieved in 24 subjects from 7 tO 15 days after the standard operation. Wound"ndehiscences and bacterial infections were observed in 4 subjects."nThe conclusion can be made from the results is that the early closure of evulsive facial wounds may"nreduce the rate of wound dehiscence and infection because of high vascularity in this area.

  2. Sustainable antimicrobial effect of silver sulfadiazine-loaded nanosheets on infection in a mouse model of partial-thickness burn injury.

    Science.gov (United States)

    Ito, Keisuke; Saito, Akihiro; Fujie, Toshinori; Nishiwaki, Keisuke; Miyazaki, Hiromi; Kinoshita, Manabu; Saitoh, Daizoh; Ohtsubo, Shinya; Takeoka, Shinji

    2015-09-01

    Partial-thickness burn injury has the potential for reepithelialization and heals within 3weeks. If the wound is infected by bacteria before reepithelization, however, the depth of disruption increases and the lesion easily progresses to the full-thickness dermal layers. In the treatment of partial-thickness burn injury, it is important to prevent the wound area from bacterial infection with an antimicrobial dressing. Here, we have tested the antimicrobial properties of polymeric ultra-thin films composed of poly(lactic acid) (termed "PLA nanosheets"), which have high flexibility, adhesive strength and transparency, and silver sulfadiazine (AgSD), which exhibits antimicrobial efficacy. The AgSD-loaded nanosheet released Ag(+) for more than 3days, and exerted antimicrobial efficacy against methicillin-resistant Staphylococcus aureus (MRSA) in an in vitro Kirby-Bauer test. By contrast, a cell viability assay indicated that the dose of AgSD used in the PLA nanosheets did not show significant cytotoxicity toward fibroblasts. In vivo evaluation using a mouse model of infection in a partial-thickness burn wound demonstrated that the nanosheet significantly reduced the number of MRSA bacteria on the lesion (more than 10(5)-fold) and suppressed the inflammatory reaction, thereby preventing a protracted wound healing process.

  3. Treating infected diabetic wounds with superoxidized water as anti-septic agent: a preliminary experience

    International Nuclear Information System (INIS)

    To evaluate the effectiveness of superoxidized water (MicrocynTM) in diabetic patients with different wounds. One hundred known diabetic patients were enrolled. Half were randomized to the intervention group (those whose wounds were managed with superoxidized water) and half to the control group (whose wounds were treated with normal saline) using a table of random numbers. The two groups were matched for age, gender, duration of diabetes and category of wound. All patients received appropriate surgical treatment for their wounds as required. Local wound treatment was carried out daily using superoxidized water soaked gauzes on twice daily basis in the intervention group and normal saline in the control group. The treatment was continued until wound healing. The main outcome measures were duration of hospital stay, downgrading of the wound category, wound healing time and need for interventions such as amputation. Statistically significant differences were found in favour of the superoxidized water group with respect to duration of hospital stay, downgrading of the wound category and wound healing time. Although the initial results of employing superoxidized water for the management of infected diabetic wounds are encouraging, further multicentre clinical trials are warranted before this antiseptic is recommended for general use. It may offer an economical alternative to other expensive antiseptics with positive impact on the prevailing infection rates, patient outcomes and patient satisfaction. (author)

  4. Oral ketamine and dexmedetomidine in adults' burns wound dressing--A randomized double blind cross over study.

    Science.gov (United States)

    Kundra, Pankaj; Velayudhan, Savitri; Krishnamachari, Srinivasan; Gupta, Suman Lata

    2013-09-01

    Study was designed to compare analgesic efficacy and side effects of oral dexmedetomidine and ketamine in adults for burn wound dressing. Sixty healthy adults with thermal burns with burn area (20-50%) were randomly assigned into 2 groups. In Group K 5mg/kg ketamine and in Group D 4 mcg/kg dexmedetomidine was given orally. Patients crossed over to the other group the following day. Visual analogue score, sedation score, haemodynamic parameters were recorded from 30min after drug administration to 2h after procedure. Patients' preference was also recorded. Mean VAS score was significantly reduced from baseline in both the groups at all time points (Pdressing. Oral ketamine produced significantly better pain relief than dexmedetomidine but was associated with delirium and excessive salivation.

  5. Predictive Value of IL-8 for Sepsis and Severe Infections after Burn Injury - A Clinical Study

    OpenAIRE

    Kraft, Robert; Herndon, David N; Finnerty, Celeste C.; Cox, Robert A.; Song, Juquan; Jeschke, Marc G.

    2015-01-01

    The inflammatory response induced by burn injury contributes to increased incidence of infections, sepsis, organ failure, and mortality. Thus, monitoring post-burn inflammation is of paramount importance but so far there are no reliable biomarkers available to monitor and/or predict infectious complications after burn. As IL-8 is a major mediator for inflammatory responses, the aim of our study was to determine whether IL-8 expression can be used to predict post-burn sepsis, infections, and m...

  6. Septicemia: The Principal Killer of Burns Patients

    Directory of Open Access Journals (Sweden)

    B. R. Sharma

    2005-01-01

    Full Text Available Burn injury is a major problem in many areas of the world and it has been estimated that 75% of all deaths following burns are related to infection. Burns impair the skin’s normal barrier function thus allowing microbial colonization of the burn wounds and even with the use of topical antimicrobial agents, contamination is almost unavoidable. It is therefore essential for every burn institution to determine its specific pattern of burn wound microbial colonization, time related changes in predominant flora and antimicrobial resistance profiles. This would allow early management of septic episodes with proper empirical systemic antibiotics before the results of microbiologic culture becomes available, thus improving the overall infection-related morbidity and mortality. We attempted to examine the factors affecting risk of infection; strategies for infection control and prevention in burn victims.

  7. 蓝光治疗烧伤残余创面64例%Therapeutic effect of blue light in treatment of residual burn wounds

    Institute of Scientific and Technical Information of China (English)

    李鹰; 张敬群; 靳方方; 郑启兵; 刘芳; 高凤林; 徐加红; 杨柳; 鲁海强

    2015-01-01

    目的 探讨蓝光治疗烧伤残余创面的疗效. 方法 选择2013年4月-2013年10月大面积烧伤残余创面患者64例,烧伤面积30% ~ 80%,残余创面面积0.5%~3%,按随机数字表法分为对照组(32例)和治疗组(32例).对照组采用聚维酮碘纱布换药治疗,治疗组在对照组治疗基础上,采用蓝光照射治疗.比较两组治疗后5d创面感染控制率、治疗后10 d创面细菌清除率、创面愈合情况及创面总愈合时间. 结果 治疗后5d,治疗组感染控制19例,基本控制9例,控制不佳4例,感染控制率为88%;对照组分别为8例、14例、10例,感染控制率为69%(P<0.05).治疗后10 d,治疗组、对照组创面细菌清除率分别为81%、63% (P <0.05);治疗组创面治愈20例,显效9例,好转2例,无效1例,创面愈合率为91%,对照组分别为5例、14例、8例、5例,创面愈合率为59% (P <0.05);治疗组、对照组创面愈合时间分别为(12.5±4.5)d、(18.5±6.5)d(P<0.05). 结论 蓝光可有效杀灭烧伤残余创面细菌,加快创面愈合速度,是治疗烧伤残余创面的新型方法,值得临床推广.%Objective To investigate the effect of blue light in treating the residual burn wounds.Methods Sixty-four massive burned patients with residual wounds (burn area of 30%-80% total body surface area and residual wound of 0.5%-3%) treated between April 2013 and October 2013 were allocated to control group (32 cases) and treatment group (32 cases) according to the random number table.In control group,the wounds were dressed with povidone-iodine gauze.And,except for this,patients in treatment group were treated with blue light therapy.Between-group comparison was made on infection control,bacterial clearance rate,wound healing,and healing time.Results On the fifth day after treatment,treatment group showed infection control in 19 cases,basic control in 9 cases and non-control in 4 cases,with the infection control rate of 88%;on the

  8. Long-term prognosis of patients with surgical wound infections.

    Science.gov (United States)

    Poulsen, K B; Gottschau, A

    1997-10-01

    This study examined if surgical wound infections (SWI) result in a severe prognosis regarding general health and increase the consumption of social resources. A group of 1301 patients were interviewed by self-administered questionnaires during 1993-1994, while operated during hospitalization in seven Danish hospitals. These patients were followed up at least once by similar questionnaires at a median time of 5.5 and 10.0 months postoperatively. The consequences of surgically diagnosed SWI were analyzed in a hospital cohort of 58 infected patients and 648 controls. Postdischarge infections were analyzed in a patient cohort of 263 cases and 767 controls. Changes in health was measured by the General Health Questionnaire, Activities of Daily Living index, and self-assessed health. Consumption of resources were estimated by reliance on assistance from family and friends, use of home services, and contacts to doctors. It was found that the long-term prognosis of general health was unaffected by SWIs. However significantly increased social dependence was found for patients with SWIs compared to uninfected patients. Almost one-fourth of the operations were complicated by an SWI. Most of the infections were recognized only after discharge and were thought to be of minor importance, which may explain why no chronic impairment of the health was found for patients with an SWI. A bias toward no-effect may have been introduced if patients with severe SWIs abstained from participation. The societal cost of care for patients with minor infections seems to be large. The causal relation between outcome and SWI needs to be further investigated. PMID:9327669

  9. Tilapia Piscidin 4 (TP4 Stimulates Cell Proliferation and Wound Closure in MRSA-Infected Wounds in Mice

    Directory of Open Access Journals (Sweden)

    Hang-Ning Huang

    2015-05-01

    Full Text Available Antimicrobial peptides (AMPs are endogenous antibiotics that directly affect microorganisms, and also have a variety of receptor-mediated functions. One such AMP, Tilapia piscidin 4 (TP4, was isolated from Nile tilapia (Oreochromis niloticus; TP4 has antibacterial effects and regulates the innate immune system. The aim of the present study was to characterize the role of TP4 in the regulation of wound closure in mice and proliferation of a keratinocyte cell line (HaCaT and fibroblast cell line (Hs-68. In vitro, TP4 stimulated cell proliferation and activated collagen I, collagen III, and keratinocyte growth factor (KGF gene expression in Hs-68 cells, which induces keratin production by HaCaT cells. This effect was detectable at TP4 concentrations of 6.25 µg/mL in both cell lines. In vivo, TP4 was found to be highly effective at combating peritonitis and wound infection caused by MRSA in mouse models, without inducing adverse behavioral effects or liver or kidney toxicity. Taken together, our results indicate that TP4 enhances the survival rate of mice infected with the bacterial pathogen MRSA through both antimicrobial and wound closure activities mediated by epidermal growth factor (EGF, transforming growth factor (TGF, and vascular endothelial growth factor (VEGF. The peptide is likely involved in antibacterial processes and regulation of tissue homeostasis in infected wounds in mice. Overall, these results suggest that TP4 may be suitable for development as a novel topical agent for wound dressing.

  10. Rapid enzyme analysis as a diagnostic tool for wound infection: Comparison between clinical judgment, microbiological analysis, and enzyme analysis

    NARCIS (Netherlands)

    Blokhuis-Arkes, Miriam H.E.; Haalboom, Marieke; Palen, van der Job; Heinzle, Andrea; Sigi, Eva; Guebitz, Georg; Beuk, Roland

    2015-01-01

    In clinical practice, diagnosis of wound infection is based on the classical clinical signs of infection. When infection is suspected, wounds are often swabbed for microbiological culturing. These methods are not accurate (clinical judgment in chronic wounds) or provide results after several days (w

  11. The quality of measurement of surgical wound infection as the basis for monitoring: a systematic review.

    Science.gov (United States)

    Bruce, J; Russell, E M; Mollison, J; Krukowski, Z H

    2001-10-01

    Comparison of postoperative surgical wound infection rates between institutions and over time is only valid if standard, valid and reliable definitions are used. The aim of this review was to assess evidence of validity and reliability of the definition and measurement of surgical wound infection. A systematic review was undertaken of prospective studies of surgical wound infection published over a seven-year period; 1993-1999. The information extracted from individual studies included: definition of surgical wound infection; details of wound assessment scale, scoring or grading scale systems; and evidence of assessment of validity, reliability and feasibility of identified definitions and grading systems. Two independent reviewers appraised 112 prospective studies, 90 of which were eligible for inclusion; eight studies assessed validity and/or reliability. Forty-one different definitions of surgical wound infection were identified, five of which were 'standard' definitions proposed by multi-disciplinary groups. Presence of pus was the most frequently used single component of any definition; the CDC definitions of 1988 and 1992 were the most widely implemented standard definitions; and the ASEPSIS wound assessment scale was the most frequently used quantitative grading tool. Only two formal validations of a definition were found, and six studies of reliability. This review highlights the extent of variation in definition of surgical wound infection used in clinical practice, and the need for validation of both content and organization of a surveillance system. However, realistically, there will have to be a balance between the quality of the measurement and the practicality of surveillance.

  12. Staged Concept for Treatment of Severe Postsaphenectomy Wound Infection

    Directory of Open Access Journals (Sweden)

    Thomas Schroeter

    2011-01-01

    Full Text Available The saphenous vein remains the most commonly used conduit in coronary artery bypass surgery. Vein harvest is a critical component with significant morbidity associated with leg wounds from open technique. Occurring complications are hematoma, postoperative pain, skin changes, neuropathy, and septic or nonseptic wound complications. Within the context of a recent case, we present our approach to postsaphenectomy wound management.

  13. 浅谈临床防治烧伤感染对策%A brief account of prevention and treatment of infection in burn patients

    Institute of Scientific and Technical Information of China (English)

    柴家科; 盛志勇

    2008-01-01

    Prevention and treatment of infection in burn patients involve a wide range of issues.This present article is to introduce only briefly clinical experience focusing on this problem.Among them,satisfactory timely prevention and treatment of burn shock is imperative because it exerts tremendous impact on homeostasis,including especially deterioration of immune functions.Early gastro-intestinal feeding is known to help restore gastro-intestinal circulation after shock,and it is an important avenue to give important nutritional elements like glutamine.It is also very important to excise devitalized tissue,followed by total coverage of all open wounds as early as possible,so that nidus of infection is removed.Rational ase of antibiotic,immunological modulation and other measured were also important contributory factors in successfully preventing and treating infection in patients with major burns.

  14. Effect of ozone water rinse on wound healing in rats withPseudomonas aeruginosa infection

    Institute of Scientific and Technical Information of China (English)

    Ju-Hua Ye; Jun-Wu Huang; Hong-Yun Shi

    2016-01-01

    Objective:To study the promoting effect of ozone water rinse on wound healing in rats with Pseudomonas aeruginosa infection.Methods:Wistar male rats were selected as experimental animals and randomly divided into control group, chlorhexidine group and ozone water group,Pseudomonas aeruginosa-infected wounds were made and cleaned with normal saline, chlorhexidine and ozone water respectively; would healing of three groups was observed, wound tissue was collected and contents of inflammatory factors, apoptosis molecules and autophagy markers were detected.Results:Wound healing rates of chlorhexidine group and ozone water group were higher than that of control group and wound healing time was shorter than that of control group, wound healing rate of ozone water group was higher than that of chlorhexidine group and wound healing time was shorter than that of chlorhexidine group; TNF-α, IL-1, IL-2, Fas, FasL and Beclin-1 contents and LC3Ⅱ/LC3Ⅰ ratios in wound tissue of chlorhexidine group and ozone water group were lower than those of control group, and TNF-α, IL-1, IL-2, Fas, FasL and Beclin-1 contents and LC3Ⅱ/LC3Ⅰ ratios in wound tissue of ozone water group were lower than those of chlorhexidine group.Conclusions:Compared with normal saline and chlorhexidine, ozone water rinse helps to promote wound healing, improve wound healing rate and shorten wound healing time in rats withPseudomonas aeruginosa infection, and meanwhile it can inhibit cell apoptosis and autophagy in the wounds.

  15. In Vitro Assessment of the Antibacterial Potential of Silver Nano-Coatings on Cotton Gauzes for Prevention of Wound Infections

    Directory of Open Access Journals (Sweden)

    Federica Paladini

    2016-05-01

    Full Text Available Multidrug-resistant organisms are increasingly implicated in acute and chronic wound infections, thus compromising the chance of therapeutic options. The resistance to conventional antibiotics demonstrated by some bacterial strains has encouraged new approaches for the prevention of infections in wounds and burns, among them the use of silver compounds and nanocrystalline silver. Recently, silver wound dressings have become widely accepted in wound healing centers and are commercially available. In this work, novel antibacterial wound dressings have been developed through a silver deposition technology based on the photochemical synthesis of silver nanoparticles. The devices obtained are completely natural and the silver coatings are characterized by an excellent adhesion without the use of any binder. The silver-treated cotton gauzes were characterized through scanning electron microscopy (SEM and thermo-gravimetric analysis (TGA in order to verify the distribution and the dimension of the silver particles on the cotton fibers. The effectiveness of the silver-treated gauzes in reducing the bacterial growth and biofilm proliferation has been demonstrated through agar diffusion tests, bacterial enumeration test, biofilm quantification tests, fluorescence and SEM microscopy. Moreover, potential cytotoxicity of the silver coating was evaluated through 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide colorimetric assay (MTT and the extract method on fibroblasts and keratinocytes. Inductively coupled plasma mass spectrometry (ICP-MS was performed in order to determine the silver release in different media and to relate the results to the biological characterization. All the results obtained were compared with plain gauzes as a negative control, as well as gauzes treated with a higher silver percentage as a positive control.

  16. Polymeric Membrane Dressings for Topical Wound Management of Patients With Infected Wounds in a Challenging Environment: A Protocol With 3 Case Examples.

    Science.gov (United States)

    Benskin, Linda L

    2016-06-01

    Patients with acute wounds often delay seeking medical assistance until an incapacitating infection has developed. When such patients come for help at a remote Christian clinic in northern Ghana, West Africa, the goals of care are to resolve and prevent a return of infection, decrease pain, enable an immediate return to normal activities, and facilitate healing. Because the local protocol of care, Edinburgh University Solution of Lime (EUSOL)-soaked gauze, did not meet these goals, the author tried using a variety of donated wound dressing regimens. Ultimately, polymeric membrane dressings (PMDs) were observed to meet patient care needs while also reducing clinic staff time and resources, and a PMD protocol of care was developed. Three (3) representative patients who presented with acute wounds and infection are described: a 20-year-old man with a hand abscess, a 16-year-old boy with a malleolus wound, and an approximately 20-year-old woman with an injection abscess, all otherwise relatively healthy, albeit undernourished. All 3 patients re- ceived oral antibiotics, their wounds were initially cleansed and debrided, and an appropriate configuration of either regular or silver-containing PMDs was applied to all exposed wound surfaces. Dressing changes were scheduled based upon the personalized plan of care. In all 3 patients, the pain-relieving properties of PMDs allowed resumption of activi- ties within 1 day of initiating treatment, the dressings' continuous wound cleansing system kept the wounds clean and free of infection despite the challenging environment, and the wounds healed steadily. Managing infected acute wounds with PMDs through complete wound closure was time efficient for clinic staff and met all 4 major patient goals of care. Randomized, controlled studies to compare wound and quality of life outcomes in patients whose infected wounds are managed with PMDs compared with those whose wounds are managed with other advanced dressings are warranted. PMID

  17. 烧伤创面愈合的信号转导机制%Signal transduction mechanism in burn wound healing

    Institute of Scientific and Technical Information of China (English)

    罗向东

    2008-01-01

    After 50 years of development in science of bums care in China, we have basically solved coverage of deep wounds of burn trauma, as well as role of multiple growth factors and stem cell in wound healing, making great contribution to improving the treatment of patients with large area of deep bums. Surgeons are paying close attention to problems of wound healing, especially in the fields of starless healing and rehabilitation. To solve these problems, we need to do further investigation on multiple growth factors as well as proliferation/differentiation of stem cells in regulation of cell growth and differentiation in wound healing. Therefore ,we are facing a even more serious challenge.

  18. [Advances in the research of an animal model of wound due to Mycobacterium tuberculosis infection].

    Science.gov (United States)

    Chen, Ling; Jia, Chiyu

    2015-12-01

    Tuberculosis ranks as the second deadly infectious disease worldwide. The incidence of tuberculosis is high in China. Refractory wound caused by Mycobacterium tuberculosis infection ranks high in misdiagnosis, and it is accompanied by a protracted course, and its pathogenic mechanism is still not so clear. In order to study its pathogenic mechanism, it is necessary to reproduce an appropriate animal model. Up to now the study of the refractory wound caused by Mycobacterium tuberculosis infection is just beginning, and there is still no unimpeachable model for study. This review describes two models which may reproduce a wound similar to the wound caused by Mycobacterium tuberculosis infection, so that they could be used to study the pathogenesis and characteristics of a tuberculosis wound in an animal.

  19. First case of Chlorella wound infection in a human in Australia

    Directory of Open Access Journals (Sweden)

    J. Hart

    2014-07-01

    Full Text Available A 30-year-old man developed an infected knee wound 2 days after jumping his bicycle into a freshwater dam. He required repeated debridement and tissue grew bright green colonies typical of the alga Chlorella plus Aeromonas hydrophila. This, and one previously reported case, responded to surgical debridement and careful wound management.

  20. ANTIBACTERIAL RESISTANCE PATTERN OF PSEUDOMONAS AERUGINOSA CO - ISOLATED WITH OTHER AEROBIC BACTERIA FROM BURN WOUNDS IN TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Kalpana

    2014-01-01

    Full Text Available The antibacterial resistance pattern of 118 isolates from burn wounds in patients with thermal burns showing growth of Pseudomonas aeruginosa mixed with other aerobic bacteria over a period of two years ( January 2009 - Decemb er2010 were studied. Pseudomonas aeruginosa was found to be mixed with Klebsiella pneumoniae 63 ( 53.38% the most followed by Escherichia coli 27 ( 22.88% and other aerobic isolates. Pseudomonas aeruginosa was found to be highly resistant to Ceftazidime ( 72.88% and least to Imipenem ( 9.32%. Klebsiella pneumoniae was found to be most resistant to Ampicillin ( 100% and least to Amikacin ( 23.72%. Antibiotic susceptibility testing was performed for the other isolates as well

  1. 负压创面疗法应用于深Ⅱ度烧伤创面的临床观察%A preliminary study on deep second degree burn wound treated by negative pressure wound therapy

    Institute of Scientific and Technical Information of China (English)

    尹会男; 柴家科; 李利根

    2011-01-01

    目的 研究负压创面疗法(NPWT)对于深Ⅱ度烧伤创面的治疗作用.方法 采用NPWT治疗19例患者,共22个深Ⅱ度烧伤创面.观察坏死组织清除情况,记录伤后10、14、21、28 d创面愈合率和创面完全愈合时间.结果 NPWT治疗后,观察的22个创面中有18个创面的坏死组织被全部清除,其余4个创面表面坏死组织被部分清除.创面愈合率在伤后10、14、21、28 d分别为(44±27)%,(69±28)%,(90±13)%,(100±0)%.创面完全愈合时间为(20.1±4.9)d,1个创面最后通过手术封闭,其余创面均通过换药愈合.结论 NPWT具有加速深Ⅱ度创面愈合的作用,对坏死组织有效地清除可能是其重要机制之一.%Objective To study the therapeutic effects of negative pressure wound therapy ( NPWT ) on deep second degree burn wound. Methods Nineteen patients including 22 deep second degree burn wounds received the treatment of NPWT.Necrotic tissue clearance, wound healing rate and time to complete wound healing were determined. Results The necrotic tissue of 18 burn wounds in 22 burn wounds was totally removed after NPWT. Wound healing rate was 44% ±27% , 69% ±28% ,90% ±13% , 100% ±0% in 10 days, 14 days, 21 days, and 28 days postburn respectively. Time to complete wound healing was 20. 1 ±4. 9 days. Only one of the 22burn wounds was healed by operation. Conclusion NPWT inproves the wound healing of deep second degree burn, and the effective removal of the necrotic tissue could be one of its main mechanisms.

  2. 深度烧伤修复重建与康复治疗相关问题探讨%A discussion regarding reconstruction and rehabilitation of patients with deep burn wound

    Institute of Scientific and Technical Information of China (English)

    胡大海

    2009-01-01

    @@ 近半个世纪以来,随着复苏、抗感染、营养支持等治疗方法的逐步完善,大面积严重烧伤患者的存活率不断提高.然而进一步修复重建受损的体表组织结构与外观,恢复其相应的生理功能亦十分重要,因此修复重建和功能康复在深度烧伤治疗中一直备受关注.本文结合一些新的技术进展,就烧伤后修复重建与康复治疗的几个相关问题进行探讨,旨在抛砖引玉,以引起广泛讨论.%With the advances in resuscitation,infection control,and metabolic management,the treatment strategies for burn patients have improved remarkably in the last half century.As a result,more patients with deep burn wound survived,and how to optimize the burn wound care aiming at recovery of the normal appearance and physiologic function of patients has been investigated and discussed widely through both the whole treat-ment strategy making and the new techniques performing.In the present discussion,early tissue reconstruction as well as early wound covering and repair are emphasized by summarizing the improved aesthetic and functional effects obtained by applying the principles of plastic surgery in early burn wound repair,the use of composite skin grafting,the grafting with split-thickness autografts on the preserved denatured dermis or on the preserved healthy fat tissue.etc.Besides these,more attention should be given to the repair and reconstruction in specialized functional parts of the body,such as head and face,neck,hand,female breast.perineum,and joint areas,after a deep burn.The role of rehabilitation during and after the burn wound treatment process is elucidated by demonstrating its potential biophysical mechanism and preventing scar deformity.Adequate treatment of deep burn wound demands a number of important measures in-eluding the timing of surgery,adoption of essential techniques,suitable types of wound covering materials,motivated rehabilita-tion,and necessary psychological

  3. Incidence and risk factors for caesarean wound infection in Lagos Nigeria

    Directory of Open Access Journals (Sweden)

    Gab-Okafor Chidinma V

    2009-09-01

    Full Text Available Abstract Background Post caesarean wound infection is not only a leading cause of prolonged hospital stay but a major cause of the widespread aversion to caesarean delivery in developing countries. In order to control and prevent post caesarean wound infection in our environment there is the need to access the relative contribution of each aetiologic factor. Though some studies in our environment have identified factors associated with post caesarean wound infection, none was specifically designed to address these issues prospectively or assess the relative contribution of each of the risk factors. Findings Prospective multicentre study over a period of 56 months in Lagos Nigeria. All consecutive and consenting women scheduled for caesarean section and meeting the inclusion criteria were enrolled into the study. Cases were all subjects with post caesarean wound infection. Those without wound infection served as controls. Data entry and analysis were performed using EPI-Info programme version 6 and SPSS for windows version 10.0. Eight hundred and seventeen women were enrolled into the study. Seventy six (9.3% of these cases were complicated with wound infection. The proportion of subjects with body mass index greater than 25 was significantly higher among the subjects with wound infection (51.3% than in the subjects without wound infection (33.9% p = 0.011. There were also significantly higher proportions of subjects with prolonged rupture of membrane (p = 0.02, prolonged operation time (p = 0.001, anaemia (p = 0.031 and multiple vaginal examinations during labour (0.021 among the women that had wound infection compared to the women that did not have wound infection. After adjustment for confounders only prolonged rupture of membrane (OR = 4.45, prolonged operation time (OR = 2.87 and body max index > 25 (2.34 retained their association with post caesarean wound infection. Conclusion Effort should be geared towards the prevention of prolonged

  4. A STUDY ON THE POST SURGICAL WOUND INFECTIONS IN A TERTIARY CARE HOSPITAL IN KANCHIPURAM

    Directory of Open Access Journals (Sweden)

    Sivasankari

    2016-03-01

    Full Text Available BACKGROUND Surgical site infections are the infections that occur within thirty days after the operative procedure (Except in case of added implants. Surgical site infections are the 3rd most commonly reported nosocomial infections accounting for a quarter of all such infections. A wide range of organisms are known to infect wounds like gram positive cocci, gram negative bacilli, spore formers, aerobes and anaerobes. Despite the advances in operative technique and better understanding of the pathogenesis of wound infections and wound healing, surgical site infections still remain a major source of morbidity and mortality. Hence, this study was done to identify the aetiological bacterial agents and their antibiogram pattern and the risk factors associated with surgical site infections. METHODS Wounds were examined for signs and symptoms of infection in postoperative ward. All the pus swabs were processed and identified as per standard methods of identification. Antibiogram was performed as per CLSI guidelines. The isolates were screened and confirmed with double disc diffusion method using CLSI guidelines. RESULTS The rate of surgical site infections in our study was 8.3%. The rate of surgical site infections was higher (73.3% in emergency surgeries than the elective surgeries. E. coli was the commonest isolate among gram negative bacilli; 33.3% isolates of E. coli were ESBL procedures. E. coli were sensitive to cefepime and ciprofloxacin and showed maximum resistance to ampicillin and ceftazidime. All the E. coli were sensitive to imipenem.

  5. 电烧伤创面早期处理的疗效分析%Clinical analysis on early treatment of electric burn wounds

    Institute of Scientific and Technical Information of China (English)

    倪俊; 顾海峰; 陈瑞彩; 许献荣; 张杏梅

    2013-01-01

    Objective To summarize the experience of early treatment of electric burn wounds. Methods The clinical data of 32 patients with electric burn who treated in our hospital from January 2005 to December 2011 were analyzed retrospectively. Urgent escharotomy were processed on 4 limbs. 17 limbs (fingers) were amputated. 23 burn wounds were sutured. 34 burn wounds healed with dressing changing. Results 23 flaps of different types were transplanted and the outcome was excellent in 14 flaps,good in 5 flaps,fair in 4 flaps. 67 wounds were treated with free skin grafting and the outcome was excellent in 44 wounds,good in 13 wounds,fair in 10 wounds. 16 wounds were covered with flaps and 43 wounds were covered with skin grafting in primary repair group. 7 wounds were covered with flaps and 24 wounds were covered with skin grafting in delay repair group. 16 wounds were covered with flaps and 53 wounds were covered with skin grafting in high-voltage electric burn group. 7 wounds were covered with flaps and 14 wounds were covered with skin grafting in low-voltage electric burn group. Skin healing in delay repair group was better than that in primary repair group( P <0. 01). The flap healing was no statistical difference between 2 groups. Conclusion Early debridement and appropriate skin choice or flaps grafting coverage wounds are key points for good therapeutic effect in electrical burns. It could achieve better healing for skin grafting on delayed repair wounds, while flap grafting on primary repair wounds. DR acellular xeno-dermis and VSD could create a good condition for skin grafting.%目的 探讨电烧伤创面早期处理的临床效果.方法 对2005年1月至2011年12月我院收治的32例电烧伤患者的临床资料进行回顾性分析.4侧肢体创面行切开减张术,17处行截肢(指)术,23处创面行缝合术,34处创面换药治疗.结果 23处创面行皮瓣修复,愈合优、良、差者分别为14处、5处、4处.67处创面行皮片修复,愈合

  6. The human cathelicidin antimicrobial peptide LL-37 as a potential treatment for polymicrobial infected wounds.

    Directory of Open Access Journals (Sweden)

    Allen J Duplantier

    2013-07-01

    Full Text Available Diabetic patients often have ulcers on their lower-limbs that are infected by multiple biofilm-forming genera of bacteria, and the elimination of the biofilm has proven highly successful in resolving such wounds in patients. To that end, antimicrobial peptides have shown potential as a new anti-biofilm approach. The single human cathelicidin peptide LL-37 has been shown to have antimicrobial and antibiofilm activity against multiple gram-positive and gram-negative human pathogens, and have wound-healing effects on the host. The combination of the anti-biofilm effect and wound-healing properties of LL-37 may make it highly effective in resolving polymicrobially infected wounds when topically applied. Such a peptide or its derivatives could be a platform from which to develop new therapeutic strategies to treat biofilm-mediated infections of wounds. This review summarizes known mechanisms that regulate the endogenous levels of LL-37 and discusses the antibiofilm, antibacterial and immunological effects of deficient versus excessive concentrations of LL-37 within the wound environment. Here, we review recent advances in understanding the therapeutic potential of this peptide and other clinically advanced peptides as a potential topical treatment for polymicrobial infected wounds.

  7. In-vitro activity of tigecycline against methicillin-resistant Staphylococcus aureus Isolated from wounds of burn patients in Tripoli-Libya

    OpenAIRE

    Abdulazziz Zorgani; Omar Elahmer; Hisham Ziglam; Khalifa Sifaw Ghenghesh

    2012-01-01

    Objectives: Tigecycline is a new glycylcycline group antibiotic with broad-spectrum activity. In the present study wereport on in vitro activity of tigecycline as well as the comparator antimicrobials linezolid and quinupristin/dalfopristinagainst methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin resistant Staphylococcus aureus (MRSA)strains isolated from burn wounds in Tripoli-Libya.Materials and methods: Included in the study 155 MSSA and 144 MRSA isolates from wounds of ...

  8. Pseudomonas syringae pv. syringae uses proteasome inhibitor syringolin A to colonize from wound infection sites.

    Directory of Open Access Journals (Sweden)

    Johana C Misas-Villamil

    2013-03-01

    Full Text Available Infection of plants by bacterial leaf pathogens at wound sites is common in nature. Plants defend wound sites to prevent pathogen invasion, but several pathogens can overcome spatial restriction and enter leaf tissues. The molecular mechanisms used by pathogens to suppress containment at wound infection sites are poorly understood. Here, we studied Pseudomonas syringae strains causing brown spot on bean and blossom blight on pear. These strains exist as epiphytes that can cause disease upon wounding caused by hail, sand storms and frost. We demonstrate that these strains overcome spatial restriction at wound sites by producing syringolin A (SylA, a small molecule proteasome inhibitor. Consequently, SylA-producing strains are able to escape from primary infection sites and colonize adjacent tissues along the vasculature. We found that SylA diffuses from the primary infection site and suppresses acquired resistance in adjacent tissues by blocking signaling by the stress hormone salicylic acid (SA. Thus, SylA diffusion creates a zone of SA-insensitive tissue that is prepared for subsequent colonization. In addition, SylA promotes bacterial motility and suppresses immune responses at the primary infection site. These local immune responses do not affect bacterial growth and were weak compared to effector-triggered immunity. Thus, SylA facilitates colonization from wounding sites by increasing bacterial motility and suppressing SA signaling in adjacent tissues.

  9. 重视负压伤口治疗技术在烧伤外科中的应用%Lay emphasis on the application of negative pressure wound therapy technique in burn surgery

    Institute of Scientific and Technical Information of China (English)

    柴家科; 申传安

    2015-01-01

    In recent years,negative pressure wound therapy (NPWT) technique has been widely used in burn surgery,including wound repair,skin grafting,and cosmetic procedures,showing promising clinical results.Based on the literature and clinical experience,the mechanism of NPWT and its clinical application in burn surgery are briefly iterated herewith.

  10. Topical agents in burn care

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    Momčilović Dragan

    2002-01-01

    Full Text Available Introduction Understanding of fluid shifts and recognition of the importance of early and appropriate fluid replacement therapy have significantly reduced mortality in the early post burn period. After the bum patient successfully passes the resuscitation period, the burn wound represents the greatest threat to survival. History Since the dawn of civilization, man has been trying to find an agent which would help burn wounds heal, and at the same time, not harm general condition of the injured. It was not until the XX century, after the discovery of antibiotics, when this condition was fulfilled. In 1968, combining silver and sulfadiazine, fox made silver-sulfadiazine, which is a 1% hydro-soluble cream and a superior agent in topical treatment of burns today. Current topical agents None of the topical antimicrobial agents available today, alone or combined, have the characteristics of ideal prophylactic agents, but they eliminate colonization of burn wound, and invasive infections are infrequent. With an excellent spectrum of activity, low toxicity, and ease of application with minimal pain, silver-sulfadiazine is still the most frequently used topical agent. Conclusion The incidence of invasive infections and overall mortality have been significantly reduced after introduction of topical burn wound antimicrobial agents into practice. In most burn patients the drug of choice for prophylaxis is silver sulfadiazine. Other agents may be useful in certain clinical situations.

  11. Intensive Care Unit Infections and Antibiotic Use

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    Ayşegül Yeşilkaya

    2011-07-01

    Full Text Available Burn wound infections is the leading cause of morbidity and mortality in burn trauma patients. Although burn wound is sterile at the beginning, because of risk factors such as prolonged hospital stay, immunesuppression and burn affecting large body surface area, colonisation firstly with Staphylococcus aureus and then Pseudomonas aeruginosa will occur later. Delay in wound closure and treatment with broad-spectrum antibiotic will result wound colonisation with antibiotic-resistant bacteria. To control colonization and to prevent burn wound infection topical antimicrobial dressings are used. The criteria used for the diagnosis of sepsis and wound infections are different in burn victims. Surface swabs from burn wounds must be cultured for the early assestment of infection. Although histopathological examination and quantitative culture of wound tissue biopsy has been known as the gold standard for the verification of invasive burn wound infection, many burn centers cannot do histopathological examination. When the traditional treatment modalities such as debridement of necrotic tissue, cleaning of wound and topical antimicrobial dressing application fails in the management of burn patient, cultures must be taken from possible foci of infection for the early diagnosis. After specimen collection, empirical bactericidal systemic antibiotic treatment should be started promptly. Inappropriate utilization of antibiotics may cause selection of resistant bacteria in the flora of the patient and of the burn unit which facilitates an infection or an outbreak at the end. Infection control in the burn unit includes surveillance cultures, cohort patient care staff, standard isolation precautions, strict hand hygiene compliance and appropariate antibiotic utilization. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 55-61

  12. Chitosan based substrates for wound infection detection based on increased lysozyme activity.

    Science.gov (United States)

    Tegl, Gregor; Rollett, Alexandra; Dopplinger, Jasmin; Gamerith, Clemens; Guebitz, Georg M

    2016-10-20

    There is a strong need of point-of-care diagnostics for early detection of wound infection. In this study, substrates based on functionalized chitosan were developed for visual detection of elevated lysozyme activity, an infection biomarker in wound fluids. For efficient hydrolysis by lysozyme, N-acetyl chitosan with a final degree of acetylation of around 50% was synthesized. N-acetylated chitosan and a chitosan-starch composite were labeled with structurally different dyes resulting in lysozyme-responsive biomaterials. Incubation with lysozyme in buffer and artificial wound fluid lead to a release of colored hydrolysis products already after 2h incubation. Tests in human wound fluid from infected wounds indicated a clear visual color change after 2.5h compared to control samples. A higher degree of swelling of the chitosan/starch containing substrate led to faster hydrolysis by lysozyme. This study demonstrates the potential of the lysozyme-responsive materials for diagnosis of wound infection and provides different diagnostic substrates for potential incorporation in point-of-care devices. PMID:27474566

  13. An evaluation of nutritional practice in a paediatric burns unit

    NARCIS (Netherlands)

    S. Vijfhuize; M. Verburg (Melissa); L. Marino; M. van Dijk (Monique); H. Rode (Heinz)

    2010-01-01

    textabstractIntroduction. Burn injuries evoke a systemic metabolic response with profound effects on organ function, susceptibility to infection, wound healing, growth and development, and mortality. Children are especially vulnerable to nutritional deficiencies owing to their limited energy reserve

  14. Efficacy of a children’s procedural preparation and distraction device on healing in acute burn wound care procedures: study protocol for a randomized controlled trial

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    Brown Nadia J

    2012-12-01

    Full Text Available Abstract Background The intense pain and anxiety triggered by burns and their associated wound care procedures are well established in the literature. Non-pharmacological intervention is a critical component of total pain management protocols and is used as an adjunct to pharmacological analgesia. An example is virtual reality, which has been used effectively to dampen pain intensity and unpleasantness. Possible links or causal relationships between pain/anxiety/stress and burn wound healing have previously not been investigated. The purpose of this study is to investigate these relationships, specifically by determining if a newly developed multi-modal procedural preparation and distraction device (Ditto™ used during acute burn wound care procedures will reduce the pain and anxiety of a child and increase the rate of re-epithelialization. Methods/design Children (4 to 12 years with acute burn injuries presenting for their first dressing change will be randomly assigned to either the (1 Control group (standard distraction or (2 Ditto™ intervention group (receiving Ditto™, procedural preparation and Ditto™ distraction. It is intended that a minimum of 29 participants will be recruited for each treatment group. Repeated measures of pain intensity, anxiety, stress and healing will be taken at every dressing change until complete wound re-epithelialization. Further data collection will aid in determining patient satisfaction and cost effectiveness of the Ditto™ intervention, as well as its effect on speed of wound re-epithelialization. Discussion Results of this study will provide data on whether the disease process can be altered by reducing stress, pain and anxiety in the context of acute burn wounds. Trial registration ACTRN12611000913976

  15. Polypragmasia in the therapy of infected wounds - conclusions drawn from the perspectives of low temperature plasma technology for plasma wound therapy.

    Science.gov (United States)

    Kramer, Axel; Hübner, Nils-Olaf; Weltmann, Klaus-Dieter; Lademann, Jürgen; Ekkernkamp, Axel; Hinz, Peter; Assadian, Ojan

    2008-11-03

    As long as a wound is infected, the healing process cannot begin. The indication for wound antiseptic is dependent on the interaction between the wound, the causative micro-organisms, and the host immune system. An uncritical colonisation is a condition whereby micro-organisms on a wound will proliferate, yet the immune system will not react excessively. Wound antiseptic is most often not necessary unless for epidemiologic reasons like colonisation with multi-resistant organisms. In most instances of a microbial contamination of the wound and colonisation, thorough cleaning will be sufficient.Bacterial counts above 10(5) to 10(6) cfu per gram tissue (critical colonisation) might decrease wound healing due to release of toxins, particularly in chronic wounds. Traumatic and heavily contaminated wounds therefore will require anti-infective measures, in particular wound antiseptic. In such situations, even a single application of an antiseptic compound will significantly reduce the number of pathogens, and hence, the risk of infection. If a wound infection is clinically manifest, local antiseptics and systemic antibiotics are therapeutically indicated.The prophylactic and therapeutic techniques for treatment of acute and chronic wounds (chemical antiseptics using xenobiotics or antibiotics, biological antiseptic applying maggots, medical honey or chitosan, physical antiseptic using water-filtered infrared A, UV, or electric current) mostly have been empirically developed without establishing a fundamental working hypothesis for their effectiveness.The most important aspect in controlling a wound infection and achieving healing of a wound is meticulous debridement of necrotic material. This is achieved by surgical, enzymatic or biological means e.g. using maggots. However, none of these methods (with some exception for maggots) is totally gentle to vital tissue and particularly chemical methods possess cytotoxicity effects.DERIVED FROM THE GENERAL PRINCIPLES OF

  16. Effects of irrigation with different solution on Incidence of Wound Infection

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    Majid Zamani

    2015-05-01

    Full Text Available Introduction: Management of acute and chronic wounds has significantly altered in the last decade but little attention has been paid to the solution used for cleansing the wounds. Therefore, the present study aimed to compare the effects of tap water, distilled water, and normal saline for wound cleansing in emergency department. Methods: This is a double-blind randomized clinical trial with a 10-day follow up. Patients who had superficial wounds were randomly divided into 3 treatment groups: normal saline, distilled water, and tap water. The wounds were cleansed using a 20 - 60 milliliter syringe with an 18 gauge needle. All the patients were discharged with the same antibiotic and were followed 48 hours and 10-day to determine the presence or absence of infection symptoms. The evaluated outcomes were infection incidence in the first 48 hours and 10 days after being discharged. Results: 1200 patients were included in the present study (57% male, average age 25.5 ± 11.0 years. 43 (3.5% patients showed infection symptoms in the first 48 hours. Ten (2.5% patients were in normal saline treated group, 15 (3.7% patients were in distilled water group, and 18 (4.4% patients were in tap water treated group (p=0.32. 13 (3.2% patients in normal saline group, 20 (4.9% patients in distilled water group and 23 (5.6% in the tap water group did not take their antibiotics. Prevalence of infection were higher in patients who did not take antibiotics (p < 0.001. The 10-day follow-up revealed that all the patients were recovered and showed no infection symptoms. Conclusion: The results of the present study showed that the prevalence of infection in using the 3 agents (normal saline, distilled water and tap water for cleansing wounds was similar. Therefore, drinking water could be considered as an alternative for cleansing wounds.

  17. Effects of low intensity laser in in vitro bacterial culture and in vivo infected wounds

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    Pâmela Rosa Pereira

    2014-01-01

    Full Text Available OBJECTIVE: to compare the effects of low intensity laser therapy on in vitro bacterial growth and in vivo in infected wounds, and to analyze the effectiveness of the AsGa Laser technology in in vivo wound infections. METHODS: in vitro: Staphylococcus aureus were incubated on blood agar plates, half of them being irradiated with 904 nm wavelength laser and dose of 3J/cm2 daily for seven days. In vivo: 32 male Wistar rats were divided into control group (uninfected and Experimental Group (Infected. Half of the animals had their wounds irradiated. RESULTS: in vitro: there was no statistically significant variation between the experimental groups as for the source plates and the derived ones (p>0.05. In vivo: there was a significant increase in the deposition of type I and III collagen in the wounds of the infected and irradiated animals when assessed on the fourth day of the experiment (p=0.034. CONCLUSION: low-intensity Laser Therapy applied with a wavelength of 904nm and dose 3J/cm2 did not alter the in vitro growth of S. aureus in experimental groups; in vivo, however, it showed significant increase in the deposition of type I and III collagen in the wound of infected and irradiated animals on the fourth day of the experiment.

  18. The Study of Wound Infection Rate Due to Midsternatomy after Heart Surgeries

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    R. Safiarian

    2011-01-01

    Full Text Available Introduction & Objective: Sternal wound infection and dehiscence are feared complications observed in 0.4-5% of cardiac operations. Even nowadays the mortality remains as high as 20-40%. The aim of the current study was to determine the rate of sternal wound infection. Material and Methods: The outcomes of 388 patients undergoing cardiac surgery during a 7 month follow up were analyzed and their risk factors such as obesity, diabetes, cigarette smoking, blood transfusion, renal failure, hypertension, COPD, preoperative ejection fraction, aortic clamping time, and time of cardio pulmonary bypass were evaluated. The data was analyzed by t-test & 2 statistical tests. Results: The present study revealed that 3 patients developed wound infection and dehiscence and its incidence was 0.74% (P=0.042. There was not any significant relationship between wound infection and the other risk factors (P>0.05. Conclusions: Our results indicate that ejection fraction preoperatively is very important in sternal wound infection. (Sci J Hamadan Univ Med Sci 2011;17(4:39-42

  19. A STUDY ON ROLE OF VARIOUS TYPES OF TOPICAL OINTMENT AND ITS OUTCOME AMONG BURN PATIENTS : AN INTERESTING FOLLOW UP STUDY

    OpenAIRE

    Sunita; Kamlesh; Avinash; Singh,; Dhiraj

    2015-01-01

    Burn injury causes major bulk of the surgical emergencies. Burn infection makes the burn wound complicated causes considerable mortality and morbidity. Timely and effective use of antimicrobial and topical dressings revolutionizes burn care by decreasing invasive wound infection. The administration of broad - spectrum antibiotics on routine basis is likely to en courage. The emergence of resistant organism therefore, timely and judicial use of antibiotics is essenti...

  20. Augmentation of quality of wound healing of deep burn%更进一步提高深度烧伤创面修复质量

    Institute of Scientific and Technical Information of China (English)

    黄晓元

    2009-01-01

    This article summarizes methods of repair of massive and deep wounds, elucidates how to improve wound healing quality and avoid scar deformity after deep hum. A part of denatured dermis (non-necrotic)in deep partial-thickness burn, "mixed degree" burn, even in full-thickness burn wounds before forming eschar can be preserved and covered with autolo-gous skin, thereby to avoid secondary damage to the structure of subcutaneous tissue and the junction of dermis-adipose, thus to result in good functions, appearance, and survival rate. After skin grafting, wound healing quality and appearance are im-proved, joint function and elasticity of skin are enhanced, the degree of scar contracture is relieved due to preservation of nor-mal adipose tissue after escharectomy. The study of composite artifical skin will be actively developed in the future. Tissue-en-gineering skin and stem cells can be successfully used in pa-tients with deep burns for starless healing with restoration of physiological functions in a short period.

  1. The management of perineal wounds

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    Ramesh k Sharma

    2012-01-01

    Full Text Available Management of perineal wounds can be very frustrating as these invariably get contaminated from the ano-genital tracts. Moreover, the apparent skin defect may be associated with a significant three dimensional dead space in the pelvic region. Such wounds are likely to become chronic and recalcitrant if appropriate wound management is not instituted in a timely manner. These wounds usually result after tumor excision, following trauma or as a result of infective pathologies like hideradenitis suppurativa or following thermal burns. Many options are available for management of perineal wounds and these have been discussed with illustrative case examples. A review of literature has been done for listing commonly instituted options for management of the wounds in perineum.

  2. Anti-inflammatory and Wound Healing Activities of Aloe vera, Honey and Milk Ointment on Second-Degree Burns in Rats.

    Science.gov (United States)

    Farzadinia, Parviz; Jofreh, Niloofar; Khatamsaz, Saeed; Movahed, Ali; Akbarzadeh, Samad; Mohammadi, Mostafa; Bargahi, Afshar

    2016-09-01

    The aim of the present study was morphological and morphometric investigation of burn healing impacts of an honey, milk, and Aloe vera (HMA) ointment on experimentally induced second-degree burns, to approve the medicinal basis of its use in Iranian traditional medicine. A total of 21 male Albino rats weighing 200 to 300 g were divided into 3 groups of 7, including (1) control group, (2) positive control group, and (3) the treatment group that were treated with eucerin, silver sulfadiazine 3% and HMA ointment 5% respectively.After anesthetizing, the second-degree burns (1 cm(2) areas) were made on the back of the animals using a digital controlled hot plaque, and each group was treated topically, based on the time scheduled. Then, skin punch biopsies were obtained on the 1st, 14th, and 28th days of post-burn induction; processed; and stained using hematoxylin and eosin and Masson's trichrome methods. The results showed that HMA ointment induces cell proliferation, increasing the wound closure rate, blood vessel counts, and collagen fiber density in treated animals. It also reduced the wound secretions, inflammation, and scar formation. According to the obtained morphological, morphometric results, we concluded that the traditional HMA ointment, which is rich in therapeutic biomaterials and minerals, has multiple healing effects on burn wounds in rats. PMID:27217089

  3. Nutrition Support in Burn Patients

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    Cem Aydoğan

    2012-08-01

    Full Text Available Severe burn trauma causes serious metabolic derangements. Increased metabolic rate which is apart of a pathophysiologic characteristic of burn trauma results in protein-energy malnutrition. This situation causes impaired wound healing, muscle and fat tissue’s breakdown, growth retardation in children and infections. Nutrition support is vital in the treatment strategies of burn victims to prevent high mortal and disabling complications in this devastating trauma. Our aim in this study is to review management of nutrition in burn victims. (Journal of the Turkish Society Intensive Care 2012; 10: 74-83

  4. A review on the nonoperative removal of necrotic tissue from burn wounds

    NARCIS (Netherlands)

    Klasen, HJ

    2000-01-01

    The study of nonoperative debridement of burns got underway during:thr Second World War. A large number of substances such as enzymes of plant origin, acids and proteolytic enzymes:of bacterial origin were examined since. The proteolytic enzymes derived from filtrates of C, histolyticum and B, subti

  5. Evaluation of healing of infected cutaneous wounds treated with different energy densities

    Science.gov (United States)

    Santos, Nicole R. S.; Cangussú, Maria C. T.; N. dos Santos, Jean; Pinheiro, Antonio L. B.

    2011-03-01

    We aimed assess the effects of different energy densities of the association of red/IR laser light on the healing of cutaneous wounds infected Staphylococcus aureus. Background: Wound infection is the most common complication on healing wounds and cause both vascular and cellular responses on the tissue. Several therapeutics is used for improving wound healing including the use of different light sources, such as the Laser. Some energy densities present positive photobiological effects on the healing process. Material and Methods: 24 young adult male Wistar rats, under general anesthesia, had their dorsum shaven, cleaned and a 1 x 1cm cutaneous wound created with a scalpel and left without no suturing or dressings. The wounds were infected with Staphylococcus aureus and were randomly divided in 8 subgroups of 3 animals in each: Control, Group 10J/cm2, Group 20J/cm2, and Group 30J/cm2, 7 and 14 days each group. Laser phototherapy was carried out with a diode (λ680nm/790nm, P= 30mW/40mW, CW, Laser, Ø = 3mm, PD=424mW/cm2 and 566mW/cm2, t=11.8/ 8.8 sec, E=0.35J) and started immediately after surgery and repeated at every other day during 7 days. Laser light was applied on 4 points around wounded area. The animals were killed at either 8th or 15th day after contamination. Specimens were taken, routinely cut and processed to wax, stained and underwent histological analysis. The results were statistically analyzed. Results: Both 20 and 30J/cm2 caused intense collagen deposition at the end of the experimental time. But, when 20 J/cm2 was used the fibers were also well organized. Conclusion: Our results indicate that irradiated subjects showed improved wound healing being the 20 J/cm2 the energy the caused better histological response.

  6. MICROBIOLOGICAL PROFILE OF BILE IN CHOLELITHIASIS AND THEIR IMPLICATION IN CAUSING POST OPERATIVE WOUND INFECTIONS

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    Shahi

    2014-12-01

    Full Text Available BACKGROUND: Cholecystitis is a common indication for major abdominal surgeries. It may occur with or without obstruction of common bile duct. Obstruction leads to secondary bacterial infection of bile. Bactibilia is an important predisposing factor for post-operative complications. Hence, this study was designed to determine the prevalence of bacteria in bile samples of cholecystitis patients and to correlate bactibilia and post-operative wound infection. MATERIALS AND METHODS: Bile samples collected intra-operatively were subjected to gram stain, culture, and antibiotic sensitivity testing. The patients were followed-up for post-operative complications. If post-operative wound infection was found, cultures were done and correlated with bacteria isolated from bile samples. RESULTS: Bactibilia was found in 43/100 (43% of patients. Polymicrobial flora was found in 7% of bile samples. Escherichia coli, citrobacter, Klebsiella pneumoniae and pseudomonas were the predominant organisms isolated. Post-operative wound infection was found in ten (10% patients who had bactibilia. Amikacin, gentamicin, ceftriaxone sulbatum, pipracillin tazobactum, imipenem were among most effective in prophylactic regimen. CONCLUSION: The organisms responsible for bactibilia were found to cause post-operative infections in the same patient warranting the use of prophylactic antibiotics in every patient undergoing cholecystectomy. All patients undergoing cholecystectomy should receive prophylactic antibiotic to prevent post-operative wound infections.

  7. 成批重度烧伤患者相关感染的个体化治疗%Individualized treatment of infection on mass severe burn casualties

    Institute of Scientific and Technical Information of China (English)

    巴特

    2016-01-01

    Successful treatment of mass severe burn casualties is one of the important criteria to test the emergency response ability of department. Burn sepsis, pulmonary infection, local wound infection, enterogenous infection, and a series of infections in the process of mass burn casualties are seriously threatening the life of the patients. In addition to the routine treatment of patients with severe burn, this article focuses on the individual treatment programs for patients with different infections, and achieved good results. Mass burn casualties with severe burn treatment, need to adjust the specific circumstances, in order to maximize the success rate of treatment.%成批重度烧伤患者的成功救治是考验科室对突发事件应急能力的重要标准之一。成批烧伤患者救治的过程中,烧伤脓毒症、肺部感染、局部创面感染以及肠源性感染等一系列感染问题严重地威胁着患者的生命。除了对重度烧伤患者的常规治疗以外,本文着重介绍了针对患者不同感染情况进行的个体化治疗方案,并且取得良好效果。成批重度烧伤患者的治疗,需要针对具体情况进行调整,才能最大程度地提高救治成功率。

  8. Evaluation of Drug-Resistance Pseudomonas and Staphylococcal Infections in Admitted Burned Patients in

    Directory of Open Access Journals (Sweden)

    E. Nemati, M.Sc

    2007-09-01

    Full Text Available Nosocomial infection is an important prognostic factor in out comes of burned patients. In this descriptive cross. Sectional study, 82 burned patients and related medical equipment were assessed in zareh hospital in 2033-2004. Pseudomonas aeruginosa and staphylococcus areus were found in 69(51.4% and 31 (23.2% of 134 clinical specimens respectively. Hence it is mandatory to plan programs for redusing harmful and resistance bacterial infection in this patients.

  9. A Case of Wound Infection with Providencia rettgeri and Coincident Gout in a Patient from Guam.

    Science.gov (United States)

    Washington, Michael A; Barnhill, Jason; Griffin, Jaclyn M

    2015-11-01

    Providencia rettgeri (P. rettgeri) is a ubiquitous organism that is infrequently associated with human disease. Here we report the isolation of this organism from a polymicrobial wound infection resulting from ruptured tophi on a 54-year-old male patient from Guam. We describe the identification and confirmation of this organism, and propose metabolic synergy as a possible mechanism of pathogenesis. To our knowledge, this is the first published report of a wound infection colonized by P. rettgeri from Guam, and the first report to speculate upon the role of bacterial synergy in P. rettgeri pathogenesis.

  10. Murine Model Imitating Chronic Wound Infections for Evaluation of Antimicrobial Photodynamic Therapy Efficacy

    Science.gov (United States)

    Fila, Grzegorz; Kasimova, Kamola; Arenas, Yaxal; Nakonieczna, Joanna; Grinholc, Mariusz; Bielawski, Krzysztof P.; Lilge, Lothar

    2016-01-01

    It is generally acknowledged that the age of antibiotics could come to an end, due to their widespread, and inappropriate use. Particularly for chronic wounds alternatives are being thought. Antimicrobial Photodynamic Therapy (APDT) is a potential candidate, and while approved for some indications, such as periodontitis, chronic sinusitis and other niche indications, its use in chronic wounds is not established. To further facilitate the development of APDT in chronic wounds we present an easy to use animal model exhibiting the key hallmarks of chronic wounds, based on full-thickness skin wounds paired with an optically transparent cover. The moisture-retaining wound exhibited rapid expansion of pathogen colonies up to 8 days while not jeopardizing the host survival. Use of two bioluminescent pathogens; methicillin resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa permits real time monitoring of the pathogens. The murine model was employed to evaluate the performance of four different photosensitizers as mediators in Photodynamic Therapy. While all four photosensitizers, Rose Bengal, porphyrin TMPyP, New Methylene Blue, and TLD1411 demonstrated good to excellent antimicrobial efficacy in planktonic solutions at 1 to 50 μM concentrations, whereas in in vivo the growth delay was limited with 24–48 h delay in pathogen expansion for MRSA, and we noticed longer growth suppression of P. aeruginosa with TLD1411 mediated Photodynamic Therapy. The murine model will enable developing new strategies for enhancement of APDT for chronic wound infections. PMID:27555843

  11. Murine Model Imitating Chronic Wound Infections for Evaluation of Antimicrobial Photodynamic Therapy Efficacy.

    Science.gov (United States)

    Fila, Grzegorz; Kasimova, Kamola; Arenas, Yaxal; Nakonieczna, Joanna; Grinholc, Mariusz; Bielawski, Krzysztof P; Lilge, Lothar

    2016-01-01

    It is generally acknowledged that the age of antibiotics could come to an end, due to their widespread, and inappropriate use. Particularly for chronic wounds alternatives are being thought. Antimicrobial Photodynamic Therapy (APDT) is a potential candidate, and while approved for some indications, such as periodontitis, chronic sinusitis and other niche indications, its use in chronic wounds is not established. To further facilitate the development of APDT in chronic wounds we present an easy to use animal model exhibiting the key hallmarks of chronic wounds, based on full-thickness skin wounds paired with an optically transparent cover. The moisture-retaining wound exhibited rapid expansion of pathogen colonies up to 8 days while not jeopardizing the host survival. Use of two bioluminescent pathogens; methicillin resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa permits real time monitoring of the pathogens. The murine model was employed to evaluate the performance of four different photosensitizers as mediators in Photodynamic Therapy. While all four photosensitizers, Rose Bengal, porphyrin TMPyP, New Methylene Blue, and TLD1411 demonstrated good to excellent antimicrobial efficacy in planktonic solutions at 1 to 50 μM concentrations, whereas in in vivo the growth delay was limited with 24-48 h delay in pathogen expansion for MRSA, and we noticed longer growth suppression of P. aeruginosa with TLD1411 mediated Photodynamic Therapy. The murine model will enable developing new strategies for enhancement of APDT for chronic wound infections. PMID:27555843

  12. Practice-oriented expert recommendation for the treatment of critical colonised and local infected wounds using polihexanide

    OpenAIRE

    Vasel-Biergans, Anette; Strohal, Robert; Riepe, Gunnar; Kramer, Axel; Gerber, Veronika; Dissemond, Joachim; Eberlein, Thomas

    2009-01-01

    Wound infections are special and challenging situations in the therapy of acute and chronic wounds. Typical complications are riskful not only for the therapeutic process but also for amputation and viability of patients. Polihexanide is an exceedingly appropriate antimicrobial substance for using in critical colonised and local infected acute and chronic wounds. This evaluation is based on different properties of the compound like the broad antimicrobial spectrum, the excellent cell and tiss...

  13. Practice-oriented expert recommendation for the treatment of critical colonised and local infected wounds using polihexanide

    OpenAIRE

    Dissemond, J; Gerber, V.; Kramer, A.; Riepe, G.; Strohal, R; Vasel-Biergans, A; Eberlein, T.

    2009-01-01

    Wound infections are special and challenging situations in the therapy of acute and chronic wounds. Typical complications are riskful not only for the therapeutic process but also for amputation and viability of patients. Polihexanide is an exceedingly appropriate antimicrobial substance for using in critical colonised and local infected acute and chronic wounds. This evaluation is based on different properties of the compound like the broad antimicrobial spectrum, the excellent cell and...

  14. 也谈严重烧伤感染治疗%To intensify our understanding about management of severe burn infection

    Institute of Scientific and Technical Information of China (English)

    张勤; 廖镇江

    2009-01-01

    Nowadays, it is necessary to emphasize the three basic inseparable elements in the treatment of severe burn infection, which are systemic care, burn wound care, and ra-tional use of antimicrobia/s topically or systematically. Systemic care has been shifted from simple nutritional support to maintai-ning the systemic homeostasis, including balancing immune-in-flammatory response, and protecting organs from dysfunction.Some work focused on regulating systemic immune response in the initial phase and the balance of inflammatory response after occurrence of severe burn infection have been reported. These results at least broaden our thinking to recognize that treatment should not only destroy microbes, but also balance the response of the body. Escharectomy in earlier phase has been a consen-sus. Currently, we turn our vision into how to use "damage con-trol surgery (DCS)" concept in management of severe burn.DCS in burn care includes the evaluation of perioperative situa-tion more accurate to make a more appropriate surgical decision. Meanwhile, an overall strategy should be established to confront the rapidly increasing drug resistance of the pathogens. The re-lease of endotoxin after use of antimicrobials, which has been studied widely, should be explored further.

  15. [Controlling infection and spread of carbapenems-resistant Klebsiella pneumoniae among burn patients].

    Science.gov (United States)

    Huan, Jingning

    2015-02-01

    The emergence and spread of carbapenems-resistant Klebsiella pneumoniae (CRKP) in burn ward is an important threat to burn management. CRKP isolates are resistant to almost all available antibiotics and are susceptible only to polymyxins and tigecycline. The mechanism of the drug resistance of CRKP is associated with the plasmid-encoded carbapenemase Klebsiella pneumoniae carbapenemase (KPC), a carbapenem-hydrolyzing β-lactamase. Antibiotics which can currently be used to treat CRKP infection include polymyxins, tigecycline, and some aminoglycosides. The efficacy of using antibiotics in combination is better than that of single-agent therapy for the treatment of CRKP infection in bloodstream. In order to control CRKP infection in burn patients, strategies for preventing CRKP dissemination in burn ward are strongly advocated.

  16. Fast Blue RR—Siloxane Derivatized Materials Indicate Wound Infection Due to a Deep Blue Color Development

    Directory of Open Access Journals (Sweden)

    Doris Schiffer

    2015-09-01

    Full Text Available There is a strong need for simple and fast methods for wound infection determination. Myeloperoxidase, an immune system-derived enzyme was found to be a suitable biomarker for wound infection. Hence, alkoxysilane-derivatized Fast Blue RR was immobilized via simple hydrolytic polymerization. The resulting enzyme-responsive siloxane layers were incubated with myeloperoxidase, wound fluid or hemoglobin. The reaction was monitored via HPLC measurements and the color development quantified spectrophotometrically. Myeloperoxidase was indeed able to oxidize immobilized Fast Blue RR leading to a blue colored product. No conversion was detected in non-infected wound fluids. The visible color changes of these novel materials towards blue enable an easy distinction between infected and non-infected wound fluids.

  17. Antimicrobial blue light therapy for Candida albicans burn infection in mice

    Science.gov (United States)

    Zhang, Yunsong; Wang, Yucheng; Murray, Clinton K.; Hamblin, Michael R.; Gu, Ying; Dai, Tianhong

    2015-05-01

    In this preclinical study, we investigated the utility of antimicrobial blue light therapy for Candida albicans infection in acutely burned mice. A bioluminescent strain of C. albicans was used. The susceptibilities to blue light inactivation were compared between C. albicans and human keratinocyte. In vitro serial passaging of C. albicans on blue light exposure was performed to evaluate the potential development of resistance to blue light inactivation. A mouse model of acute thermal burn injury infected with the bioluminescent strain of C. albicans was developed. Blue light (415 nm) was delivered to mouse burns for decolonization of C. albicans. Bioluminescence imaging was used to monitor in real time the extent of fungal infection in mouse burns. Experimental results showed that C. albicans was approximately 42-fold more susceptible to blue light inactivation in vitro than human keratinocyte (P=0.0022). Serial passaging of C. albicans on blue light exposure implied a tendency for the fungal susceptibility to blue light inactivation to decrease with the numbers of passages. Blue light reduced fungal burden by over 4-log10 (99.99%) in acute mouse burns infected with C. albicans in comparison to infected mouse burns without blue light therapy (P=0.015).

  18. Wound management with vacuum-assisted closure in postoperative infections after surgery for spinal stenosis

    Directory of Open Access Journals (Sweden)

    Karaaslan F

    2014-12-01

    Full Text Available Fatih Karaaslan,1 Şevki Erdem,2 Musa Ugur Mermerkaya11Department of Orthopaedics and Traumatology, Bozok University Medical School, Yozgat, Turkey; 2Department of Orthopaedics and Traumatology, Haydarpasa Numune Training Hospital, Istanbul, TurkeyObjective: To evaluate the results of negative-pressure wound therapy (NPWT in the treatment of surgical spinal site infections.Materials and methods: The use of NPWT in postoperative infections after dorsal spinal surgery (transforaminal lumbar interbody fusion plus posterior instrumentation was studied retrospectively. From February 2011 to January 2012, six patients (females out of 317 (209 females; 108 males were readmitted to our clinic with surgical site infections on postoperative day 14 (range 9–19 and were treated with debridement, NPWT, and antibiotics. We evaluated the clinical and laboratory data, including the ability to retain the spinal hardware and recurrent infections.Results: The incidence of deep postoperative surgical site infection was six (1.89% patients (females out of 317 patients (209 females; 108 males at 1 year. All patients completed their wound NPWT regimen successfully. An average of 5.1 (range 3–8 irrigation and debridement sessions was performed before definitive wound closure. The mean follow-up period was 13 (range 12–16 months. No patient had a persistent infection requiring partial or total hardware removal. The hospital stay infection parameters normalized within an average of 4.6 weeks.Conclusion: The study illustrates the usefulness of NPWT as an effective adjuvant treatment option for managing complicated deep spinal surgical wound infections.Keywords: surgical infection, NPWT, VAC, TLIF

  19. WOUND INFECTION AFTER SCOLIOSIS SURGERY:AN ANALYSIS OF 15 CASES

    Institute of Scientific and Technical Information of China (English)

    李书纲; 仉建国; 等

    2002-01-01

    Objective:To discuss the causes and treatments of wound infections after scoliosis surgery.Methods:Nine hundred and twenty-four cases of scoliosis were reviewed,and the clinical data of 15 cases of postoperative infection were analysed retrospectively.Results:All 15 cases underwent spinal posterior fusion with autologous bone graft using instrumentations.Seven were diagnosed as early infection,and 8 were delayed infection.Radical debridement was performed in all 15 cases.The duration of antibiotics administration was 10 to 34 days with continuous closed irrigation for 2-4weeks and primary closure for the wounds.All patients were followed up for an average of 3.5years (2 to 7.5years) with good outcomes and no recurrence.Conclusion:Wound infection following surgical correction of scoliosis primarily results from intraoperative seeding,although host-related and operation-related factors may contribute to its development.Once the infections are diagnosed,good results can be achieved by prompt surgical debridement,irrigation and reasonably administered antibiotics.Removal of hardware may be necessary in deep infections.

  20. The surgical team as a source of postoperative wound infections caused by Streptococcus pyogenes

    DEFF Research Database (Denmark)

    Kolmos, H J; Svendsen, R N; Nielsen, S V

    1997-01-01

    Postoperative wound infection, caused by Streptococcus pyogenes transmitted during the operation from members of the surgical team, is a rare but serious complication of surgery. This study describes three cases, which could be traced to an orthopaedic surgeon, who carried the epidemic strain...

  1. A rare cause of wound infection after an open fracture: Shewanella putrefaciens

    OpenAIRE

    Prinja, Aditya; Singh, Jagwant; Davis, Nwaka; Urwin, Gillian

    2013-01-01

    An elderly gentleman presented with an open fracture of the calcaneum and ankle, following a boating accident. Despite treatment with repeated surgical debridement, delayed closure, prolonged antibiotics and strict adherence to national guidelines on the management of open fractures, he developed a wound infection with a rare organism, Shewanella putrefaciens, that appears to be increasing in prevalence.

  2. Multidrug resistant Psudomonas aeruginosa infections complicating surgical wounds and the potential challenges in managing post-operative wound infections:University of Calabar Teaching Hospital experience

    Institute of Scientific and Technical Information of China (English)

    Jombo GT; Akpan S; Epoke J; Denen Akaa P; Odey F

    2010-01-01

    Objective:To ascertain the antimicrobial susceptibility profile of Pseudomonas aeruginosa (P. aeruginosa) recovered from surgical site infections (SSIs). Methods:The study was retrospective in nature and was compiled for a period of five years (1st February, 2004-31st January, 2009). Data were generated from the culture of post-operative wound swab specimens by the microbiology laboratory of University of Calabar Teaching Hospital. Relevant information from the patients’ records was compiled, such as age, gender, type of surgical procedure, microorganisms recovered and their antibiotic sensitivity patterns. Obtained data was analysed by using Epi Info 6 statistical software. Results:Of the 4 533 wound swab specimens processed, 673 were culture positive and P. aeruginosa was recovered from 13.1%of the culture positive specimens with its rate of recovery decreasing with age progression (P0.05). Most of the P. aeruginosa isolates were from general surgery wards and least from orthopaedic wards. Ofloxacin, ceftriaxone and augmentin were the most active antibiotics while ampicillin, tetracycline and co-trimoxazole were the least active antibiotics, with no antibiotic having a 100%activity against the organism. Conclusions:In view of the high resistance displayed by P. aeruginosa recovered from SSIs, adequate antiseptic procedures should be entrenched to avoid colonization of surgical wounds by this microorganism as well as others with similar sensitivity profile. Ofloxacin, ceftriaxone and augmentin may be considered for prevention of P.aeruginosa infection.

  3. Staphylococcal Scalded-Skin Syndrome Complicating Wound Infection in a Preterm Infant with Postoperative Chylothorax

    Science.gov (United States)

    Peters, Bjoern; Hentschel, Juliane; Mau, Harald; Halle, Elke; Witte, Wolfgang; Obladen, Michael

    1998-01-01

    The course of infection in a 3-week-old premature newborn suffering from extensive dermatitis with flaccid blisters is described. Staphylococcus aureus was recovered from a local wound infection around a chest tube inserted to drain a postoperative chylothorax. The strain isolated tested positive for the eta gene for exfoliative toxin A, the causative agent of staphylococcal scalded-skin syndrome (SSSS). In this case, prematurity and loss of chylus with consecutive lymphopenia may have contributed to development of SSSS. PMID:9738069

  4. Wound management with vacuum-assisted closure in postoperative infections after surgery for spinal stenosis

    OpenAIRE

    Karaaslan F; Erdem Ş; Mermerkaya MU

    2014-01-01

    Fatih Karaaslan,1 Şevki Erdem,2 Musa Ugur Mermerkaya11Department of Orthopaedics and Traumatology, Bozok University Medical School, Yozgat, Turkey; 2Department of Orthopaedics and Traumatology, Haydarpasa Numune Training Hospital, Istanbul, TurkeyObjective: To evaluate the results of negative-pressure wound therapy (NPWT) in the treatment of surgical spinal site infections.Materials and methods: The use of NPWT in postoperative infections after dorsal spinal surgery (transforaminal lumbar in...

  5. Review of Subcutaneous Wound Drainage in Reducing Surgical Site Infections after Laparotomy

    Directory of Open Access Journals (Sweden)

    B. Manzoor

    2015-01-01

    Full Text Available Purpose. Surgical site infections (SSIs remain a significant problem after laparotomies. The aim of this review was to assess the evidence on the efficacy of subcutaneous wound drainage in reducing SSI. Methods. MEDLINE database was searched. Studies were identified and screened according to criteria to determine their eligibility for meta-analysis. Meta-analysis was performed using the Mantel-Haenszel method and a fixed effects model. Results. Eleven studies were included with two thousand eight hundred and sixty-four patients. One thousand four hundred and fifty patients were in the control group and one thousand four hundred and fourteen patients were in the drain group. Wound drainage in all patients shows no statistically significant benefit in reducing SSI incidence. Use of drainage in high risk patients, contaminated wound types, and obese patients appears beneficial. Conclusion. Using subcutaneous wound drainage after laparotomy in all patients is unnecessary as it does not reduce SSI risk. Similarly, there seems to be no benefit in using it in clean and clean contaminated wounds. However, there may be benefit in using drains in patients who are at high risk, including patients who are obese and/or have contaminated wound types. A well designed trial is needed which examines these factors.

  6. Combination of photodynamic and ultrasonic therapy for treatment of infected wounds in animal model

    Science.gov (United States)

    Menyaev, Yulian A.; Zharov, Vladimir P.

    2006-02-01

    One of the important problems of modern medicine is treatment of infected wounds. There are many diversified expedients of treatment, but none of them obey the modern physician completely. The aim of this study is to develop and test a new combined method of photodynamic ultrasonic therapy (PDUST) for treatment of infected wounds with focus on experimental trials. PDUST is based on a combination of two methods: photodynamic (PD) therapy (PDT) with photosensitizer and low frequency ultrasonic (US) therapy with antibiotic as tools for treatment of wounds and effectively killing bacteria. The main parameters are: US frequency - 26.5 kHz; US tip elongation - 40+/-20 μm wavelength of light emitting diodes (LED) array - 660+/-10 nm; light intensity on biotissue surface - 1-2 mW/cm2; photosensitizer - an aluminum disulfonated phtalocyanine dissolved in a physiological solution in concentration 10 mg/l. The experiments were carried out with 70 male chinchilla rabbits divided into 7 groups, thus the dynamics of wounds healing were studied in different modes of PDUST. The PD and US methods supplement each other and in conjunction provide additive and especially synergetic effects. The experimental data demonstrated advantages of new technology in comparison with conventional methods in cases of treatment of extended suppurative inflammatory and profound wounds. The more detailed study of PDUST method's mechanism, which is based on low intensity of LED light, PD therapy and US influence is required.

  7. Nitrosoglutathione generating nitric oxide nanoparticles as an improved strategy for combating Pseudomonas aeruginosa-infected wounds.

    Science.gov (United States)

    Chouake, Jason; Schairer, David; Kutner, Allison; Sanchez, David A; Makdisi, Joy; Blecher-Paz, Karin; Nacharaju, Parimala; Tuckman-Vernon, Chaim; Gialanella, Phil; Friedman, Joel M; Nosanchuk, Joshua D; Friedman, Adam J

    2012-12-01

    Pseudomonas aeruginosa is a community-acquired, nosocomial pathogen that is an important cause of human morbidity and mortality; it is intrinsically resistant to several antibiotics and is capable of developing resistance to newly developed drugs via a variety of mechanisms. P aeruginosa's ubiquity and multidrug resistance (MDR) warrants the development of innovative methods that overcome its ability to develop resistance. We have previously described a nitric oxide-releasing nanoparticle (NO-np) platform that effectively kills gram-positive and gram-negative organisms in vitro and accelerates clinical recovery in vivo in murine wound and abscess infection models. We have also demonstrated that when glutathione (GSH) is added to NO-np, the nitroso intermediate S-nitrosoglutathione (GSNO) is formed, which has greater activity against P aeruginosa and other gram-negative organisms compared with NO-np alone. In the current study, we evaluate the potential of NO-np to generate GSNO both in vitro and in vivo in a murine excisional wound model infected with an MDR clinical isolate of P aeruginosa. Whereas NO-np alone inhibited P aeruginosa growth in vitro for up to 8 hours, NO-np+GSH completely inhibited P aeruginosa growth for 24 hours. Percent survival in the NO-np+GSH-treated isolates was significantly lower than in the NO-np (36.1% vs 8.3%; P=.004). In addition, NO-np+GSH accelerated wound closure in P aeruginosa-infected wounds, and NO-np+GSH-treated wounds had significantly lower bacterial burden when compared to NO-np-treated wounds (P<.001). We conclude that GSNO is easily generated from our NO-np platform and has the potential to be used as an antimicrobial agent against MDR organisms such as P aeruginosa. PMID:23377518

  8. The Increasing Problem of Wound Bacterial Burden and Infection in Acute and Chronic Soft-Tissue Wounds Caused by Methicillin-Resistant Staphylococcus aureus

    OpenAIRE

    Demling, Robert H.; Waterhouse, Barbara

    2007-01-01

    Methicillin-resistant Staphylococcus aureus (MRSA) has become a leading cause of colonization and infection in both acute and chronic soft-tissue wounds. Objective: Our objective is to define this current epidemic problem caused by both community-acquired MRSA (CA-MRSA) and hospital-acquired MRSA (HA-MRSA), focusing on the similarities and differences between these 2 isolates as well as the impact on wound management decisions. Methods: Methods used include a literature review on the growth o...

  9. The Duration of Negative Pressure Wound Therapy Can Be Reduced Using the HeartShield Device in Patients With Deep Sternal Wound Infection.

    OpenAIRE

    Ingemansson, Richard; Malmsjö, Malin; Lindstedt Ingemansson, Sandra

    2014-01-01

    Background: Heart rupture resulting in lethal bleeding is a devastating complication associated with negative pressure wound therapy (NPWT) in patients with deep sternal wound infection (DSWI). We have previously reported that the use of a protective HeartShield device in combination with NPWT decreases the risk of damage to the heart. This article presents a retrospective analysis of NPWT duration with and without the HeartShield device. Subjects and patients: The study included 6 patients t...

  10. Prospect of a method of infected wound healing with a help of Calliphoridae blowfly screwworms

    Directory of Open Access Journals (Sweden)

    L. I. Faly

    2012-02-01

    Full Text Available Complex assessment of possibilities of infected wound healing with a help of screwworms of blowfly of the family Calliphoridae in the hospitals of Ukraineis offered. On the basis of available data the mechanism of therapeutic action is shown, and the medicinal properties of substances containing in the secretions and excretions of the blowfly screwworms are described. The gist of the treatment method and traits of the blowfly cultivation in a laboratory are highlighted. The quality standards for specialized biological laboratories are presented. The proposed wound healing method is proved as promising.

  11. In-vitro Activity of Tigecycline against Methicillin-Resistant Staphylococcus aureus Isolated from Wounds of Burn Patients in Tripoli-Libya

    OpenAIRE

    Zorgani, Abdulazziz; Elahmer, Omar; Ziglam, Hisham; Ghenghesh, Khalifa Sifaw

    2012-01-01

    Objectives: Tigecycline is a new glycylcycline group antibiotic with broad-spectrum activity. In the present study we report on in vitro activity of tigecycline as well as the comparator antimicrobials linezolid and quinupristin/dalfopristin against methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin resistant Staphylococcus aureus (MRSA) strains isolated from burn wounds in Tripoli-Libya. Materials and methods: Included in the study 155 MSSA and 144 MRSA ...

  12. Predictive Value of IL-8 for Sepsis and Severe Infections after Burn Injury - A Clinical Study

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Finnerty, Celeste C; Cox, Robert A; Song, Juquan; Jeschke, Marc G

    2014-01-01

    The inflammatory response induced by burn injury contributes to increased incidence of infections, sepsis, organ failure, and mortality. Thus, monitoring post-burn inflammation is of paramount importance but so far there are no reliable biomarkers available to monitor and/or predict infectious complications after burn. As IL-8 is a major mediator for inflammatory responses, the aim of our study was to determine whether IL-8 expression can be used to predict post-burn sepsis, infections, and mortality other outcomes post-burn. Plasma cytokines, acute phase proteins, constitutive proteins, and hormones were analyzed during the first 60 days post injury from 468 pediatric burn patients. Demographics and clinical outcome variables (length of stay, infection, sepsis, multiorgan failure (MOF), and mortality were recorded. A cut-off level for IL-8 was determined using receiver operating characteristic (ROC) analysis. Statistical significance is set at (p<0.05). ROC analysis identified a cut-off level of 234 pg/ml for IL-8 for survival. Patients were grouped according to their average IL-8 levels relative to this cut off and stratified into high (H) (n=133) and low (L) (n=335) groups. In the L group, regression analysis revealed a significant predictive value of IL-8 to percent of total body surface area (TBSA) burned and incidence of MOF (p<0.001). In the H group IL-8 levels were able to predict sepsis (p<0.002). In the H group, elevated IL-8 was associated with increased inflammatory and acute phase responses compared to the L group (p<0.05). High levels of IL-8 correlated with increased MOF, sepsis, and mortality. These data suggest that serum levels of IL-8 may be a valid biomarker for monitoring sepsis, infections, and mortality in burn patients. PMID:25514427

  13. Burn wound angiogenesis is increased by exogenously administered recombinant leptin in rats A administração exógena de leptina recombinante induz à angiogênese em queimaduras cutâneas provocadas em ratos

    OpenAIRE

    Ioannis Liapakis; Stavros Anagnostoulis; Anastasios Karayiannakis; Dimitris Korkolis; Maria Lambropoulou; Alan Matarasso; Constantinos Simopoulos

    2008-01-01

    BACKGROUND: Leptin is a potent direct angiogenic factor that stimulates endothelial cell migration and activation in vitro and angiogenesis in vivo. In addition, leptin has been discussed to play an important role in angiogenesis, as it promotes the formation of new blood vessels. PURPOSE: The effect of exogenously administered leptin on the healing process of a full tissue burn wound model. METHODS: Sixty-three Sprague-Dawley male rats were used. Full tissue burn wound was created by electro...

  14. Use of antibiotics in the management of postirradiation wound infection and sepsis

    International Nuclear Information System (INIS)

    Ionizing gamma irradiation depresses the host defenses and enhances the susceptibility of the immunocompromised host to local and systemic infection due to endogenous or exogenous microorganisms. Trauma and wounding act synergistically and decrease the survival after exposure to irradiation. The current antimicrobial agents suitable for controlling serious infections and their use in post irradiation local and systemic infection with and without trauma are discussed. The experience gained in managing immunocompromised patients following chemotherapy is reviewed. Empiric single agent or combination agent therapy should be directed at the eradication of potential gram-negative as well as gram-positive pathogens. The most important organisms known to cause these infections are Pseudomonas sp. and Enterobacteriaceae. Management of intra-abdominal infections following trauma should include early surgical correlation and antimicrobials directed against the Bacteroides fragilis group and Enterobacteriaceae. Staphylococcus aureus and Streptococcus pyogenes cause most skin and soft tissue infections following trauma. Chemoprophylaxis of enteric sources of systemic infection can be achieved by antimicrobials that selectively inhibit the Enterobacteriaceae sp. and preserve the anaerobic flora. The management of infection in the injured and irradiated host includes supportive and restorative therapy. Supportive therapy includes debridement and cleansing of wounds, fluids, immunoglobulin, and antimicrobials. Restorative therapy includes definite surgery repair and replenishment of the immune system by use of immunomodulators, growth factors, and bone marrow transplantation. Further studies are needed to examine the usefulness of presently available drugs and experimental agents in the irradiated and traumatized host. 111 references

  15. Use of antibiotics in the management of postirradiation wound infection and sepsis

    Energy Technology Data Exchange (ETDEWEB)

    Brook, I.

    1988-07-01

    Ionizing gamma irradiation depresses the host defenses and enhances the susceptibility of the immunocompromised host to local and systemic infection due to endogenous or exogenous microorganisms. Trauma and wounding act synergistically and decrease the survival after exposure to irradiation. The current antimicrobial agents suitable for controlling serious infections and their use in post irradiation local and systemic infection with and without trauma are discussed. The experience gained in managing immunocompromised patients following chemotherapy is reviewed. Empiric single agent or combination agent therapy should be directed at the eradication of potential gram-negative as well as gram-positive pathogens. The most important organisms known to cause these infections are Pseudomonas sp. and Enterobacteriaceae. Management of intra-abdominal infections following trauma should include early surgical correlation and antimicrobials directed against the Bacteroides fragilis group and Enterobacteriaceae. Staphylococcus aureus and Streptococcus pyogenes cause most skin and soft tissue infections following trauma. Chemoprophylaxis of enteric sources of systemic infection can be achieved by antimicrobials that selectively inhibit the Enterobacteriaceae sp. and preserve the anaerobic flora. The management of infection in the injured and irradiated host includes supportive and restorative therapy. Supportive therapy includes debridement and cleansing of wounds, fluids, immunoglobulin, and antimicrobials. Restorative therapy includes definite surgery repair and replenishment of the immune system by use of immunomodulators, growth factors, and bone marrow transplantation. Further studies are needed to examine the usefulness of presently available drugs and experimental agents in the irradiated and traumatized host. 111 references.

  16. Cografts of artificial dermis matrix and autogenetic split-thickness of repaired skin in severe hand wounds in patients with deep burns

    Directory of Open Access Journals (Sweden)

    Liu Hongqi

    2014-01-01

    Full Text Available The aim of this paper was to evaluate the effect of using artificial dermis matrix plus autologous split-thickness skin (ADM and ASTS in the treatment of deep-burns in hands of severely burned patients.We recruited a total of 58 patients with large area burns greater than 80% that were eschar-excised. Twenty-eight of them were treated with ADM and ASTS (test group; 30 were treated with autologous medium-thickness skin (AMTS (control group. The healing time of the hand wound was noted, clinical and photographic evaluations were performed, and a Jebsen-Taylor hand function test was compared and analyzed in the two groups. The wound healing time in the test group (24.22±3.34 days were longer than that of the control group (13.42±3.36 days and statistically significant. The healing time of skin graft donor sites was shorter than that of the control group (7.14±1.63 vs. 14.28±2.37 days and statistically significant (P<0.05. The 3rd and 6th month follow-up with clinical and functional evaluations revealed no differences between the two groups. In addition, there was no obvious scar formation and less pigmentation in either group. The repair of deeply burned hands with artificial dermis matrix was beneficial to both wound healing and the donor site, and was beneficial to the whole body rehabilitation of severely burned patients.

  17. Negative Pressure Wound Therapy on Surgical Site Infections in Women Undergoing Elective Caesarean Sections: A Pilot RCT

    OpenAIRE

    Wendy Chaboyer; Vinah Anderson; Joan Webster; Anne Sneddon; Lukman Thalib; Gillespie, Brigid M

    2014-01-01

    Obese women undergoing caesarean section (CS) are at increased risk of surgical site infection (SSI). Negative Pressure Wound Therapy (NPWT) is growing in use as a prophylactic approach to prevent wound complications such as SSI, yet there is little evidence of its benefits. This pilot randomized controlled trial (RCT) assessed the effect of NPWT on SSI and other wound complications in obese women undergoing elective caesarean sections (CS) and also the feasibility of conducting a defi...

  18. Human Wound Infection with Mannheimia glucosida following Lamb Bite.

    Science.gov (United States)

    Lau, Jillian S Y; Omaleki, Lida; Turni, Conny; Barber, Stuart Richard; Browning, Glenn Francis; Francis, Michelle J; Graham, Maryza; Korman, Tony M

    2015-10-01

    Mannheimia spp. are veterinary pathogens that can cause mastitis and pneumonia in domestic cattle and sheep. While Mannheimia glucosida can be found as normal flora in oral and respiratory mucosa in sheep, there have been no reported cases of human infection with this organism. PMID:26202121

  19. Effect of hBD2 genetically modified dermal multipotent stem cells on repair of infected irradiated wounds

    International Nuclear Information System (INIS)

    Deficiencies in repair cells and infection are two of the main factors that can hinder the process of wound healing. In the present study, we investigated the ability of human beta-defensin-2 (hBD2) genetically modified dermal multipotent stem cells (dMSCs) to accelerate the healing irradiated wounds complicated by infections. An hBD2 adenovirus expression vector (Adv-hBD2) was firstly constructed and used to infect dMSCs. The antibacterial activity of the supernatant was determined by Kirby-Bauer method and macrodilution broth assay. Time to complete wound healing, residual percentage of wound area, and the number of bacteria under the scar were measured to assess the effects of Adv-hBD2-infected dMSC transplantation on the healing of irradiated wounds complicated by Pseudomonas aeruginosa infection. Results showed that the supernatant from Adv-hBD2-infected dMSCs had obvious antibacterial effects. Transplantation of Adv-hBD2-infected dMSCs killed bacteria in the wound. The complete wound healing time was 19.8±0.45 days, which was significantly shorter than in the control groups (P<0.05). From 14 days after transplantation, the residual wound area was smaller in the experimental group than in the control groups (P<0.05). In conculsion, we found that transplantation of hBD2 genetically modified dMSCs accelerated the healing of wounds complicated by P. aeruginosa infection in whole body irradiated rats. (author)

  20. Photodynamic therapy with a cationic functionalized fullerene rescues mice from fatal wound infections

    Science.gov (United States)

    Lu, Zongshun; Dai, Tianhong; Huang, Liyi; Kurup, Divya B; Tegos, George P; Jahnke, Ashlee; Wharton, Tim; Hamblin, Michael R

    2011-01-01

    Aims Fullerenes are under intensive study for potential biomedical applications. We have previously reported that a C60 fullerene functionalized with three dimethylpyrrolidinium groups (BF6) is a highly active broad-spectrum antimicrobial photosensitizer in vitro when combined with white-light illumination. We asked whether this high degree of in vitro activity would translate into an in vivo therapeutic effect in two potentially lethal mouse models of infected wounds. Materials & methods We used stable bioluminescent bacteria and a low light imaging system to follow the progress of the infection noninvasively in real time. An excisional wound on the mouse back was contaminated with one of two bioluminescent Gram-negative species, Proteus mirabilis (2.5 × 107 cells) and Pseudomonas aeruginosa (5 × 106 cells). A solution of BF6 was placed into the wound followed by delivery of up to 180 J/cm2 of broadband white light (400–700 nm). Results In both cases there was a light-dose-dependent reduction of bioluminescence from the wound not observed in control groups (light alone or BF6 alone). Fullerene-mediated photodynamic therapy of mice infected with P. mirabilis led to 82% survival compared with 8% survival without treatment (p < 0.001). Photodynamic therapy of mice infected with highly virulent P. aeruginosa did not lead to survival, but when photodynamic therapy was combined with a suboptimal dose of the antibiotic tobramycin (6 mg/kg for 1 day) there was a synergistic therapeutic effect with a survival of 60% compared with a survival of 20% with tobramycin alone (p < 0.01). Conclusion These data suggest that cationic fullerenes have clinical potential as an antimicrobial photosensitizer for superficial infections where red light is not needed to penetrate tissue. PMID:21143031

  1. Surface enhanced Raman spectroscopy as a point-of-care diagnostic for infection in wound effluent

    Science.gov (United States)

    Ghebremedhin, Meron; Yesupriya, Shubha; Crane, Nicole J.

    2016-03-01

    In military medicine, one of the challenges in dealing with large combat-related injuries is the prevalence of bacterial infection, including multidrug resistant organisms. This can prolong the wound healing process and lead to wound dehiscence. Current methods of identifying bacterial infection rely on culturing microbes from patient material and performing biochemical tests, which together can take 2-3 days to complete. Surface Enhanced Raman Spectroscopy (SERS) is a powerful vibrational spectroscopy technique that allows for highly sensitive structural detection of analytes adsorbed onto specially prepared metal surfaces. In the past, we have been able to discriminate between bacterial isolates grown on solid culture media using standard Raman spectroscopic methods. Here, SERS is utilized to assess the presence of bacteria in wound effluent samples taken directly from patients. To our knowledge, this is the first attempt for the application of SERS directly to wound effluent. The utilization of SERS as a point-of-care diagnostic tool would enable physicians to determine course of treatment and drug administration in a matter of hours.

  2. Wound Chronicity, Inpatient Care, and Chronic Kidney Disease Predispose to MRSA Infection in Diabetic Foot Ulcers

    Science.gov (United States)

    Yates, Christopher; May, Kerry; Hale, Thomas; Allard, Bernard; Rowlings, Naomi; Freeman, Amy; Harrison, Jessica; McCann, Jane; Wraight, Paul

    2009-01-01

    OBJECTIVE To determine the microbiological profile of diabetes-related foot infections (DRFIs) and the impact of wound duration, inpatient treatment, and chronic kidney disease (CKD). RESEARCH DESIGN AND METHODS Postdebridement microbiological samples were collected from individuals presenting with DRFIs from 1 January 2005 to 31 December 2007. RESULTS A total of 653 specimens were collected from 379 individuals with 36% identifying only one isolate. Of the total isolates, 77% were gram-positive bacteria (staphylococci 43%, streptococci 13%). Methicillin-resistant Staphylococcus aureus (MRSA) was isolated from 23%; risk factors for MRSA included prolonged wound duration (odds ratio 2.31), inpatient management (2.19), and CKD (OR 1.49). Gram-negative infections were more prevalent with inpatient management (P = 0.002) and prolonged wound duration (P < 0.001). Pseudomonal isolates were more common in chronic wounds (P < 0.001). CONCLUSIONS DRFIs are predominantly due to gram-positive aerobes but are usually polymicrobial and increase in complexity with inpatient care and ulcer duration. In the presence of prolonged duration, inpatient management, or CKD, empiric MRSA antibiotic cover should be considered. PMID:19587371

  3. Healing Potentials of Oral Moringa Oleifera Leaves Extract and Tetracycline on Methicillin Resistant Staphylococcus Aureus Infected Wounds of Wistar rats.

    Science.gov (United States)

    Eyarefe, Oghenemega D; Idowu, Aderayo; Afolabi, Jeremiah M

    2015-01-01

    The effects of oral dose of aqueous extract of Moringa oleifera and tetracycline antibiotics on cutaneous wounds infected with Staphylococcus aureus were studied in eighteen adult wistar rats (159±31.5g) randomized into three groups: Group A, n = 6, Moringa oleifera-(300 mg/kg). Group B, n = 6, tetracycline (9.4 mg/kg) and Group C, n = 6, Sterile water (control). Six millimetres diameter nape wound, created on each rat under 2% xylazine (5 mg/kg) and 5% ketamine (35 mg/kg), was contaminated with Staphylococcus aureus (108 Colony Forming Unit (CFU). Following infection, treatment was commenced with daily oral dose of test preparations and the wounds were evaluated every other day i.e., day 3, 5, 7, 9, 11, 13 and 15 for wetness (wound exudation), wound edge oedema, hyperaemia, granulation tissues and contraction (diameter). Severe wound exudation existed in all the groups between days 0-3 (p = 1.00). A significantly less wound exudation was observed at days 3-5 (p = 0.000) and 5-9 (p = 0.003) (ControlMoringa). Wound edge oedema was significantly less on days 5-9 (p = 0.000) and 9-15 (p = 0.001) (ControlMoringaMoringa Moringa> Tetracycline). Differences in wound diameter was not significant except at days 5-9 (p = 0.013) (Control> Moringa >Tetracycline). Oral doses of Moringa oleifera extract (300mg/kg) and tetracycline (9.4mg/kg) are not effective as antimicrobial or immune-boosting agents to enhance healing of wounds infected with Staphylococcus aureus and hence not recommended for rapid clearance of Staphylococcus aureus infected wounds.

  4. Major bleeding during negative pressure wound/V.A.C.® - therapy for postsurgical deep sternal wound infection - a critical appraisal

    Directory of Open Access Journals (Sweden)

    Segers Patrique

    2011-09-01

    Full Text Available Abstract Negative-pressure wound therapy, commercially known as vacuum-assisted closure (V.A.C.® therapy, has become one of the most popular (and efficacious interim (prior to flap reconstruction or definite methods of managing deep sternal wound infection. Complications such as profuse bleeding, which may occur during negative-pressure therapy but not necessarily due to it, are often attributed to a single factor and reported as such. However, despite the wealth of clinical experience internationally available, information regarding certain simple considerations is still lacking. Garnering information on all the factors that could possibly influence the outcome has become more difficult due to a (fortunate decrease in the incidence of deep sternal wound infection. If more insight is to be gained from fewer clinical cases, then various potentially confounding factors should be fully disclosed before complications can be attributed to the technique itself or improvements to negative-pressure wound therapy for deep sternal wound infection can be accepted as evidence-based and the guidelines for its use adapted. The authors propose the adoption of a simple checklist in such cases.

  5. The Relationship Between Antibiotic Resistance and Agr Type in Methicillin-Resistant Staphylococcus aureus (MRSA Isolated From Burn Wound of Hospitalized Patient in Tehran

    Directory of Open Access Journals (Sweden)

    Mohammad Sadegh Vaziri

    2015-12-01

    Full Text Available Introduction: Staphylococcus aureus is the major cause of hospital and community-acquired infections. This bacterium possesses an accessory gene regulator (agr that plays role in colonization, expression of virulence factors and antibiotic resistance. It’s four major polypeptide with variable sequences lead to at least four agr type in S. aureus.The aim of this study was to determine the relationship between the antibiogram patterns with agr type of clinical S. aureus.Methods: Detection of methicillin-resistant Staphylococcus aureus (MRSA from burn wounds was performed by phenotypic and genotypic profiles. The antibiotics resistance pattern was determined by disk agar diffusion (Tigecycline (TGC, Ciprofloxacin(CIP, Erythromycin(E, Cloxacillin(CX, Clindamycin(CD, Imipenem(IMI, Co-trimoxazole(SXT, Kanamycin(K, Teicoplanin(TEC, Gentamicin(GM, Mupirocin(MUP, Ceftriaxone (CTR. The agr typing by PCR-RFLP method using the Restriction endonuclease ScaI was performed and spss19 was used for data analysis.Results: The total of 76 MRSA isolates was studied. The agr type distribution was 75.6% Type I, 8.2% Type II, 5.4% Type III, 10.8% type IV. The most antibiotics resistant agr type belongs to the type I. There was no significance relationship between every agr type and antibiotics but only a statistically significant association exist between CX, E, CTR, SXT, GM, CIP antibiotics and all agr types (P<0.05.Conclusion: There was no significance relationship between every agr type and antibiotics but significant relationship observed between resistance to some antibiotics with all agr types could be related to the number and source of isolated bacteria or extra use of these antibiotics. By considering that agr locus belongs to upstream genes so it may use the Quorum Sensing (QS system to induce the most drug resistance.

  6. Catheter-related infections in a northwestern São Paulo reference unit for burned patients care

    Directory of Open Access Journals (Sweden)

    Cláudio Penido Campos Júnior

    2010-04-01

    Full Text Available Despite improvements in care and rehabilitation of burned patients, infections still remain the main complication and death cause. Catheter-related infections are among the four most common infections and are associated with skin damage and insertion site colonization. There are few studies evaluating this kind of infection worldwide in this special group of patients. Padre Albino Hospital Burn Care Unit (PAHBCU is the only reference center in the Northwestern São Paulo for treatment of burned patients. This paper presents the results of a retrospective study aiming at describing the epidemiological and clinical features of catheter-related infections at PAHBCU.

  7. 糖尿病对烧伤创面氧化应激状态的影响%Effects of diabetes on oxidative stress in burn wounds

    Institute of Scientific and Technical Information of China (English)

    龚小花; 吴文俊; 陈雄; 周琦; 沈飞霞; 陈如俊

    2016-01-01

    Objective: To observe the metabolite level of oxidative stress in burned patients with or without type 2 diabetes mellitus, and to explore the relationship between oxidative stress and diabetic burned wounds. Methods: The patients were divided into 3 groups, including burned patients without DM (Burn group), burned patients with DM (DM-B group) and DM without burns. And another 21 healthy subjects were enrolled as con-trol group. The levels of superoxide dismutase (SOD) and malondialdehyde (MDA) in plasma and wounds were detected.Results: The plasma levels of SOD in the DM-B group, Burn group and DM group were lower than that of the control group (P<0.05). The plasma concentrations of MDA were statistically signiifcantly higher in the groups of DM-B, Burn and DM in comparison with the control group. The levels of SOD in the burn wounds were lower in DM-B group compared to Burn group on the 1st day following injury (P<0.05), which maintained until the 21st day. In DM-B group a statistically signiifcant increase of the MDA was observed from the 1st day until the 21st day.Conclusion: These data show evidence of a marked,long-lasting oxidative stress in burned patients with DM compared to the burned patients without DM. For this reason, burned patients with DM are rec-ommended to receive exogenous antioxidants.%目的:研究糖尿病(DM)对烧伤患者机体血清和烧伤创面氧化应激状态的影响,探讨DM烧伤创面愈合延迟或者不愈合发生的可能机制。方法:选择2型DM合并烧伤患者26例(DM-B组),单纯烧伤患者22例(Burn组),并选择同期匹配单纯DM患者20例(DM组)及健康人群21例(对照组)。收集受检者的空腹血清、创面组织标本测定超氧化物歧化酶(SOD)及丙二醛(MDA)水平。结果:①DM-B组、Burn组和DM组患者的血清标本中SOD活性、MDA水平与对照组比较差异均有统计学意义(P<0.05)。与Burn组比较,DM-B组血清SOD活性进

  8. Improved Surgical Site Infection (SSI) rate through accurately assessed surgical wounds

    OpenAIRE

    John, Honeymol; Nimeri, Abdelrahman; Ellahham, Samer

    2015-01-01

    Sheikh Khalifa Medical City's (SKMC) Surgery Institute was identified as a high outlier in Surgical Site Infections (SSI) based on the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) - Semi-Annual Report (SAR) in January 2012. The aim of this project was to improve SSI rates through accurate wound classification. We identified SSI rate reduction as a performance improvement and safety priority at SKMC, a tertiary referral center. We used the American Col...

  9. Predictive Value of IL-8 for Sepsis and Severe Infections After Burn Injury: A Clinical Study.

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Finnerty, Celeste C; Cox, Robert A; Song, Juquan; Jeschke, Marc G

    2015-03-01

    The inflammatory response induced by burn injury contributes to increased incidence of infections, sepsis, organ failure, and mortality. Thus, monitoring postburn inflammation is of paramount importance but, so far, there are no reliable biomarkers available to monitor and/or predict infectious complications after burn. As interleukin 8 (IL-8) is a major mediator for inflammatory responses, the aim of our study was to determine whether IL-8 expression can be used to predict postburn sepsis, infections, and mortality. Plasma cytokines, acute-phase proteins, constitutive proteins, and hormones were analyzed during the first 60 days after injury from 468 pediatric burn patients. Demographics and clinical outcome variables (length of stay, infection, sepsis, multiorgan failure [MOF], and mortality) were recorded. A cutoff level for IL-8 was determined using receiver operating characteristic analysis. Statistical significance is set at P Patients were grouped according to their average IL-8 levels relative to this cutoff and stratified into high (H) (n = 133) and low (L) (n = 335) groups. In the L group, regression analysis revealed a significant predictive value of IL-8 to percent of total body surface area burned and incidence of MOF (P inflammatory and acute-phase responses compared with the L group (P burn patients.

  10. Genome Sequence of a Virulent Pseudomonas aeruginosa Strain, 12-4-4(59), Isolated from the Blood Culture of a Burn Patient.

    Science.gov (United States)

    Karna, S L Rajasekhar; Chen, Tsute; Chen, Ping; Peacock, Trent J; Abercrombie, Johnathan J; Leung, Kai P

    2016-03-03

    Pseudomonas aeruginosa is an opportunistic pathogen that frequently infects wounds, significantly impairs wound healing, and causes morbidity and mortality in burn patients. Here, we report the genome sequence of a virulent strain of P. aeruginosa, 12-4-4(59), isolated from the blood culture of a burn patient.

  11. Effectiveness of Natural Antifungal Compounds in Controlling Infection by Grapevine Trunk Disease Pathogens through Pruning Wounds.

    Science.gov (United States)

    Cobos, Rebeca; Mateos, Rosa María; Álvarez-Pérez, José Manuel; Olego, Miguel Angel; Sevillano, Silvia; González-García, Sandra; Garzón-Jimeno, Enrique; Coque, Juan José R

    2015-09-01

    Grapevine trunk fungal pathogens, such as Diplodia seriata and Phaeomoniella chlamydospora, can infect plants through pruning wounds. They cause grapevine trunk diseases and are involved in grapevine decline. Accordingly, the protection of pruning wounds is crucial for the management of grapevine trunk diseases. The efficacy of different natural antifungals in inhibiting the growth of several fungi causing grapevine trunk diseases was evaluated in vitro. The fungi showing greater in vitro efficacy were tested on autoclaved grape wood assays against D. seriata and P. chlamydospora. Based on results from these assays, chitosan oligosaccharide, vanillin, and garlic extract were selected for further evaluation on pruning wounds inoculated with D. seriata and P. chlamydospora in field trials. A significant decrease in plant mortality was observed after 2 years of growth in the plants treated with the different natural antifungals compared to the mortality rate observed in infected plants that were not treated with antifungals. Also, the infection rate for the inoculated pathogens was significantly reduced in plants treated with the selected natural antifungals. Therefore, natural antifungals represent a promising alternative for disease control and could provide significant economic benefits for the grape-growing industry. PMID:26162882

  12. Antimicrobial activities against biofilm formed by Proteus mirabilis isolates from wound and urinary tract infections

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    R Wasfi

    2012-01-01

    Full Text Available Background: Bacterial species are capable of living as biofilm and/or planktonic forms. There is increasing evidence for the role of bacterial biofilm in various wound and urinary tract infections (UTIs. The aim of the present study was to evaluate the ability of the bacteria, isolated from urinary tract infections (UTIs and wound infections, to form biofilm and correlate the role of biofilm with their antimicrobial resistance. Materials and Methods: All the isolated bacteria were screened for their ability to form biofilm using the microtitre plate method. Results: Wound isolates of Staphylococcus aureus and Enterobacter sp. had more biofilm forming capacity than the UTI isolates. Proteus mirabilis isolates were among the strongest biofilm forming bacteria and were chosen for antimicrobial study. In sub-MIC concentrations of antimicrobial agents used, ciprofloxacin was found to be the most effective in decreasing biofilm formation. On the other hand, ceftriaxone and ciprofloxacin were effective in partial removal of preformed biofilm biomass. Conclusion: Ciprofloxacin was more effective in killing bacterial cells especially at high antimicrobial concentrations that could be reached in urine levels and can be used in impregenating catheters.

  13. A new flexible DBD device for treating infected wounds: in vitro and ex vivo evaluation and comparison with a RF argon plasma jet

    International Nuclear Information System (INIS)

    Cold plasma has been shown to provide a promising alternative antimicrobial treatment for wound healing. We developed and tested a flexible surface dielectric barrier discharge (DBD) and compared it to an argon gas based plasma jet operated remotely with a distance between plasma plume and sample of 8 mm. Tests were conducted using different models: on cultured cells, on ex vivo human skin and on bacteria (Pseudomonas aeruginosa) (on agar, in suspension, in collagen/elastin matrix or on ex vivo human skin), allowing us to directly compare bactericidal with safety aspects under identical conditions. Both plasma devices were highly efficient when used on bacteria in non-buffered solutions, but DBD was faster in reaching the maximum bacterial reduction. Treatment of bacteria on intact skin with DBD resulted in up to 6 log reductions in 3 min. The jet was far less efficient on intact skin. Even after 8 min treatment no more than 2 log reductions were obtained with the jet. Treatment of bacteria in burn wound models with DBD for 6 min resulted in a 4.5 log reduction. Even when using DBD for 6 min on infected burn wound models with colonizing or biofilm phase bacteria, the log reductions were 3.8 or 3.2 respectively. DBD plasma treatment for 6 min did not affect fibroblast viability, whereas a treatment for 8 min was detrimental. Similarly, treatment with DBD or plasma jet for 6 min did also not affect the metabolic activity of skin biopsies. After treatment for 8 min with DBD or plasma jet, 78% or 60% of activity in skin biopsies remained, respectively. Multiple treatments of in vitro burn wound models with surface DBD for 6 min or with plasma jet for 8 min did not affect re-epithelialization. With the flexible surface DBD plasma strip we were able to quickly inactivate large numbers of bacteria on and in skin. Under the same conditions, viability of skin cells or re-epithelialization was not affected. The DBD source has potential for treating

  14. A new flexible DBD device for treating infected wounds: in vitro and ex vivo evaluation and comparison with a RF argon plasma jet

    Science.gov (United States)

    Boekema, B. K. H. L.; Vlig, M.; Guijt, D.; Hijnen, K.; Hofmann, S.; Smits, P.; Sobota, A.; van Veldhuizen, E. M.; Bruggeman, P.; Middelkoop, E.

    2016-02-01

    Cold plasma has been shown to provide a promising alternative antimicrobial treatment for wound healing. We developed and tested a flexible surface dielectric barrier discharge (DBD) and compared it to an argon gas based plasma jet operated remotely with a distance between plasma plume and sample of 8 mm. Tests were conducted using different models: on cultured cells, on ex vivo human skin and on bacteria (Pseudomonas aeruginosa) (on agar, in suspension, in collagen/elastin matrix or on ex vivo human skin), allowing us to directly compare bactericidal with safety aspects under identical conditions. Both plasma devices were highly efficient when used on bacteria in non-buffered solutions, but DBD was faster in reaching the maximum bacterial reduction. Treatment of bacteria on intact skin with DBD resulted in up to 6 log reductions in 3 min. The jet was far less efficient on intact skin. Even after 8 min treatment no more than 2 log reductions were obtained with the jet. Treatment of bacteria in burn wound models with DBD for 6 min resulted in a 4.5 log reduction. Even when using DBD for 6 min on infected burn wound models with colonizing or biofilm phase bacteria, the log reductions were 3.8 or 3.2 respectively. DBD plasma treatment for 6 min did not affect fibroblast viability, whereas a treatment for 8 min was detrimental. Similarly, treatment with DBD or plasma jet for 6 min did also not affect the metabolic activity of skin biopsies. After treatment for 8 min with DBD or plasma jet, 78% or 60% of activity in skin biopsies remained, respectively. Multiple treatments of in vitro burn wound models with surface DBD for 6 min or with plasma jet for 8 min did not affect re-epithelialization. With the flexible surface DBD plasma strip we were able to quickly inactivate large numbers of bacteria on and in skin. Under the same conditions, viability of skin cells or re-epithelialization was not affected. The DBD source has potential for treating

  15. Clinical Trial on the Incidence of Wound Infection and Patient Satisfaction After Stoma Closure: Comparison of Two Skin Closure Techniques

    OpenAIRE

    Yoon, Sang Il; Bae, Sun Mi; Namgung, Hwan; Park, Dong Guk

    2015-01-01

    Purpose Surgical site infection (SSI) is one of the most common complications that can occur after stoma closure. Reports have described differences in the incidence of wound infection depending on the skin closure technique, but there is no consensus on the ideal closure technique for a stoma wound. The aim of this study was to compare the incidence of SSI and the patient satisfaction between a circumferential purse-string approximation (CPA) and a primary linear closure (PC) of a stoma woun...

  16. Herpes simplex virus infection in burned patients: epidemiology of 11 cases.

    Science.gov (United States)

    Bourdarias, B; Perro, G; Cutillas, M; Castede, J C; Lafon, M E; Sanchez, R

    1996-06-01

    Burned patients suffer significant immunosuppression during the first 3 or 4 weeks after hospitalization. Herpes simplex virus (HSV) infections are commonly seen in immunosuppressed patients and may account for considerable morbidity and some mortality. We studied retrospectively 11 patients with severe burn injury who became infected with HSV. We determined the prevalence of viral infection in this group of patients. Serological testing and viral culture was used to diagnose HSV infection. No general complications appeared in these 11 patients in association with HSV but two patients died of multiorgan failure. Locally, areas of active epidermal regeneration were most commonly affected. Acyclovir therapy was not used and the duration of hospitalization was normal in these 11 patients. PMID:8781721

  17. ASSISTANCE FOR BURNED SINK PATIENTS AT HOSPITAL BY THE PERSPECTIVE OF INFECTION CONTROL: A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Ariadna Pires Damaceno

    2002-06-01

    Full Text Available The infection in burnings is very common, involve of the main mechanism of defense: the skin. Thus,this study aimed to identify and to analyze the measures adopted for the prevention and control of the infectionsrelated to this area. The research was constituted by a case study and data were obtained from systemizeobservation and of a questionnaire applied to the teams medical and of nursing of a unit of handling of burnnings ofthe city of Goiânia. The results showed deficiencies related to the infection control and pointed to the need of thetrainmen and update in infection control as direct patient’s care as in articles processing used for this care.Therefore the adequacy of procedure to the prevention and control of the nosocomial infections becomesnecessary.

  18. [The present status, counter-measures and new trends on burn infection].

    Science.gov (United States)

    Xiao, Guang-xia

    2007-04-01

    In recent fifty years, Pseudomonas aeruginosa and Staphylococcus aureus were continuously the predominant in burn infections, the only change seen was a rapid increase in their drug-resistance. Under the pressure of antibiotics, Some opportunistic bacteria that were resistant to all available antibiotics emerged, such as Acinetobacter baumanii and Maltophilia stenotrophomonas. For critically burn patients, basing on early surgical intervention, early and short-term use of broad-spectrum antibiotic is advisable, and it may control the infection promptly, prevent further inflammatory reaction, as well as minimize the emergence of antibacterial resistance. To control infections due to pandrug-resistant bacteria, cyclic use of some old antibiotics may be helpful. In dealing with severe infection, a combination of anti-pathogen and anti-inflammatory reaction measures should be considered. PMID:17649876

  19. MANAGEMENT OF β-LACTAMASE PRODUCERS THROUGH INFECTION CONTROL MEASURES IN BURN ICU

    OpenAIRE

    Nachhatarjit; Kanwardeep; Maninder; Kaminderdeep; Aruna

    2015-01-01

    BACKGROUND AND OBJECTIVES Multi-Drug Resistant (MDR) pathogens due to various β-lactamases are major contributors in increasing morbidity and mortality rates in Burn Intensive Care Units, ICU. This study is aimed to apply the various infection control measures and to compare the results of two halves of study and to establish a relation between environment, Health Care Workers (HCWs) and patients regarding manifestation of nosocomial infection. DESIGN AND SETTING ...

  20. 烧伤创面愈合的理论探索与临床实践%Basic and clinical research in the field of burn wound healing

    Institute of Scientific and Technical Information of China (English)

    陆树良

    2008-01-01

    The basic and clinical research in wound healing have made great progress in China in the past 50 years. The method of " intermingle skin transplantation" which was first advocated by surgeons of Ruijin Hospital in 1966 greatly reduced the amount of autologous donor skin, thus making the coverage of an extensive burn wound possible. This method is al so known as " Chinese therapy". In 1986,doctors of Jishuitan Hospital reported successful coverage of an extensive burn wound with mieroautografts and allogeneic skin. The basic research of wound healing has been carried out since 1992,a series of studies showed the characteristics of biological behaviours of cells in concern, extracellular matrix and growth factor, the mechanism underlying progressive injury in deep second burn wound, the effect of " skin island" and the local immune tolerance induced by it (which are the key factors of intermingle transplantation).The induction of local immune tolerance has now become the re search hot subject of skin transplantation immunology. Stem cell research in the field of wound healing has been extensively car ried out. The theory of " dermal template defection" has been proposed as one of the mechanisms of scar formation. On the other hand, great progress has been achieved in the treatment of bums on the basis of clinical researches. Doctors of PLA 304 hospital found that excision of eschar on patients with extensive deep burn injury at early shock stage greatly decreased the occurrence of complications and mortality. Doctors of Ruijin Hospital reported that healing of deep second burn wound could be improved by tangential excision of burn eschar within 24 hours after burn injury. Doctors of Xiang ya Hospital reported patients suffering from deep bums of the hands got satisfied functional restoration when treated with tangential excision of eschar while degraded dermal tissue could be retained with transplantation of autoskin grafts.

  1. Epoetin Alpha and Epoetin Zeta: A Comparative Study on Stimulation of Angiogenesis and Wound Repair in an Experimental Model of Burn Injury

    Directory of Open Access Journals (Sweden)

    Natasha Irrera

    2015-01-01

    Full Text Available Deep second-degree burns are characterized by delayed formation of granulation tissue and impaired angiogenesis. Erythropoietin (EPO is able to stimulate angiogenesis and mitosis, activating vascularization and cell cycle. The aim of our study was to investigate whether two biosimilar recombinant human erythropoietins, EPO-α and EPO-Z, may promote these processes in an experimental model of burn injury. A total of 84 mice were used and a scald burn was produced on the back after shaving, in 80°C water for 10 seconds. Mice were then randomized to receive EPO-α (400 units/kg/day/sc or EPO-Z (400 units/kg/day/sc or their vehicle (100 μL/day/sc 0.9% NaCl solution. After 12 days, both EPO-α and EPO-Z increased VEGF protein expression. EPO-α caused an increased cyclin D1/CDK6 and cyclin E/CDK2 expression compared with vehicle and EPO-Z (p<0.001. Our study showed that EPO-α and EPO-Z accelerated wound closure and angiogenesis; however EPO-α resulted more effectively in achieving complete skin regeneration. Our data suggest that EPO-α and EPO-Z are not biosimilars for the wound healing effects. The higher efficacy of EPO-α might be likely due to its different conformational structure leading to a more efficient cell proliferation and skin remodelling.

  2. Contact dermatitis presenting as non-healing wound: case report

    OpenAIRE

    Leelavathi M; Le YY; Tohid H; Hasliza AH

    2011-01-01

    Abstract Topical antiseptics are commonly used in the management of minor wounds, burns, and infected skin. These agents are widely used by health professionals and are often self-prescribed by patients as they are easily available over-the-counter. This case illustrates a 73 year old man who presented with a non-healing wound on his right forearm for 4 weeks. The wound started from an insect bite and progressively enlarged with increasing pruritus and burning sensation. Clinically an ill-def...

  3. Superficially, longer, intermittent ozone theraphy in the treatment of the chronic, infected wounds.

    Science.gov (United States)

    Białoszewski, Dariusz; Kowalewski, Michał

    2003-10-30

    Background. Ozone therapy - i.e. the treatment of patients by a mixture of oxygen and ozone - has been used for many years as a method ancillary to basic treatment, especially in those cases in which traditional treatment methods do not give satisfactory results, e.g. skin loss in non-healing wounds, ulcers, pressure sores, fistulae, etc. Material and methods. In the Department of Phisiotherapy of the Medical Faculty and the Department of the Orthopedics and Traumatology of the Locomotor System at the Medical University of Warsaw in the period from January 2001 until November 2002, 23 patients with heavy,chronic, antibiotic resistants septic complications after trauma, surgical procedures and secundary skin infetions were treated with ozone. The ozone therapy was administered using an authorial technique of superficially, longer, intermittent ozone application. Results. In the wounds of the all experienced patients the inhibition of septic processes and wound healing was much faster than normal. Conclusions. Our data confirm the advantages wich result from the technique of superficially, longer, intermittent ozone theraphy in combined treatment for septic complications in the soft tissue, especially in the locomotor system. These technique makes posttraumatic infections and promotes quicker healing of post-surgical and post-traumal complications - chronic septic infections. This method also lowers the cost of antibiotic therapy and is sometimes the only available auxiliary technique to support surgical procedures.

  4. Superficially, longer, intermittent ozone theraphy in the treatment of the chronic, infected wounds.

    Science.gov (United States)

    Białoszewski, Dariusz; Kowalewski, Michał

    2003-10-30

    Background. Ozone therapy - i.e. the treatment of patients by a mixture of oxygen and ozone - has been used for many years as a method ancillary to basic treatment, especially in those cases in which traditional treatment methods do not give satisfactory results, e.g. skin loss in non-healing wounds, ulcers, pressure sores, fistulae, etc. Material and methods. In the Department of Phisiotherapy of the Medical Faculty and the Department of the Orthopedics and Traumatology of the Locomotor System at the Medical University of Warsaw in the period from January 2001 until November 2002, 23 patients with heavy,chronic, antibiotic resistants septic complications after trauma, surgical procedures and secundary skin infetions were treated with ozone. The ozone therapy was administered using an authorial technique of superficially, longer, intermittent ozone application. Results. In the wounds of the all experienced patients the inhibition of septic processes and wound healing was much faster than normal. Conclusions. Our data confirm the advantages wich result from the technique of superficially, longer, intermittent ozone theraphy in combined treatment for septic complications in the soft tissue, especially in the locomotor system. These technique makes posttraumatic infections and promotes quicker healing of post-surgical and post-traumal complications - chronic septic infections. This method also lowers the cost of antibiotic therapy and is sometimes the only available auxiliary technique to support surgical procedures. PMID:17679848

  5. Novel curcumin-loaded gel-core hyaluosomes with promising burn-wound healing potential: Development, in-vitro appraisal and in-vivo studies.

    Science.gov (United States)

    El-Refaie, Wessam M; Elnaggar, Yosra S R; El-Massik, Magda A; Abdallah, Ossama Y

    2015-01-01

    Despite its effectiveness, curcumin (Curc) dermal delivery is handicapped by hydrophobicity, high metabolism and poor skin permeation. In this work, the potential of novel self-assembled nanogels, namely gel-core hyaluosome (GC-HS) to enhance Curc delivery to wound sites, enhance healing rate and decrease scar formation was evaluated. Curc-GC-HS were prepared using film hydration technique and evaluated regarding size, zeta potential (ZP), entrapment efficiency (% EE), and in vitro release. Structure elucidation was performed using light, polarizing and transmission electron microscopy (TEM). In-vivo burn-wound healing potential, skin deposition ability and histological study were evaluated using female Sprague Dawley rats. Curc-GC-HS were compared to conventional transfersomal gel (Curc-T-Pl gel), and other conventional gels. Curc-GC-HS showed nanosize (202.7 ± 0.66 nm), negative ZP (-33 ± 2.6 mV) and % EE (96.44 ± 1.29%). TEM revealed discrete vesicles with characteristic bilayer structure. Polarizing microscopy proposed liquid crystalline consistency. Burn-wound healing study showed that Curc-GC-HS was the only system exhibiting marked improvement at day 7 of treatment. At 11th day, Curc-GC-HS treated wounds showed almost normal skin with no scar confirmed by histological analysis. Curc-GC-HS showed five folds higher skin deposition compared to conventional Curc-T-Pl gel. To conclude, novel gel-core hyaluosomes elaborated are promising nanogels able to increase Curc skin penetration and dermal localization while protecting it against degradation. Future perspective encompasses assessing potential of novel nanocarrier for skin cancer therapy.

  6. 弱激光疗法治疗烧伤创面的疗效观察%Clinical Effect Observation of Treating Burn Wound with Low Level Laser Therapy

    Institute of Scientific and Technical Information of China (English)

    孙春红; 陈刚; 闫柏刚

    2014-01-01

    目的:探讨弱激光疗法对于治疗烧伤创面愈合的影响。方法:采用前瞻性研究方法对我院自2012年11月至2013年09月收治的度烧伤患者92例,随机分为对照组(41例)和观察组(51例),对照组采用常规治疗,观察组采用常规治疗联合弱激光疗法治疗。观察两组治疗效果。结果两组患者在治疗7d和14d时愈合率无差异(P>0.05),治疗21d后观察组创面愈合率明著高于对照组(P<0.05)。观察组创面平均愈合时间、局部感染发生率、抗生素平均使用时间及平均住院天数明著优于对照组(P<0.05)。结论弱激光疗法对于治疗烧伤创面的愈合具有显著作用。%Objective Investigate the effects of low level laser therapy for the treatment of burn wound. Methods Choosed 92 pa-tients suffered  degree burns wound from November 2012 to September 2013 were randomly divided into control group (41 cases) and study group (51 cases), which Control group treatment with conventional, and study group treatment combined with conventional and low level laser therapy. Compared the effects of two groups. Results Two groups of patients in the treatment of 7d and 14d when healing was no difference (P>0.05), The healing rates of study group better than control group significantly in the treatment of 21 day (P<0.05). Average healing time of study group, the incidence of local infection, antibiotics average time significantly better than the control group (P<0.05).Conclusion Low Level Laser Therapy for the treatment of burn wounds have a significant effect.

  7. 聚氨基葡萄糖羧酸钠在烧伤创面应用中的临床疗效观察%Clinical Observation on the Therapeutic Effect of Glucosamine Carboxylic Acid Sodium Therapy for Burn Wounds

    Institute of Scientific and Technical Information of China (English)

    潘维诚

    2014-01-01

    [ABSTRACT]Objective: To investigate the therapeutic effect of Glucosamine carboxylic acid sodium (Shuyoukang) of the burn wounds. Methods:50 patients from January 2013 to June 2013 admitted to burn department of our hospital were chosen.30 cases ofⅡ° burn wound patients set their own controls who were divided into group A (Shuyoukang group) and group B (Vaseline group) according to the wound treatment;another 20 cases underwent skin graft surgery who were divided into group C (Shuyoukang group) and D (Vaseline group).Pain degree, healing period, infection state, drug reactions, and aesthetic appearance of the patients were observed and compared.. Results:Compared with those of the BD control group, AC group were decreased in the sense of pain (P>0.05).Wound healing time of AC group was significantly increased (P0.05);There was no difference on drug reactions and aesthetic appearance. Conclusion: Glucosamine carboxylic acid sodium medical biological colloid has a good histocompatibility, apparently promoteⅡ° burn wound healing and donor sites.%目的:探讨聚氨基葡萄糖羧酸钠医用生物胶体液(术优康)对烧伤创面的治疗作用。方法:以2013年1月至2013年6月我院烧伤科收治的50例患者为研究对象,其中30例Ⅱ°烧伤患者设自身创面对照,根据创面处理情况分为A组(术优康组)和B组(凡士林组);另20例患者行植皮手术,以大腿前外侧为供皮区,根据创面处理情况分为C组(术优康组)和D组(凡士林组)。观察各组患者换药时疼痛感、创面愈合时间、创面感染情况、创面愈合后外观及药物反应。结果:A、C组相比B、D组换药时疼痛感较轻,无显著差异(P>0.05),创面愈合时间明显提前,比较有显著差异(P<0.05);A组较B组创面感染发生率无显著差异(P>0.05);创面愈合后外观无明显差别;无明显药物反应。结论:聚氨基葡萄糖羧酸钠医用生

  8. Low dose of lipopolysaccharide pretreatment can alleviate the inflammatory response in wound infection mouse model

    Institute of Scientific and Technical Information of China (English)

    Dong Wang; Yang Liu; Yan-Rui Zhao; Jun-Lin Zhou

    2016-01-01

    Purpose:To assess the effects of lipopolysaccharide (LPS) pretreatment on wound infection mouse model and evaluate the biological safety of the optimal pretreatment dose in vivo.Methods:Mice were pretreated with LPS of different doses at 48 and 24 h before femoral medial longitudinal incision was made and infected with different bacteria.Results:It is showed that 0.5 mg/kg/time of LPS pretreatment can significantly alleviate the inflammation in mouse model infected with methicillin-resistances Staphylococcus aureus,methicillin-sensitive S.aureus,Pseudomonas aeruginosa,or Escherichia coli compared with doses of 0.25 mg/kg/time,1 mg/kg/time,and 1.5 mg/kg/time.Conclusions:LP5 pretreatment can alleviate the inflammation in mouse model and the optimal dose is 0.5 mg/kg/time,and meanwhile it does not damage organs' function.

  9. Growth factors, silver dressings and negative pressure wound therapy in the management of hard-to-heal postoperative wounds in obstetrics and gynecology: a review

    OpenAIRE

    Stanirowski, Paweł Jan; Wnuk, Anna; Cendrowski, Krzysztof; Sawicki, Włodzimierz

    2015-01-01

    Purpose The last two decades witnessed the development of numerous innovative regimens for the management of patients with abnormally healing and infected wounds. Growth factors, negative pressure wound therapy (NPWT) and antiseptic dressings containing silver are examples of methods with best documented efficacy, being widely used in the treatment of acute and chronic post-traumatic wounds, burns and ulcers of various etiology. As far as obstetrics and gynecology are concerned, prevention an...

  10. Establishment of wound care center and development of burns and plastic surgery discipline%伤口治疗中心建立与烧伤整形学科发展

    Institute of Scientific and Technical Information of China (English)

    刘毅

    2011-01-01

    @@ 伴随着我国社会经济的高速发展,人民生活水平日益提高,生活习惯和饮食习惯逐渐发生变化,由此也导致疾病谱出现相应改变.以糖尿病为例,我国糖尿病发病率呈逐年增高的趋势.%To study the interaction between establishment of wound care center and development of discipline of burns and plastic surgery. The changes in number of outpatient,time for dressing change per patient, outpatient service income,number of inpatients and operations in our hospital were summarized and retrospectively analyzed before and after establishment of wound care center. The proportion of patients with chronic wounds and skin and soft tissue defects after trauma among all inpatients in the same term were investigated. Meanwhile, the development of discipline of burns and plastic surgery before and after establishment of wound care center was analyzed. Compared with those in the year before establishment of wound care center, outpatient number, time for dressing change per patient,outpatient service income, inpatient number, and amount of operations were all increased(with increase rate of 330% , 569%,325%, 161% , and 173%, respectively) in the year after establishment of wound care center. The ratio of patients with chronic wounds and skin and soft tissue defects after trauma among all inpatients was respectively increased from 4.3% and 4.5% in the year before establishment of wound care center to 9.2% and 12.4% in the year after establishment of wound care center. Patient satisfaction, bed utilization rate, levels of wound treatment and repair were all improved after establishment of wound care center. So we come to conclusions as follows. Establishment of wound care center can promote development of the standard of burns and plastic surgery. Comprehensive use of multidisciplinary theories and techniques concerning burns, plastic and aesthetic surgery, medical aesthetics, etc. can be beneficial for improvement of quality of wound

  11. Prevention of abdominal wound infection (PROUD trial, DRKS00000390: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Heger Ulrike

    2011-11-01

    Full Text Available Abstract Background Wound infection affects a considerable portion of patients after abdominal operations, increasing health care costs and postoperative morbidity and affecting quality of life. Antibacterial coating has been suggested as an effective measure to decrease postoperative wound infections after laparotomies. The INLINE metaanalysis has recently shown the superiority of a slowly absorbable continuous suture for abdominal closure; with PDS plus® such a suture has now been made available with triclosan antibacterial coating. Methods/Design The PROUD trial is designed as a randomised, controlled, observer, surgeon and patient blinded multicenter superiority trial with two parallel groups and a primary endpoint of wound infection during 30 days after surgery. The intervention group will receive triclosan coated polydioxanone sutures, whereas the control group will receive the standard polydioxanone sutures; abdominal closure will otherwise be standardized in both groups. Statistical analysis is based on intention-to-treat population via binary logistic regression analysis, the total sample size of n = 750 is sufficient to ensure alpha = 5% and power = 80%, an interim analysis will be carried out after data of 375 patients are available. Discussion The PROUD trial will yield robust data to determine the effectiveness of antibacterial coating in one of the standard sutures for abdominal closure and potentially lead to amendment of current guidelines. The exploration of clinically objective parameters as well as quality of life holds immediate relevance for clinical management and the pragmatic trial design ensures high external validity. Trial Registration The trial protocol has been registered with the German Clinical Trials Register (DRKS00000390.

  12. Effect of double-layer human amnion on wound healing in deep second-degree burns of animals%复层人羊膜覆盖治疗深Ⅱ度烫伤创面的动物实验

    Institute of Scientific and Technical Information of China (English)

    宋炬赫; 樊昌东; 李瑶

    2008-01-01

    proved to be normal skin at post-injury 12 days by means of light microscope, scanning electron microscope and transmission electron microscope. Bacteriology was detected to be negative.CONCLUSION: Double-layer radiation-treated human amnion plays a protective role on the burn wound in rats. It may facilitate epithelial growth, avoid wound infection and accelerate the healing of deep second-degree burn.

  13. [Advancement of maggot including living body to treat chronic infected wounds].

    Science.gov (United States)

    Zhang, Zhen; Wang, Shouyu; Diao, Yunpeng; Zhang, Houli; Huang, Shanshan; Lv, Decheng

    2009-12-01

    Human has used maggot to treat diseases for thousands of years. In recent years, with abuse of antibiotic and the rising incidence of antibiotic resistance, maggot therapy, as a surgical alternative, is mainly applied to treat chronic infected wounds on account of its low cost, efficacy and safety. Its mechanisms are disinfection, bio-debridement and enhancement of tissue regeneration. Maggot therapy which serves as a kind of biological therapy is promising. However, living maggot therapy could result in inevitable complications, so that we should apply traditional Chinese medicine theory to investigate and develop new delivery method of maggot. The review summarizes the past and present of maggot therapy.

  14. Effect of apple cider vinegar on the healing of experimentally–induced wounds infected with Pseudomonas aeruginosa

    Directory of Open Access Journals (Sweden)

    A. H. Alawi

    2008-01-01

    Full Text Available Standard wounds were made in the backs of 18 rabbits. The rabbits were then divided into 6 equal groups. Rabbits of group (1, constituted a control group and their wounds were treated with physiological saline solution. In group (2, the wounds were treated with Cefotaxime at a concentration of 500 mg. Wounds of the third, fourth, and fifth groups were treated with 5%, 3.75%, and 2.5% apple cider vinegar respectively. Wounds of the sixth groups of rabbits were treated with a combination of equal amounts of Cefotaxime and apple cider vinegar 3.75%. All of the wounds were infected with various isolates of Pseudomonas aeruginosa at the time of infected. Wound treatment was done each 48 hours until complete healing. Results of this study indicated that using apple cider vinegar 3.75% gave results similar to those obtained by using the antibiotic (same rates of bacterial reduction. However, using a combination of equal amounts of apple cider vinegar and the antibiotic lead to more rapid and more better healing than using each one of them alone.

  15. 噬菌体治疗创面细菌感染研究进展%Advances in the treatment of wound bacterial infection with phage

    Institute of Scientific and Technical Information of China (English)

    崔泽龙

    2015-01-01

    The treatment of wound bacterial infection is an extremely difficult problem in clinic, especially in patients with large wounds which are infected by multidrug resistant, pan-resistant or omni-resistant bacteria.In recent years, with a grim prospect of antibiotic resistance, phage therapy is re-valued by researchers after being ignored for nearly half a century.Phage therapy has made great achievements in prevention and control of bacterial infection of open wounds.This review is mainly focused on the latest research progress of phage therapy in wound bacterial infection.

  16. Can we use C-reactive protein levels to predict severe infection or sepsis in severely burned patients?

    Science.gov (United States)

    Jeschke, Marc G; Finnerty, Celeste C; Kulp, Gabriela A; Kraft, Robert; Herndon, David N

    2013-01-01

    This is a large cohort analysis in severely burned pediatric children to determine whether C-reactive protein (CRP) can be used as a predictor for severe infection or sepsis. Nine-hundred eighteen pediatric burn patients were enrolled in this study. CRP values were measured throughout acute hospitalization and for up to 6 months postburn. Demographic data, incidence of infection, surgical interventions and other relevant clinical information was compiled from medical records. We performed an extensive literature search to identify models that other groups have developed to determine the effects of CRP levels postburn to assess the value of these parameters as predictors of sepsis or severe infection. Statistical analysis was performed using ANOVA and regression analysis where appropriate. Three-hundred fifteen female and 603 male pediatric patients were enrolled in this study. Average total body surface area (TBSA) burn was 45±23%, with full thickness burn over 32±27% TBSA, and patients were 7±6 years old. CRP values significantly correlated with burn size, survival and gender. Significantly higher levels of CRP were found in large burns, in non-survivors, and in females, p<0.05. Using various described models to determine whether CRP levels change before and after an event can predict sepsis or severe infection, we found that CRP cannot predict severe infection or sepsis. Although CRP is a marker of the inflammatory response postburn, CRP fails to predict infection or sepsis in severely burn patients. PMID:23875119

  17. Exploring quality of life, physical and psychosocial morbidity for patients with non-infected wounds: a pilot study

    OpenAIRE

    Ousey, Karen; Edward, Karen-leigh; Stephenson, John

    2014-01-01

    This article reports on the results of a pilot study exploring health-related quality of life and the experience of being resilient in patients who develop acute, non-infected surgical wounds. By investigating this under-researched area of wound management, the project team intended to highlight the aspects of patient empowerment in healing post-surgery, encompassing the physical, social and psychological domains. Participants were recruited from patients who had undergone a surgical procedur...

  18. Methods for identifying surgical wound infection after discharge from hospital: a systematic review

    Directory of Open Access Journals (Sweden)

    Moore Peter J

    2006-11-01

    Full Text Available Abstract Background Wound infections are a common complication of surgery that add significantly to the morbidity of patients and costs of treatment. The global trend towards reducing length of hospital stay post-surgery and the increase in day case surgery means that surgical site infections (SSI will increasingly occur after hospital discharge. Surveillance of SSIs is important because rates of SSI are viewed as a measure of hospital performance, however accurate detection of SSIs post-hospital discharge is not straightforward. Methods We conducted a systematic review of methods of post discharge surveillance for surgical wound infection and undertook a national audit of methods of post-discharge surveillance for surgical site infection currently used within United Kingdom NHS Trusts. Results Seven reports of six comparative studies which examined the validity of post-discharge surveillance methods were located; these involved different comparisons and some had methodological limitations, making it difficult to identify an optimal method. Several studies evaluated automated screening of electronic records and found this to be a useful strategy for the identification of SSIs that occurred post discharge. The audit identified a wide range of relevant post-discharge surveillance programmes in England, Scotland and Wales and Northern Ireland; however, these programmes used varying approaches for which there is little supporting evidence of validity and/or reliability. Conclusion In order to establish robust methods of surveillance for those surgical site infections that occur post discharge, there is a need to develop a method of case ascertainment that is valid and reliable post discharge. Existing research has not identified a valid and reliable method. A standardised definition of wound infection (e.g. that of the Centres for Disease Control should be used as a basis for developing a feasible, valid and reliable approach to defining post

  19. Reduction in Surgical Wound Infection Rates Associated with Reporting Data to Surgeons

    Directory of Open Access Journals (Sweden)

    GD Taylor

    1994-01-01

    Full Text Available Several studies have shown that wound infection (surgical site infection [ ssi ] rates fall when surgeons are provided with data on their performance. Since 1987, the authors have been performing concurrent surveillance of surgical patients and confidentially reporting surgeon-specific ssi rates to individual surgeons and their clinical directors, and providing surgeons with the mean rates of their peers. The program has been gradually refined and expanded. Data are now collected on wound infection risk and report risk adjusted rates compared with the mean for hospitals in the United States National Nosocomial Infections Surveillance (nnis data bank. Since inception through to December 1993, ssi rates have fallen 68% in clean contaminated general surgery cases (relative risk [rr] 0.36, 95% ci 0.2 to 0.6, P=0.0001, 64% in clean plastic surgery cases (rr 0.35, 95% ci 0.06 to 1.8, 72% in caesarean section cases (rr 0.23, 95% ci 0.03 to 1.96 and 42% in clean cardiovascular surgery cases (rr 0.59, 95% ci 0.34 to 1.0. In clean orthopedic surgery the ssi rate remained stable from 1987 through 1992. In 1993 a marked increase was experienced. Reasons for this are being explored. Overall there was a 32% decrease in ssi rate between the index year and 1993 or, in percentage terms, 2.8% to 1.9% (rr 0.65, 95% ci 0.51 to 0.86, P=0.002. ssi surveillance should become standard in Canadian hospitals interested in improving the quality of surgical care and reducing the clinical impact and cost associated with nosocomial infection.

  20. Clinical identification of bacteria in human chronic wound infections: culturing vs. 16S ribosomal DNA sequencing

    Directory of Open Access Journals (Sweden)

    Rhoads Daniel D

    2012-11-01

    Full Text Available Abstract Background Chronic wounds affect millions of people and cost billions of dollars in the United States each year. These wounds harbor polymicrobial biofilm communities, which can be difficult to elucidate using culturing methods. Clinical molecular microbiological methods are increasingly being employed to investigate the microbiota of chronic infections, including wounds, as part of standard patient care. However, molecular testing is more sensitive than culturing, which results in markedly different results being reported to clinicians. This study compares the results of aerobic culturing and molecular testing (culture-free 16S ribosomal DNA sequencing, and it examines the relative abundance score that is generated by the molecular test and the usefulness of the relative abundance score in predicting the likelihood that the same organism would be detected by culture. Methods Parallel samples from 51 chronic wounds were studied using aerobic culturing and 16S DNA sequencing for the identification of bacteria. Results One hundred forty-five (145 unique genera were identified using molecular methods, and 68 of these genera were aerotolerant. Fourteen (14 unique genera were identified using aerobic culture methods. One-third (31/92 of the cultures were determined to be Staphylococcus aureus, Pseudomonas aeruginosa, and Enterococcus faecalis with higher relative abundance scores were more likely to be detected by culture as demonstrated with regression modeling. Conclusion Discordance between molecular and culture testing is often observed. However, culture-free 16S ribosomal DNA sequencing and its relative abundance score can provide clinicians with insight into which bacteria are most abundant in a sample and which are most likely to be detected by culture.

  1. Effect of near-infrared diode laser and indocyanine green to treat infections on different wound models

    Science.gov (United States)

    Topaloglu, Nermin; Yuksel, Sahru; Gulsoy, Murat

    2014-05-01

    The emergence of antibiotic resistant bacteria causes significant increase in deaths due to wound infections around the world. Nowadays, it could be impossible to find appropriate antibiotics to treat some bacterial strains, especially multidrug resistant types. The aim of this study is to use photodynamic therapy that destroys these kinds of bacteria with the interaction of Indocyanine green (ICG) and 808-nm diode laser. In this study, antibacterial Photodynamic Therapy technique that we call ICG-IR Laser PDT was applied on antibiotic-resistant strains of Staphylococcus aureus that infected two different types of wound model (excisional and abrasion wound model) in vivo. Wistar albino rats were used to create animal wound models. Excisional or abrasion wounds were formed on the dorsal skin of the rats. They were infected with Staphylococcus aureus. 300 mW and 500 mW of 808-nm diode laser were applied on the wounds for 30 minutes and 15 minutes of exposure duration, respectively. ICG concentrations applied topically were 500, 1000, 1500 and 2000 μg/ml. Then the tissue was dissected properly and homogenized in buffer solution. From this solution, bacterial cell count was determined by serial dilution method. 1-2 log reduction in viable cell count was observed after these applications. The temperature increase in the tissue was between 6-8°C during these applications. From these findings, it was understood that this method with 808-nm and ICG is promising but it must be improved by further dosimetry studies.

  2. Does single application of topical chloramphenicol to high risk sutured wounds reduce incidence of wound infection after minor surgery? Prospective randomised placebo controlled double blind trial

    OpenAIRE

    Heal, Clare F; Petra G Buettner; Cruickshank, Robert; Graham, David; Browning, Sheldon; Pendergast, Jayne; Drobetz, Herwig; Gluer, Robert; Lisec, Carl

    2009-01-01

    Objective To determine the effectiveness of a single application of topical chloramphenicol ointment in preventing wound infection after minor dermatological surgery. Design Prospective randomised placebo controlled double blind multicentre trial. Setting Primary care in a regional centre in Queensland, Australia. Participants 972 minor surgery patients. Interventions A single topical dose of chloramphenicol (n=488) or paraffin ointment (n=484; placebo). Main outcome measure Incidence of infe...

  3. Bacterial Respiratory Tract Infections are Promoted by Systemic Hyperglycemia after Severe Burn Injury in Pediatric Patients

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Mlcak, Ronald P; Finnerty, Celeste C; Cox, Robert A; Williams, Felicia N; Jeschke, Marc G

    2014-01-01

    Background Burn injuries are associated with hyperglycemia leading to increased incidence of infections with pneumonia being one of the most prominent and adverse complication. Recently, various studies in critically ill patients indicated that increased pulmonary glucose levels with airway/blood glucose threshold over 150 mg/dl lead to an overwhelming growth of bacteria in the broncho-pulmonary system, subsequently resulting in an increased risk of pulmonary infections. The aim of the present study was to determine whether a similar cutoff value exists for severely burned pediatric patients. Methods One-hundred six severely burned pediatric patients were enrolled in the study. Patients were divided in two groups: high (H) defined as daily average glucose levels >75% of LOS >150 mg/dl), and low (L) with daily average glucose levels >75% of the LOS mechanical ventilation (L: 21% H: 32%) and off mechanical ventilation (L: 5% H: 15%), as well as ARDS were significantly higher in the high group (L: 3% H: 19%), p<0.05, while atelectasis was not different. Patients in the high group required significantly longer ventilation compared to low patients (p<0.05). Furthermore, incidence of infection and sepsis were significantly higher in the high group, p<0.05. Conclusion Our results indicate that systemic glucose levels over 150 mg/dl are associated with a higher incidence of pneumonia confirming the previous studies in critically ill patients. PMID:24074819

  4. Novel application of vacuum sealing drainage with continuous irrigation of potassium permanganate for managing infective wounds of gas gangrene.

    Science.gov (United States)

    Hu, Ning; Wu, Xing-Huo; Liu, Rong; Yang, Shu-Hua; Huang, Wei; Jiang, Dian-Ming; Wu, Qiang; Xia, Tian; Shao, Zeng-Wu; Ye, Zhe-Wei

    2015-08-01

    Traumatic gas gangrene is a fatal infection mainly caused by Clostridium perfringens. It is a challenge to manage gas gangrene in open wounds and control infection after debridement or amputation. The aim of the present study was to use vacuum sealing drainage (VSD) with continuous irrigation of potassium permanganate to manage infective wounds of gas gangrene and observe its clinical efficacy. A total of 48 patients with open traumatic gas gangrene infection were included in this study. Amputations were done for 27 patients, and limb salvage procedures were performed for the others. After amputation or aggressive debridement, the VSD system, including polyvinyl alcohol (PVA) foam dressing and polyurethane (PU) film, with continuous irrigation of 1:5000 potassium permanganate solutions, was applied to the wounds. During the follow-up, all the patients healed without recurrence within 8-18 months. There were four complications. Cardiac arrest during amputation surgery occurred in one patient who suffered from severe septic shock. Emergent resuscitation was performed and the patient returned to stable condition. One patient suffered from mixed infection of Staphylococcal aureus, and a second-stage debridement was performed. One patient suffered from severe pain of the limb after the debridement. Exploratory operation was done and the possible reason was trauma of a local peripheral nerve. Three cases of crush syndrome had dialysis treatment for concomitant renal failure. In conclusion, VSD can convert open wound to closed wound, and evacuate necrotic tissues. Furthermore, potassium permanganate solutions help eliminate anaerobic microenvironment and achieve good therapeutic effect on gas gangrene and mixed infection. VSD with continuous irrigation of potassium permanganate is a novel, simple and feasible alternative for severe traumatic open wounds with gas gangrene infection. PMID:26223928

  5. 烧伤患者真菌感染分析%A clinical study of fungal infection in burn patients

    Institute of Scientific and Technical Information of China (English)

    罗高兴; 吴军; 张家平; 罗奇志; 黄跃生; 彭毅志; 聂志宏; 张晓兵; 庄颖; 袁志强; 张立辉; 周秘; 程文广

    2009-01-01

    Objective To address the features of the fungal infection after burn injury in clinic.Methods Three thousand nine hundred and nine bum patients admitted to our institute from Jan. 2003 to Dec. 2006 were involved in this study. Two thousand two hundred and seventy-one samples were harvested for fungal detection by culture from 467 patients suspected to be infected by fungi based on their clinic mani-festations. The collected samples included wound tissue, blood, urine, stool, sputum, catheters and others.The antibiotic sensitivity of the identified fungi were determined by routine method. When same kind of fun-gus was found from different samples taken from one patient, it was recorded as one positive sample. The samples were ranked in an ascending order as wound secretion, stool, urine, sputum and bronchia alveolar lavage fluid, arteriovenous catheter or urinary catheter, blood. Only the positive sample of the highest rank source was recorded as the positive strain of fungus from this particular patient. Results It was found 61 fungal positive samples from the 2271 samples collected. Out of 467 patients, 38 strains of fungi were detec-ted from 36 bum patients during the investigated period, the incidence was O. 92% (36/3909). The most three commonest types among the identified 38 strains of fungi were Candida tropicalis (42.1%), Candida albicans (31.6%) and Candida famata (T. Famata, 10.5% ). The drug sensitivity tests demonstrated that most of the strains detected in this investigation, with the exception of candida galbrata, were sensitive to most of the routine antimyeotics agents such as Amphotericin B, Fluconazol, and ltraconazole etc. Among the 36 fungus positive patients, in 18 patients the burn area exceeded 80% TBSA, 12 patients with 50%-79% TBSA, 4 patients with 30% -49% TBSA, and in 2 patients the burn area was smaller than 30% TBSA. It was found most of the fungal infections(77.78% ) occurred 2 weeks after burn injury, and 8 of the 36 fun-gus-infected

  6. Early infection during burn-induced inflammatory response results in increased mortality and p38-mediated neutrophil dysfunction.

    Science.gov (United States)

    Adediran, Samuel G; Dauplaise, Derrick J; Kasten, Kevin R; Tschöp, Johannes; Dattilo, Jonathan; Goetzman, Holly S; England, Lisa G; Cave, Cindy M; Robinson, Chad T; Caldwell, Charles C

    2010-09-01

    Following burn injury, the host is susceptible to bacterial infections normally cleared by healthy patients. We hypothesized that during the systemic immune response that follows scald injury, the host's altered immune status increases infection susceptibility. Using a murine model of scald injury under inhaled anesthesia followed by intraperitoneal infection, we observed increased neutrophil numbers and function at postburn day (PBD) 1 compared with sham-burned and PBD4 mice. Further, increased mortality, bacteremia, and serum IL-6 were observed in PBD1 mice after Pseudomonas aeruginosa (PA) infection compared with sham-burned and PBD4 mice infected with PA. To examine these disparate responses, we investigated neutrophils isolated at 5 and 24 h following PA infection from PBD1 and sham-burned mice. Five hours after infection, there was no significant difference in number of recruited neutrophils; however, neutrophils from injured mice had decreased activation, active-p38, and oxidative burst compared with sham-burned mice. In direct contrast, 24 h after infection, we observed increased numbers, active-p38, and oxidative burst of neutrophils from PBD1 mice. Finally, we demonstrated that in neutrophils isolated from PBD1 mice, the observed increase in oxidative burst was p38 dependent. Altogether, neutrophil activation and function from thermally injured mice are initially delayed and later exacerbated by a p38-dependent mechanism. This mechanism is likely key to the observed increase in bacterial load and mortality of PBD1 mice infected with PA.

  7. Strategies for prevention and cure of burn infection%烧伤感染防治对策

    Institute of Scientific and Technical Information of China (English)

    郇京宁; 高成金

    2009-01-01

    Infection is still the major cause of death in severe burn patients, thus the optimization of antibiotic therapy is an important approach to the annihilation of pathogenic bacte-ria and the decrease of drug-resistance bacteria. It is urgent for burn surgeons to face the selection pressure of antibiotics and the fungous infections following the incorrect use of antibiotics. Re-gardless of its complexity, the treatment of sepsis associated with post-burn bacterial infections should be systematical. Besides the effective anti-shock therapy, early enteral feeding, excision of necrotic tissues, and effective anti-infection treatment, the immunological regulation and the prevention and cure of coagula-tion disorders are necessary in the treatment of severely burned patients.

  8. Biobased silver nanocolloid coating on silk fibers for prevention of post-surgical wound infections

    Directory of Open Access Journals (Sweden)

    Dhas SP

    2015-10-01

    Full Text Available Sindhu Priya Dhas, Suruthi Anbarasan, Amitava Mukherjee, Natarajan Chandrasekaran Center for Nanobiotechnology, VIT University, Vellore, India Abstract: Bombyx mori silk fibers are an important biomaterial and are used in surgical sutures due to their remarkable biocompatibility. The major drawback to the application of biomaterials is the risk of bacterial invasion, leading to clinical complications. We have developed an easy and cost-effective method for fabrication of antibacterial silk fibers loaded with silver nanoparticles (AgNPs by an in situ and ex situ process using an aqueous extract of Rhizophora apiculata leaf. Scanning electron microscopy revealed that well dispersed nanoparticles impregnated the silk fibers both in situ and ex situ. The crystalline nature of the AgNPs in the silk fibers was demonstrated by X-ray diffraction. The thermal and mechanical properties of the silk fibers were enhanced after they were impregnated with AgNPs. The silver-coated silk fibers fabricated by the in situ and ex situ method exhibited more than 90% inhibition against Pseudomonas aeruginosa and Staphylococcus aureus. Silk fibers doped with AgNPs were found to be biocompatible with 3T3 fibroblasts. The results obtained represent an important advance towards the clinical application of biocompatible AgNP-loaded silk fibers for prevention of surgical wound infections. Keywords: silk fibers, silver nanoparticles, antibacterial activity, wound infections, cytotoxicity, 3T3 fibroblast cells

  9. 烧伤患者医院感染相关因素分析%Analysis of related factors for nosocomial infections among burn patients

    Institute of Scientific and Technical Information of China (English)

    谢金; 沈光裕; 林欣; 林明南

    2012-01-01

    OBJECTIVE To investigate the related factors of nosocomial infections among burn patients so as to take effective measures for prevention and control of nosocomial infections. METHODS We carried out a retrospective survey of 3220 burn patients from Jan 2007 to Dec 2009. RESULTS The incidence of nosocomial infections was 12. 7% in the patients aged less than 3 years old and 32. 4% in the patients aged more than 60 years old ,which was significantly higher than 8. 2% in the patients aged from 3 to 59 years of age. the difference in the incidence of nosocomial infections among the three groups was statistically significant (χ2 =69. 328, P<0. 01); the incidence of nosocomial infections during 3 time periods were 1.4% (5-20d) ,4. 4% (21-40d) , and 46. 5% (more than 40d), the difference was statistically significant (χ2 =981. 248, P<0.01); the incidence of nosocomial infections of the light burn was 1. 5% , the moderate burn 7. 1%, the severe burn 78. 4%, the difference was statistically significant (χ2 = 1606. 598. P<0.01). The infection rate in tracheotomy group was significantly higher than that in non-tracheotomy group ( 68.1% vs 3. 4%),the difference was statistically significant (χ2 = 59.077, P<0. 01) i the top 3 infection sites were in order as follows: burn wound, respiratory tract, and gastrointestinal tract. CONCLUSION Nosocomial infections are related to the age, hospital stay, severity of the burn, and tracheotomy. It is necessary to take active, targeted prevention measures.%目的 了解烧伤患者发生医院感染的相关因素,以采取有效的预防和控制措施.方法 对2007年1月-2009年12月3220例烧伤患者进行回顾性调查分析.结果 医院感染的发生率<3岁者为12.7%、>60岁患者为32.4%,明显高于3~59岁组(8.2%),3组年龄段患者医院感染率差异有统计学意义(x2=69.328,P<0.01);住院3个时间段5~20、21~40 d和>40 d发生的医院感染率分别为1.4%、4.4%和46.5

  10. Comparison of post-operative wound infection after inguinal hernia repair with polypropylene mesh and polyester mesh

    International Nuclear Information System (INIS)

    Objective: To compare post operative wound infection frequency after inguinal hernia repair with polypropylene and polyester mesh using standard Lichtenstein hernioplasty technique. Study Design: Randomized controlled trial. Place and Duration: This study was conducted at general surgery department CMH/MH Rawalpindi from 8th April 2007 to 1st Jan 2008 over a period of 09 months. Patients and Materials: Sixty patients received through outpatient department with diagnosis of inguinal hernia satisfying inclusion/exclusion criteria were included. Patients were divided into two groups randomly. Group 1 included those patients in whom polypropylene mesh was used while group II patients were implanted with polyester mesh. Demographic as well as data concerning post operative wound infection was collected and analyzed. Results: Fifty seven patients (95%) were males while remaining (05%) were females. Mean age in group I was 41.17+-9.99 years while in group II was 41.47+-9.79 years (p=0.907). One patient (3.3%) in each group developed wound infection diagnosed by clinical evidence of pain at wound site, redness, induration and purulent discharge. Conclusion: There is no difference in post operative wound infection rate after inguinal Lichtenstein hernioplasty using either polypropylene or polyester mesh. (author)

  11. Personalized Therapeutic Cocktail of Wild Environmental Phages Rescues Mice from Acinetobacter baumannii Wound Infections.

    Science.gov (United States)

    Regeimbal, James M; Jacobs, Anna C; Corey, Brendan W; Henry, Matthew S; Thompson, Mitchell G; Pavlicek, Rebecca L; Quinones, Javier; Hannah, Ryan M; Ghebremedhin, Meron; Crane, Nicole J; Zurawski, Daniel V; Teneza-Mora, Nimfa C; Biswas, Biswajit; Hall, Eric R

    2016-10-01

    Multidrug-resistant bacterial pathogens are an increasing threat to public health, and lytic bacteriophages have reemerged as a potential therapeutic option. In this work, we isolated and assembled a five-member cocktail of wild phages against Acinetobacter baumannii and demonstrated therapeutic efficacy in a mouse full-thickness dorsal infected wound model. The cocktail lowers the bioburden in the wound, prevents the spread of infection and necrosis to surrounding tissue, and decreases infection-associated morbidity. Interestingly, this effective cocktail is composed of four phages that do not kill the parent strain of the infection and one phage that simply delays bacterial growth in vitro via a strong but incomplete selection event. The cocktail here appears to function in a combinatorial manner, as one constituent phage targets capsulated A. baumannii bacteria and selects for loss of receptor, shifting the population to an uncapsulated state that is then sensitized to the remaining four phages in the cocktail. Additionally, capsule is a known virulence factor for A. baumannii, and we demonstrated that the emergent uncapsulated bacteria are avirulent in a Galleria mellonella model. These results highlight the importance of anticipating population changes during phage therapy and designing intelligent cocktails to control emergent strains, as well as the benefits of using phages that target virulence factors. Because of the efficacy of this cocktail isolated from a limited environmental pool, we have established a pipeline for developing new phage therapeutics against additional clinically relevant multidrug-resistant pathogens by using environmental phages sourced from around the globe. PMID:27431214

  12. Longitudinal study of horses for carriage of methicillin-resistant Staphylococcus aureus following wound infections.

    Science.gov (United States)

    Bergström, Karin; Bengtsson, Björn; Nyman, Ann; Grönlund Andersson, Ulrika

    2013-05-01

    An outbreak of methicillin-resistant Staphylococcus aureus (MRSA) infections in horses in Sweden raised questions concerning the risk posed by horses to their surroundings following MRSA infections. This initiated a longitudinal study to investigate how long MRSA-infected horses remained positive and to test the sensitivity of different anatomical sampling sites for detection of MRSA. Between October 2008 and June 2010, 9 of 15 horses notified as having MRSA-infected wounds fitted the case criteria for the study. The cases were sampled at five anatomical sites (nostrils, corner of mouth, pastern, perineum, and previous infection site) on six to seven occasions or more during approximately 12-18 months. MRSA-specific broth and agar were used for culture. Verified MRSA isolates were spa-typed. The sensitivity of sampling sites was calculated. The most sensitive sampling site was the nostrils, with a sensitivity of 0.91 (95% CI: 0.59-1.00). The other test sites had a sensitivity of 0-0.09. Individual cases tested positive, but with time all tested negative. The observed carriage time ranged from 55 to 711 days (median=143, IQR: 111-172 days), but these data should be interpreted with caution since only a small number of cases were studied. PMID:23428383

  13. Can we use C-reactive protein levels to predict severe infection or sepsis in severely burned patients?

    OpenAIRE

    Jeschke, Marc G.; Finnerty, Celeste C.; Kulp, Gabriela A; Kraft, Robert; Herndon, David N

    2013-01-01

    This is a large cohort analysis in severely burned pediatric children to determine whether C-reactive protein (CRP) can be used as a predictor for severe infection or sepsis. Nine-hundred eighteen pediatric burn patients were enrolled in this study. CRP values were measured throughout acute hospitalization and for up to 6 months postburn. Demographic data, incidence of infection, surgical interventions and other relevant clinical information was compiled from medical records. We performed an ...

  14. Stan scheller: the forerunner of clinical studies on using propolis for poor and chronic nonhealing wounds.

    Science.gov (United States)

    Kucharzewski, M; Kubacka, S; Urbanek, T; Wilemska-Kucharzewska, K; Morawiec, T

    2013-01-01

    For hundreds of years poor and chronic nonhealing wounds have constituted a serious problem to medicine. What is more, treating such wounds is an expensive let alone a long-lasting process. The following paper describes Professor Scheller's achievements in using propolis for poor and chronic non-healing wounds. The authors' intention was to present the results connected with the use of the ethanolic extract propolis, in the treatment of patients suffering from burns, venous crural ulceration, local sacral bone pressure ulcers, suppurative osteitis and arthritis, suppurative postoperative local wound complications, and infected traumatic wounds.

  15. The efficacy of hydrogel dressings as a first aid measure for burn wound management in the pre-hospital setting: a systematic review of the literature.

    Science.gov (United States)

    Goodwin, Nicholas S; Spinks, Anneliese; Wasiak, Jason

    2016-08-01

    The aim of this systematic review was to determine the supporting evidence for the clinical use of hydrogel dressings as a first aid measure for burn wound management in the pre-hospital setting. Two authors searched three databases (Ovid Medline, Ovid Embase and The Cochrane Library) for relevant English language articles published through September 2014. Reference lists, conference proceedings and non-indexed academic journals were manually searched. A separate search was conducted using the Internet search engine Google to source additional studies from burns advisory agencies, first aid bodies, military institutions, manufacturer and paramedic websites. Two authors independently assessed study eligibility and relevance of non-traditional data forms for inclusion. Studies were independently assessed and included if Hydrogel-based burn dressings (HBD) were examined in first aid practices in the pre-hospital setting. A total of 129 studies were considered for inclusion, of which no pre-hospital studies were identified. The review highlights that current use of HBD in the pre-hospital setting appears to be driven by sources of information that do not reflect the paramedic environment. We recommend researchers in the pre-hospital settings undertake clinical trials in this field. More so, the review supports the need for expert consensus to identify key demographic, clinical and injury outcomes for clinicians and researchers undertaking further research into the use of dressings as a first aid measure.

  16. The efficacy of hydrogel dressings as a first aid measure for burn wound management in the pre-hospital setting: a systematic review of the literature.

    Science.gov (United States)

    Goodwin, Nicholas S; Spinks, Anneliese; Wasiak, Jason

    2016-08-01

    The aim of this systematic review was to determine the supporting evidence for the clinical use of hydrogel dressings as a first aid measure for burn wound management in the pre-hospital setting. Two authors searched three databases (Ovid Medline, Ovid Embase and The Cochrane Library) for relevant English language articles published through September 2014. Reference lists, conference proceedings and non-indexed academic journals were manually searched. A separate search was conducted using the Internet search engine Google to source additional studies from burns advisory agencies, first aid bodies, military institutions, manufacturer and paramedic websites. Two authors independently assessed study eligibility and relevance of non-traditional data forms for inclusion. Studies were independently assessed and included if Hydrogel-based burn dressings (HBD) were examined in first aid practices in the pre-hospital setting. A total of 129 studies were considered for inclusion, of which no pre-hospital studies were identified. The review highlights that current use of HBD in the pre-hospital setting appears to be driven by sources of information that do not reflect the paramedic environment. We recommend researchers in the pre-hospital settings undertake clinical trials in this field. More so, the review supports the need for expert consensus to identify key demographic, clinical and injury outcomes for clinicians and researchers undertaking further research into the use of dressings as a first aid measure. PMID:26177570

  17. Vacuum-assisted closure therapy for infected perineal wounds after abdominoperineal resection. A retrospective cohort study

    NARCIS (Netherlands)

    Walma, M S; Burbach, J P M; Verheijen, P M; Pronk, A; van Grevenstein, W M U

    2016-01-01

    INTRODUCTION: Perineal wound complications are a main problem after abdominoperineal resection (APR). There is little evidence concerning perineal wound management. This study describes and evaluates the role of vacuum-assisted closure (VAC) therapy in wound management strategies of perineal wound i

  18. The Role of CHI3L1 (Chitinase-3-Like-1 in the Pathogenesis of Infections in Burns in a Mouse Model.

    Directory of Open Access Journals (Sweden)

    Stefan Bohr

    Full Text Available In severe burn injury the unique setting of a depleted, dysfunctional immune system along with a loss of barrier function commonly results in opportunistic infections that eventually proof fatal. Unfortunately, the dynamic sequence of bacterial contamination, colonization and eventually septic invasion with bacteria such as Pseudomonas species is still poorly understood although a limiting factor in clinical decision making. Increasing evidence supports the notion that inhibition of bacterial translocation into the wound site may be an effective alternative to prevent infection. In this context we investigated the role of the mammalian Chitinase-3-Like-1 (CHI3L1 non-enyzmatic protein predominately expressed on epithelial as well as innate immune cells as a potential bacterial-translocation-mediating factor. We show a strong trend that a modulation of chitinase expression is likely to be effective in reducing mortality rates in a mouse model of burn injury with superinfection with the opportunistic PA14 Pseudomonas strain, thus demonstrating possible clinical leverage.

  19. 大面积烧伤合并创面脓毒症40例临床分析%The Clinical Analyse of 40 Patients with Massive Burn combined Wound Sepsis

    Institute of Scientific and Technical Information of China (English)

    李孟和; 何梦龙

    2014-01-01

    目的:总结烧伤合并创面脓毒症的临床特点和防治措施。方法:回顾性分析我科2007年1月至2012年12月收治的烧伤合并创面脓毒症40例的临床资料。结果:治愈32例,死亡8例。结论:烧伤早期休克渡过不平稳及创面早期处理不当易致创面脓毒症,预防强调积极有效的液体复苏、早期肠道营养、加强代谢与免疫调理、尽早封闭创面及加强多器官功能保护与支持,治疗强调以创面处理为核心的综合治疗策略,尽早手术覆盖封闭深度创面是救治成功的关键。%Objective:To summarize the clinical characteristics , preventive and treatment measures of burn combined wound sepsis. Methods: The clinical data of 40 patients with massive burn combined wound sepsis were analyzed from Jan 2007 to Dec 2012. Results: 32 cases were cured and 8 cases died. Conclusion: Early unstable burn shock and improper wound treatment may cause wound sepsis. It was very important for prevention of burn wound sepsis to strengthen proper fluid resuscitation , positive and effective early enteral nutrition , and eary wound closure as soon as possible,immune regulation, and the protection and support of multiple organ function;Comprehensive therapy strategy to wound burn sepsis was the core management , and the operation of covering depth wound as soon as possible was the key to treat burn wound sepsis successly.

  20. Postoperative abdominal wound infection – epidemiology, risk factors, identification, and management

    Directory of Open Access Journals (Sweden)

    Azoury SC

    2015-09-01

    Full Text Available Saïd C Azoury,1 Norma Elizabeth Farrow,2 Qing L Hu,2 Kevin C Soares,1 Caitlin W Hicks,1 Faris Azar,1 Nelson Rodriguez-Unda,3 Katherine E Poruk,1 Peter Cornell,1 Karen K Burce,1 Carisa M Cooney,3 Hien T Nguyen,1 Frederic E Eckhauser1 1Department of Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA; 2School of Medicine, Johns Hopkins University, Baltimore, MD, USA; 3Department of Plastic and Reconstructive Surgery, The Johns Hopkins Hospital, Baltimore, MD, USA Abstract: Surgical site infections (SSIs complicate the postoperative course of a significant proportion of general abdominal surgical patients and are associated with excessive health care costs. SSIs increase postoperative morbidity and mortality, and may require hospital admission, intravenous antibiotics, and even surgical reintervention. Risks associated with SSIs are related to both host and perioperative factors. However, a vast majority of these infections are preventable. More recently, quality initiative programs such as American College of Surgeons National Surgical Quality Improvement Program are expanding their roles to help better monitor adherence to improvement measures. Indeed, standardizing preoperative antibiotic prophylaxis timing is perhaps the most persuasive example and this has been integral to reducing postoperative SSI rates. Herein, the authors provide an update on the epidemiology, risk factors, identification, and management of wound infections following abdominal surgery. Keywords: surgical site infection, diagnosis, treatment, prevention

  1. Bacterial Respiratory Tract Infections are Promoted by Systemic Hyperglycemia after Severe Burn Injury in Pediatric Patients

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Mlcak, Ronald P; Finnerty, Celeste C; Cox, Robert A; Williams, Felicia N; Jeschke, Marc G

    2014-01-01

    Background Burn injuries are associated with hyperglycemia leading to increased incidence of infections with pneumonia being one of the most prominent and adverse complication. Recently, various studies in critically ill patients indicated that increased pulmonary glucose levels with airway/blood glucose threshold over 150 mg/dl lead to an overwhelming growth of bacteria in the broncho-pulmonary system, subsequently resulting in an increased risk of pulmonary infections. The aim of the present study was to determine whether a similar cutoff value exists for severely burned pediatric patients. Methods One-hundred six severely burned pediatric patients were enrolled in the study. Patients were divided in two groups: high (H) defined as daily average glucose levels >75% of LOS >150 mg/dl), and low (L) with daily average glucose levels >75% of the LOS <150 mg/dl). Incidences of pneumonia, atelectasis, and acute respiratory distress syndrome (ARDS) were assessed. Incidence of infections, sepsis, and respiratory parameters were recorded. Blood was analyzed for glucose and insulin levels. Statistical analysis was performed using Student’s t-test and chi-square test. Significance was set at p<0.05. Results Patient groups were similar in demographics and injury characteristics. Pneumonia in patients on the mechanical ventilation (L: 21% H: 32%) and off mechanical ventilation (L: 5% H: 15%), as well as ARDS were significantly higher in the high group (L: 3% H: 19%), p<0.05, while atelectasis was not different. Patients in the high group required significantly longer ventilation compared to low patients (p<0.05). Furthermore, incidence of infection and sepsis were significantly higher in the high group, p<0.05. Conclusion Our results indicate that systemic glucose levels over 150 mg/dl are associated with a higher incidence of pneumonia confirming the previous studies in critically ill patients. PMID:24074819

  2. 早期应用特异性iRNA对防治烧伤患者感染的作用及机理研究%The Effect and Mechanism of Early Specific Immune RNA for Preventing Infection in Burned Patients

    Institute of Scientific and Technical Information of China (English)

    卓安山; 陈爱娟; 陈金江

    2001-01-01

    Objective To explore the effect and mechanism of early using specific immune RNA (iRNA) for preventing burn infection.Method 129 patients with serious burn were randomly divided into two groups by double blind method. The control group (n=64) was treated with routine method; The therapeutic group(n= 65) was given specific iRNA in addition to the routine therapy. The incidence of infection in two groups were investigated; Meantime, with the methods of monoclonal antibody (McAb) APAAP, 3H- TdR incorporation and MTT colorimetery, the various immune functions of patients were determined. Result (1) the incidences of wound infection and bacteriemia after burn in the therapeutic group were markedly lower than those of the control group; (2) the therapeutic group was also superior to the control group in the general condition and time of the wound healing; (3) on the l0th day postburn, the various immune founction tested in the therapeutio group have approximately restored to the normal levels, while those in the control group were still in low levels. The difference between the two groups was statistically significant (P<0.01). Conclusion Specific iRNA, which, when used early after burn, can reduce the incidence of postburn infection, and improve immune functions of burned patients.

  3. Comparative effects of two different doses of low-level laser therapy on wound healing third-degree burns in rats.

    Science.gov (United States)

    Brassolatti, Patricia; Bossini, Paulo Sérgio; Oliveira, Maria Carolina Derêncio; Kido, Hueliton Wilian; Tim, Carla Roberta; Almeida-Lopes, Luciana; Retto Da Silva De Avó, Lucimar; Araújo-Moreira, Fernando M; Parizotto, Nivaldo Antonio

    2016-04-01

    Burns are injuries caused by direct or indirect contact to chemical, physical, or biological agents. Low-level laser therapy (LLLT) is a promising treatment since it is low-cost, non-invasive, and induces cell proliferation. This study aimed to investigate the effects of LLLT (660 nm) at two different fluences (12.5 J/cm(2) and 25 J/cm(2) ) per point of application on third-degree burns in rats. Thirty rats (Wistar) divided into GC, GL12.5, and GL25 were used in the study, and submitted to burn injury through a soldering iron at 150°C, pressed on their back for 10 s. LLLT was applied immediately, and 2, 4, 6, and 8 days after wound induction. Histological analysis revealed a decreased inflammatory infiltrate in the group treated with 25 J/cm(2) , and intense inflammatory infiltrate in the control group and in the group treated with 12.5 J/cm(2) . The immunostaining of COX-2 was more intense in the control groups and in the group treated with 12.5 J/cm(2) than in the group treated with 25 J/cm(2) . Conversely, VEGF immunomarking was more expressive in the group treated with 25 J/cm(2) than it was in the other two groups. Therefore, our findings suggest that the use of 25 J/cm(2) and 1 J of energy was more effective in stimulating the cellular processes involved in tissue repair on third-degree burns in rats by reducing the inflammatory phase, and stimulating angiogenesis, thus restoring the local microcirculation which is essential for cell migration. Microsc. Res. Tech. 79:313-320, 2016. © 2016 Wiley Periodicals, Inc. PMID:26853699

  4. Observation on effects of artificial dermis for repair of large area burn wounds of hand%采用人工真皮修复大面积烧伤早期手部创面的疗效观察

    Institute of Scientific and Technical Information of China (English)

    季一发; 章静; 朱峰; 陈赟; 贺立新

    2011-01-01

    To observe the clinical effect of artificial dcrmis on early repair of burn wounds of hand. Methods:Thirty-eight burn patients who were admitted to the Youanmcn Hospital from January 2009 to September 2010 were randomly divided into two groups with 19 cases in each group. The artificial dcrmis group received early repair operation with artificial dcrmis coverage first and then split-thickness autologous skin grafting after 2 weeks. The control group received early excision of eschar, auto-microskin and allogcnic skin grafting, and autologous skin graft at the later stage. Patients in both groups were treated with dressing change, anti-infection therapy, nutrition and organ function support etc. After operation, and rehabilitation exercises were given after wound healed. Patients were followcd-up for 0. 5-1 year to compare the function of hand and contraction of the wound between the two groups. Results:The wounds were healed in 38 hands of 19 cases in artificial dcrmis group 3 weeks after the operation. The follow-up observation showed that the healing was satisfactory, and the function of extension and making fist was good, with better elasticity of composite skin, with mild scarring and lighter colorization of skin. In the control group, 1 patient died of severe infection and multiple organ failure 2 weeks after admission, the wounds of 36 hands of 18 patients healed 1 month after the operation. Follow-up observation showed that there was contracturc in different levels of the scars, mctacarpophalangcal joint dorsiflcxion deformity, webbed fingers scar, and limitation of functional activity. Conclusions;The artificial dcrmis can effectively cover the wound in cases with lack of auto-skin in the early stage of burn, and it is a better coverage material in repairing the hand surface in order to lessen scar formation of the wound in the early stage of an extensive burn.%目的:观察早期应用人工真皮修复大面积烧伤患者手

  5. 双黄烧伤膏对大鼠烧伤、烫伤的治疗作用研究%Experimental studies of shuanghuang burn ointment treatment for scald and burn wound of rat model

    Institute of Scientific and Technical Information of China (English)

    朱晓红; 凌磊; 王杨; 王强

    2012-01-01

    目的 研究双黄烧伤膏对大鼠实验性烫伤、烧伤感染的治疗作用.方法 将大鼠随机分为实验组(双黄烧伤膏组)、阳性对照组(京万红软膏组)、空白对照组.建立大鼠Ⅱ度烫伤模型、Ⅲ度烧伤感染模型,分别涂布给药,单笼饲养,观察并记录创面变化.结果 在大鼠烫伤实验中,给药15 d后,各组创面结痂面积明显变小,实验组结痂愈合时间短,与阳性对照组、空白对照组比较,差异有统计学意义(P0.05),与空白对照组相比,差异有统计学意义(P0.05),与阴性对照组相比,差异有统计学意义(P<0.01).结论 双黄烧伤膏对大鼠实验性烫伤、烧伤感染具有较好的治疗作用.%Objective To study the effects of shuanghuang burn ointment on scald and burned infectious rats. Methods Rats were randomly divided into test group( shuanghuang burn ointment ), positive control group( jingwan-hong cream )and no treatment group respectively. The drugs were administered topically on the surface of scalded and burned infection places respectively after partical-thickness scald and burn in rats. The change of the scalded and burned areas and the decrustation time were recorded. Results In the partical-thickness scalding test,the scalded areas of 15 d were smaller, there was significant difference between test group and positive control group( P < 0. 05 ), there was significant difference between test group and no treatment group( P < 0. 01 ); the scalded areas of 20 d: there was significant difference between test group and no treatment group( P <0. 01 ),but there was no significant difference compared with the positive control group. In the partical-thickness burnning infection test,the scalded areas of 9 d,there was significant difference between the test group and the no treatment group( P <0. 01 ) ,but there was no significant difference compared with the positive control group. Conclusion Burn ointment has a good anti-inflammatory, antibacterial and

  6. miR-27b represses migration of mouse MSCs to burned margins and prolongs wound repair through silencing SDF-1a.

    Directory of Open Access Journals (Sweden)

    Mu-Han Lü

    Full Text Available BACKGROUND: Interactions between stromal cell-derived factor-1α (SDF-1α and its cognate receptor CXCR4 are crucial for the recruitment of mesenchymal stem cells (MSCs from bone marrow (BM reservoirs to damaged tissues for repair during alarm situations. MicroRNAs are differentially expressed in stem cell niches, suggesting a specialized role in stem cell regulation. Here, we gain insight into the molecular mechanisms involved in regulating SDF-1α. METHODS: MSCs from green fluorescent protein transgenic male mice were transfused to irradiated recipient female C57BL/6 mice, and skin burn model of bone marrow-chimeric mice were constructed. Six miRNAs with differential expression in burned murine skin tissue compared to normal skin tissue were identified using microarrays and bioinformatics. The expression of miR-27b and SDF-1α was examined in burned murine skin tissue using quantitative real-time PCR (qPCR and immunohistochemistry (IHC, enzyme-linked immunosorbent assay (ELISA. The Correlation of miR-27b and SDF-1α expression was analyzed by Pearson analysis Correlation. miRNAs suppressed SDF-1α protein expression by binding directly to its 3'UTR using western blot and luciferase reporter assay. The importance of miRNAs in MSCs chemotaxis was further estimated by decreasing SDF-1α in vivo and in vitro. RESULTS: miR-23a, miR-27a and miR-27b expression was significantly lower in the burned skin than in the normal skin (p<0.05. We also found that several miRNAs suppressed SDF-1α protein expression, while just miR-27a and miR-27b directly bound to the SDF-1α 3'UTR. Moreover, the forced over-expression of miR-27a and miR-27b significantly reduced the directional migration of mMSCs in vitro. However, only miR-27b in burn wound margins significantly inhibited the mobilization of MSCs to the epidermis. CONCLUSION: miR-27b may be a unique signature of the stem cell niche in burned mouse skin and can suppress the directional migration of mMSCs by

  7. The middle-forearm flap based on perforator of ulnar artery for electrical burn wound on the wrist%前臂中段尺动脉穿支皮瓣修复腕部电击伤创面

    Institute of Scientific and Technical Information of China (English)

    储国平; 杨敏烈; 俞舜; 秦宏波; 赵庆国; 苏青和; 吕国忠

    2014-01-01

    Objective To dicuss the application and therapeutic effect of middle-forearm flap based on perforator of ulnar artery for electrical burn wound on the wrist.Methods From Oct.2009 to Oct.2012,10 cases of electrical burn wounds on the wrist were treated.A line from radialis medial epicondyle of humerus to the interior radialis pisiform bone was connected as flap axis.At the midpoint of the line,Doppler flow imaging meter was used to detect the emerging point of perforator vessel.The flap was designed and harvested.The flap was transferred reversely,with superficial vein retaining which was anastomosed with vein at recipient sites in 3 cases.The wounds in the donor sites were closed directly in 2 cases,and with skin graft in 8 cases.Results All the 10 flaps survived completely.7 cases without vein anastomosis underwent obvious flap edema during 2-4 days postoperatively,which resovled 1 week later.Sub-flap tissue necrosis and infection happened in 2 cases,which healed after dressing and drainage.Patients were followed up for 3-36 months with satisfactory results.Conclusions The middle-forearm flap based on perforator of ulnar artery has a stable and reliable blood supply.It offers a new choice for the electric burn wound on the wrist,especially at the ulnar side.%目的 探讨前臂中段尺动脉穿支皮瓣修复腕部电击伤创面的临床效果及应用体会.方法 2009年10月至2012年10月,对10例腕部电击伤患者,在前臂内侧近中段,以肱骨内上髁桡侧至豌豆骨桡侧略偏内的连线为皮瓣的轴心线,在轴线中点处,以多普勒血流探测仪探及穿支血管穿皮点为皮瓣旋转点,设计并切取皮瓣逆行转移修复创面,其中保留皮瓣浅静脉并与受区静脉吻合3例;供瓣区直接拉拢缝合2例,移植皮片修复8例.结果 术后10例皮瓣全部成活,但7例未吻合静脉的皮瓣术后2—4d肿胀较明显,1周后均恢复正常;2例皮瓣下组织继发坏死并感染,经换

  8. Medical management of paediatric burn injuries: best practice.

    Science.gov (United States)

    Kim, Leo K P; Martin, Hugh C O; Holland, Andrew J A

    2012-04-01

    Burns commonly occur in children and their first aid remains inadequate despite burn prevention programmes. While scald injuries predominate, contact and flame burns remain common. Although typically less severe injuries overall than those in adults, hypertrophic scarring complicating both the burn wound and even donor sites occur more frequently in children. The heterogeneous nature of burn wounds, coupled with the difficulties associated with the early clinical assessment of burn depth, has stimulated the application of novel technologies to predict burn wound outcome. This review explores current best practice in the management of paediatric burns, with a focus on prevention, optimal first aid, resuscitation, burn wound prediction and wound management strategies.

  9. Healing of Deep Wound Infection without Removal of Non-Absorbable Dura Mater (Neuro-Patch®): A Case Report.

    Science.gov (United States)

    Xiong, Nan-Xiang; Tan, Daisong Albert; Fu, Peng; Huang, Yi-Zhi; Tong, Song; Yu, Hua

    2016-01-01

    We report on a female patient who received microvascular decompression due to hemifacial spasm. Neuro-Patch® was used during the operation to repair and replace damaged dura mater. Six days after the operation, the incision wound was found to be infected. Abscesses were present deep in the incision. However, because the artificial dura mater was attached so tightly to the original dura mater, the infection was not able to spread inside the skull. After 3 months of meticulous wound cleaning and drug treatment to promote the growth of granulation tissue, we were able to gradually achieve healing of the infection without having to remove the non-absorbable artificial dura mater. By describing this case and the results of a review of the pertinent literature, we discuss the possibility of recovery of an infection without removal of artificial dura mater. PMID:27649762

  10. Tyrothricin--An underrated agent for the treatment of bacterial skin infections and superficial wounds?

    Science.gov (United States)

    Lang, C; Staiger, C

    2016-06-01

    The antimicrobial agent tyrothricin is a representative of the group of antimicrobial peptides (AMP). It is produced by Bacillus brevis and consists of tyrocidines and gramicidins. The compound mixture shows activity against bacteria, fungi and some viruses. A very interesting feature of AMPs is the fact, that even in vitro it is almost impossible to induce resistances. Therefore, this class of molecules is discussed as one group that could serve as next generation antibiotics and overcome the increasing problem of bacterial resistances. In daily practice, the application of tyrothricin containing formulations is relatively limited: It is used in sore throat medications and in agents for the healing of infected superficial and small-area wounds. However, due to the broad spectrum antimicrobial activity and the low risk of resistance development it is worth to consider further fields of application. PMID:27455547

  11. Advances in the research of laser Doppler perfusion imaging in burn wounds%激光多普勒血流灌注成像在烧伤创面中的应用研究进展

    Institute of Scientific and Technical Information of China (English)

    刘晶; 许龙顺; 胡大海; 屈怡; 王国栋; 王洪涛

    2014-01-01

    Laser Doppler perfusion imaging (LDPI)works through the Doppler effect of light wave,and it could depict the blood flow value of the entire wound in two-dimensional image without contacting the detection site directly.In resent years,LDPI has been proved to be effective to evaluate healing potential of a wound,and to predict burn depth and scar formation.The accuracy of LDPI is higher than other traditional methods and technique.However,there are still many influencing factors for the clinical application of LDPI scanning.This paper presents a comprehensive overview of advances in the research of LDPI for clinical application in the care of burn wounds and influencing factors for accurate scanning.

  12. ‘This wound has spoilt everything’: emotional capital and the experience of surgical site infections

    Science.gov (United States)

    Brown, Brian; Tanner, Judith; Padley, Wendy

    2014-01-01

    In this article we explore the experience of suffering from a surgical site infection, a common complication of surgery affecting around 5 per cent of surgical patients, via an interview study of 17 patients in the Midlands in the UK. Despite their prevalence, the experience of surgical site infections has received little attention so far. In spite of the impairment resulting from these iatrogenic problems, participants expressed considerable stoicism and we interpret this via the notion of emotional capital. This idea derives from the work of Pierre Bourdieu, Helga Nowotny and Diane Reay and helps us conceptualise the emotional resources accumulated and expended in managing illness and in gaining the most from healthcare services. Participants were frequently at pains not to blame healthcare personnel or hospitals, often discounting the infection's severity, and attributing it to chance, to ‘germs’ or to their own failure to buy and apply wound care products. The participants' stoicism was thus partly afforded by their refusal to blame healthcare institutions or personnel. Where anger was described, this was either defused or expressed on behalf of another person. Emotional capital is associated with deflecting the possibility of complaint and sustaining a deferential and grateful position in relation to the healthcare system. PMID:25470322

  13. 'This wound has spoilt everything': emotional capital and the experience of surgical site infections.

    Science.gov (United States)

    Brown, Brian; Tanner, Judith; Padley, Wendy

    2014-11-01

    In this article we explore the experience of suffering from a surgical site infection, a common complication of surgery affecting around 5 per cent of surgical patients, via an interview study of 17 patients in the Midlands in the UK. Despite their prevalence, the experience of surgical site infections has received little attention so far. In spite of the impairment resulting from these iatrogenic problems, participants expressed considerable stoicism and we interpret this via the notion of emotional capital. This idea derives from the work of Pierre Bourdieu, Helga Nowotny and Diane Reay and helps us conceptualise the emotional resources accumulated and expended in managing illness and in gaining the most from healthcare services. Participants were frequently at pains not to blame healthcare personnel or hospitals, often discounting the infection's severity, and attributing it to chance, to 'germs' or to their own failure to buy and apply wound care products. The participants' stoicism was thus partly afforded by their refusal to blame healthcare institutions or personnel. Where anger was described, this was either defused or expressed on behalf of another person. Emotional capital is associated with deflecting the possibility of complaint and sustaining a deferential and grateful position in relation to the healthcare system.

  14. 'This wound has spoilt everything': emotional capital and the experience of surgical site infections.

    Science.gov (United States)

    Brown, Brian; Tanner, Judith; Padley, Wendy

    2014-11-01

    In this article we explore the experience of suffering from a surgical site infection, a common complication of surgery affecting around 5 per cent of surgical patients, via an interview study of 17 patients in the Midlands in the UK. Despite their prevalence, the experience of surgical site infections has received little attention so far. In spite of the impairment resulting from these iatrogenic problems, participants expressed considerable stoicism and we interpret this via the notion of emotional capital. This idea derives from the work of Pierre Bourdieu, Helga Nowotny and Diane Reay and helps us conceptualise the emotional resources accumulated and expended in managing illness and in gaining the most from healthcare services. Participants were frequently at pains not to blame healthcare personnel or hospitals, often discounting the infection's severity, and attributing it to chance, to 'germs' or to their own failure to buy and apply wound care products. The participants' stoicism was thus partly afforded by their refusal to blame healthcare institutions or personnel. Where anger was described, this was either defused or expressed on behalf of another person. Emotional capital is associated with deflecting the possibility of complaint and sustaining a deferential and grateful position in relation to the healthcare system. PMID:25470322

  15. Nosocomial outbreak of disseminated orf infection in a burn unit, Gaziantep, Turkey, October to December 2012

    OpenAIRE

    Ergönül, Önder; Midilli, K.; Erkılıç, A.; Kuskucu, M.; Analay, H.; Erkılıç, S.; Benzonana, N.; Yıldırım, M. S.; Muelayim, K.; Acar H.

    2013-01-01

    www.eurosurveillance.org 1 Rapid communications Nosocomial outbreak of disseminated orf infection in a burn unit, Gaziantep, Turkey, October to December 2012 K Midilli1, A Erkılıç2, M Kuşkucu1, H Analay2, S Erkılıç3, N Benzonana4, M S Yıldırım2, K Mülayim2, H Acar4, O Ergonul ()5 1. Istanbul University, Cerrahpaşa Medical School, Istanbul 2. Dr.Ersin Arslan Hospital, Gaziantep, Turkey 3. Gaziantep University, School of Medicine, Gaziantep, Turkey ...

  16. MANAGEMENT OF β-LACTAMASE PRODUCERS THROUGH INFECTION CONTROL MEASURES IN BURN ICU

    Directory of Open Access Journals (Sweden)

    Nachhatarjit

    2015-12-01

    Full Text Available BACKGROUND AND OBJECTIVES Multi-Drug Resistant (MDR pathogens due to various β-lactamases are major contributors in increasing morbidity and mortality rates in Burn Intensive Care Units, ICU. This study is aimed to apply the various infection control measures and to compare the results of two halves of study and to establish a relation between environment, Health Care Workers (HCWs and patients regarding manifestation of nosocomial infection. DESIGN AND SETTING Over a period of three years (June 2010 to June 2013, Clinical, Environment and Health care providers samples from Burn ICU were processed in the Department of Microbiology, Sri Guru Ramdas Institute of Medical Sciences and Research, Amritsar. Organisms were identified by standard microbiological techniques and their antibiotic susceptibility was determined by Kirby Bauer disc diffusion method. The MDR were further tested for various β-lactamases by Clinical Laboratory Standard Institute (CLSI disc diffusion method using Ceftazidime and Ceftazidime + clavulanate and Cefotaxime and Cefotaxime clavulanate for Extended Spectrum Beta Lactamases (ESBL, Meropenem and meropenem + EDTA for Metallo Beta Lactamases (MBLs and 3-Dimensional test for AmpC beta lactamases. MATERIAL AND METHODS 307 clinical, 210 environmental and 117 HCWs samples in 1st and 192 clinical, 62 environmental and 92 HCWs samples in 2nd half of study were processed by standard microbiological techniques. After identification all MDR isolates were first screened for ESBL, AmpC and MBL then confirmed by the respective confirmatory tests. Results of two halves were statistically analyzed. RESULTS Infection rate was reduced from 50.16% to 40.10% in Burn patients. Culture positivity was reduced from 38.0% to 27.41% in environmental and 27.35% to 7.60% in HCWs samples. β-lactamases prevalence in Gram positive was 54.23% and Gram negative was 60.86% before and 37.03% and 54.05% after interventions. CONCLUSION In addition to the

  17. Ghrelin Therapy Improves Survival after Whole-Body Ionizing Irradiation or Combined with Burn or Wound: Amelioration of Leukocytopenia, Thrombocytopenia, Splenomegaly, and Bone Marrow Injury

    Directory of Open Access Journals (Sweden)

    Juliann G. Kiang

    2014-01-01

    Full Text Available Exposure to ionizing radiation alone (RI or combined with traumatic tissue injury (CI is a crucial life-threatening factor in nuclear and radiological events. In our laboratory, mice exposed to 60Co-γ-photon radiation (9.5 Gy, 0.4 Gy/min, bilateral followed by 15% total-body-surface-area skin wounds (R-W CI or burns (R-B CI experienced an increment of ≥18% higher mortality over a 30-day observation period compared to RI alone. CI was accompanied by severe leukocytopenia, thrombocytopenia, erythropenia, and anemia. At the 30th day after injury, numbers of WBC and platelets still remained very low in surviving RI and CI mice. In contrast, their RBC, hemoglobin, and hematocrit were recovered towards preirradiation levels. Only RI induced splenomegaly. RI and CI resulted in bone-marrow cell depletion. In R-W CI mice, ghrelin (a hunger-stimulating peptide therapy increased survival, mitigated body-weight loss, accelerated wound healing, and increased hematocrit. In R-B CI mice, ghrelin therapy increased survival and numbers of neutrophils, lymphocytes, and platelets and ameliorated bone-marrow cell depletion. In RI mice, this treatment increased survival, hemoglobin, and hematocrit and inhibited splenomegaly. Our novel results are the first to suggest that ghrelin therapy effectively improved survival by mitigating CI-induced leukocytopenia, thrombocytopenia, and bone-marrow injury or the RI-induced decreased hemoglobin and hematocrit.

  18. The use of desiccation to treat Staphylococcus aureus biofilm-infected wounds.

    Science.gov (United States)

    Park, Eugene; Long, Sarah A; Seth, Akhil K; Geringer, Matthew; Xu, Wei; Chavez-Munoz, Claudia; Leung, Kai; Hong, Seok Jong; Galiano, Robert D; Mustoe, Thomas A

    2016-03-01

    Chronic wounds colonized with biofilm present a major burden to our healthcare system. While the current paradigm for wound healing is to maintain a moist environment, we sought to evaluate the effects of desiccation, and the ability of honey to desiccate wounds, on wound healing characteristics in Staphylococcus aureus biofilm wounds. In vivo biofilm wound healing after exposure to open-air desiccation, honey, molasses, and saline was analyzed using a rabbit ear model of S. aureus biofilm wounds previously developed by our group. Wound morphology was examined using scanning electron microscopy and granulation tissue deposition was measured using light microscopy with hematoxylin and eosin staining. Viable bacterial counts in rabbit ear biofilm wounds and scabs were measured using a drop dilution method. In vitro S. aureus growth curves were established using tryptic soy broth containing honey and glycerol. Gene expression analysis of rabbit ear wounds was performed using reverse transcription quantitative PCR. Rabbit ear S. aureus biofilm wounds exposed to open-air desiccation, honey, and molasses developed a dry scab, which displaced the majority of biofilm bacteria off of the wound bed. Wounds treated with open-air desiccation, honey, and molasses expressed lower levels of the inflammatory markers tumor necrosis factor-α and interleukin-1β at postoperative day 12 compared with wounds treated with saline, and had increased levels of granulation tissue formation. In vitro growth of S. aureus in tryptic soy broth was inhibited by the presence of honey to a greater extent than by the presence of osmolality-matched glycerol. Desiccation of chronic wounds colonized with biofilm via exposure to open air or honey leads to improved wound healing by decreasing bacterial burden and inflammation, and increasing granulation tissue formation. The ability of honey to help heal chronic wounds is at least in part due to its ability to desiccate bacterial biofilm, but other

  19. Reconstruction of high voltage electric burn wound with exposed shoulder joint by thoracoacromial artery perforator propeller flap

    Science.gov (United States)

    Rout, Debesh Kumar; Nayak, Bibhuti Bhusan; Choudhury, Arun Kumar; Pati, Ajit Kumar

    2014-01-01

    We describe the reconstruction of high voltage electric burn injury with exposed shoulder joint by thoracoacromial artery perforator propeller flap based on the delto-pectoral perforators of thoracoacromial artery. The successful use of this propeller flap to cover the exposed shoulder joint in a case with limited local flap options demonstrates its use as an alternative technique. PMID:25190925

  20. Reconstruction of high voltage electric burn wound with exposed shoulder joint by thoracoacromial artery perforator propeller flap

    Directory of Open Access Journals (Sweden)

    Debesh Kumar Rout

    2014-01-01

    Full Text Available We describe the reconstruction of high voltage electric burn injury with exposed shoulder joint by thoracoacromial artery perforator propeller flap based on the delto-pectoral perforators of thoracoacromial artery. The successful use of this propeller flap to cover the exposed shoulder joint in a case with limited local flap options demonstrates its use as an alternative technique.

  1. Immunization with 3-oxododecanoyl-L-homoserine lactone-r-PcrV conjugate enhances survival of mice against lethal burn infections caused by Pseudomonas aeruginosa

    Directory of Open Access Journals (Sweden)

    Isar Dejban Golpasha

    2015-05-01

    Full Text Available Quorum Sensing and type III secretion system play an important role in the virulence of Pseudomonas (P. aeruginosa in burn wound infections. We aimed to explore the feasibility of using 3-oxo-C12-HSL-r-PcrV conjugate as a candidate vaccine against P. aeruginosa caused infections. 3-oxo-C12-HSL-r-PcrV conjugate was prepared and used for immunization of mice (10 μg, subcutaneous, three times, at 2-week intervals. Mice were divided into five groups: I: PcrV; II: 3-oxo-C12-HSL-r-PcrV (10 μg; III: 3-oxo-C12-HSL-r-PcrV (20 μg; IV: 3-oxo-C12-HSL; and V: PBS receiving groups.  After each shot of immunization, total and isotype antibody responses against corresponding antigen were measured to determine the immunization efficacy. One month after the last immunization, all groups were burned and challenged subeschar with P. aeruginosa PAO1. Survival rate and bacterial quantity in the skin and internal organs (liver and spleen were evaluated 25-hr after burn infection. Immunization with 3-oxo-C12-HSL-r-PcrV significantly increased total IgG and specific subclass antibodies (IgG1, IgG2a, IgG2b, and IgM in the serum of the groups II and III compared to the control group (p<0.001. While all the control mice (PBS injected group died within 2 days after bacterial challenge, 64% of the group I, 78% of group II, and 86% of group III, survived within 14 days after challenge. Interestingly, bacterial burden in the liver and spleen of 3-oxo-C12-HSL-r-PcrV injected group (III was significantly lower than the control group (p<0.001.  The present study proposed two-component vaccine to inhibit Pseudomonas infections in burned mouse. 

  2. Research progress of aloe in burn wound treatment%芦荟在烧伤创面应用的研究进展

    Institute of Scientific and Technical Information of China (English)

    张溪; 廖成静; 贾赤宇

    2015-01-01

    芦荟具有消炎杀菌、吸热消肿、软化皮肤、扶养细胞活力的功能,除对烧伤的伤口有促愈合作用外,还有抗炎和免疫调节等作用,常作为治疗各种烧伤的理想药品。本研究对芦荟提取物中各种有效成分之间的作用关系及其作用机制进行总结、归纳、整理,为其在临床上应用提供依据。%Aloe vera has anti-inflammatory sterilization,endothermic detumescence,soften the skin,bring up the function of the cell vitality.Laboratory studies show that aloe except to promote healing of burn wounds with,and anti-inflammatory and immunomodulatory effect,so often used as an ideal drug for the treatment of various kinds of burns.But the role of the relationship between all kinds of effective components in extract and their mechanism is still unclear.The authors summarized and finishing,to provide the basis for its clinical application.

  3. Outbreak of infection in a burns unit due to Pseudomonas aeruginosa originating from contaminated tubing used for irrigation of patients

    DEFF Research Database (Denmark)

    Kolmos, H J; Thuesen, B; Nielsen, S V;

    1993-01-01

    Five patients with extensive deep burns developed septicaemia due to Pseudomonas aeruginosa serogroup O-7.8 and phage type 21 or 21/188 shortly after they had been admitted to hospital. Four other burned patients became colonized with the same strain. The source of infection was contaminated tap...... water used for irrigation of the burns, as part of the first-aid treatment which the patients received when entering the hospital. Contamination was restricted to showers and tubing that were permanently connected to the taps, and the outbreak stopped after they had been disinfected. Tubing and showers...... used for irrigation of burns should be dismantled and heat-disinfected after each patient and not reconnected to the taps until immediately before the next treatment. Taps used for irrigation of burns should be monitored regularly for the presence of P. aeruginosa and other potentially pathogenic...

  4. Effects of irrigation with different solution on Incidence of Wound Infection

    OpenAIRE

    Majid Zamani; Fatemeh Sadeghi Panah; Mehrdad Esmailian; Reza Azizkhani; Zahra Yoosefian; Mojtaba soltani

    2015-01-01

    Introduction: Management of acute and chronic wounds has significantly altered in the last decade but little attention has been paid to the solution used for cleansing the wounds. Therefore, the present study aimed to compare the effects of tap water, distilled water, and normal saline for wound cleansing in emergency department. Methods: This is a double-blind randomized clinical trial with a 10-day follow up. Patients who had superficial wounds were randomly divided into 3 treatment groups:...

  5. 大鼠深Ⅱ度烫伤后创面自噬及凋亡的表达规律%Changes of autophagy and apoptosis in wounds after deep second-degree burn in rats

    Institute of Scientific and Technical Information of China (English)

    肖孟景; 李利根; 李晨曦; 胡泉; 马丽; 张海军

    2013-01-01

    目的 观察大鼠深Ⅱ度烫伤后72 h内创面自噬及凋亡的表达规律,探讨其与深Ⅱ度创面早期加深之间的关系.方法 Wistar大鼠背部10% TBSA深Ⅱ度烫伤,观察烫伤后1h、6h、12 h、24 h、48 h、72 h创面组织自噬标志蛋白LC3、Beclin-1的表达及变化规律;TUNEL法检测创面凋亡水平的变化规律;HE染色及Masson染色显示创面组织形态和创面深度的变化.结果 烫伤后创面组织LC3、Beclin-1蛋白水平持续下降,至伤后24h达到最低,此后稍有升高,但仍远低于正常水平;伤后创面组织TUNEL阳性细胞持续增多,至伤后48 h达到最高,此后稍有下降,但仍远高于正常水平;创面组织真皮深层自噬被激活;烫伤后创面深度随着时间的推移进行性加深.结论 大鼠深Ⅱ度烫伤后早期创面组织自噬减少,凋亡增加,可能是参与创面加深的因素;真皮深层自噬的激活,可能是一种保护机制.%Objective To observe the changes of autophagy and apoptosis in wounds after deep seconddegree burn in rats and discuss their roles in burn wound progression.Methods The Wistar rats were subjected to 10% second-degree burn injury.The expression of LC3 and Beclin-1 in the burn wounds was observed 1 h,6 h,12 h,24 h,48 h and 72 h postburn respectively.Apoptosis in the bum wound was determined by Terminaldeoxynucleoitidyl Transferase Mediated Nick End Labeling assay (TUNEL).Pathologic changes were assessed by using HE and Masson staining.Results The LC3 and Beclin-1 protein level in burn wounds continuously decreased in 24 h postburn,and then began to increase but still could not reach their normal level at 72 h postburn.The TUNEL positive cells in wounds increased continuously in 48 h postburn,and then began to decrease but still could not reach normal level at 72 h postburn.Enhanced autophagy was observed in the deep dermal layer of bum wounds.Conclusions At the early stage after burn,autophagy was suppressed and

  6. Achievements in burn surgery over the past 50 years in China

    Institute of Scientific and Technical Information of China (English)

    Shiliang WANG

    2008-01-01

    This paper reflects on the advancements of clinical and scientific research in the field of burn sur-gery in China. It includes emergency care of massive burns, resuscitation, anti-infection, prevention and cure of internal organ injuries, metabolic and nutritional sup-port, wound repair and rehabilitation, and special types of burns; it also covers pathology, microbiology, immunology, cell biology, molecular biology, and tissue engineering.

  7. MORBIDITY AND SURVIVAL PROBABILITY IN BURN PATIENTS IN MODERN BURN CARE

    Science.gov (United States)

    Jeschke, Marc G.; Pinto, Ruxandra; Kraft, Robert; Nathens, Avery B.; Finnerty, Celeste C.; Gamelli, Richard L.; Gibran, Nicole S.; Klein, Matthew B.; Arnoldo, Brett D.; Tompkins, Ronald G.; Herndon, David N.

    2014-01-01

    Objective Characterizing burn sizes that are associated with an increased risk of mortality and morbidity is critical because it would allow identifying patients who might derive the greatest benefit from individualized, experimental, or innovative therapies. Although scores have been established to predict mortality, few data addressing other outcomes exist. The objective of this study was to determine burn sizes that are associated with increased mortality and morbidity after burn. Design and Patients Burn patients were prospectively enrolled as part of the multicenter prospective cohort study, Inflammation and the Host Response to Injury Glue Grant, with the following inclusion criteria: 0–99 years of age, admission within 96 hours after injury, and >20% total body surface area burns requiring at least one surgical intervention. Setting Six major burn centers in North America. Measurements and Main Results Burn size cutoff values were determined for mortality, burn wound infection (at least two infections), sepsis (as defined by ABA sepsis criteria), pneumonia, acute respiratory distress syndrome, and multiple organ failure (DENVER2 score >3) for both children (<16 years) and adults (16–65 years). Five-hundred seventy-three patients were enrolled, of which 226 patients were children. Twenty-three patients were older than 65 years and were excluded from the cutoff analysis. In children, the cutoff burn size for mortality, sepsis, infection, and multiple organ failure was approximately 60% total body surface area burned. In adults, the cutoff for these outcomes was lower, at approximately 40% total body surface area burned. Conclusions In the modern burn care setting, adults with over 40% total body surface area burned and children with over 60% total body surface area burned are at high risk for morbidity and mortality, even in highly specialized centers. PMID:25559438

  8. 美宝创疡贴治疗高海拔地区小面积Ⅱ度烧伤临床体会%Clinical Experience of Treating Small-area Ⅱ Degree Burns with MEBO Wound & Ulcer Dressing in High Altitude Regions

    Institute of Scientific and Technical Information of China (English)

    樊新海; 蒋建纲

    2012-01-01

      Objective To analyze retrospectively the clinical efficacy of MEBO Wound & Ulcer Dressing in the treatment of small-area Ⅱ degree burn in high altitude regions. Methods The clinical data of a total of 120 Ⅱ degree burned patients with a TBSA < 5% at different locations treated with MEBO Wound & Ulcer Dressing were summarized ret-rospectively to analyze the clinical efficacy of MEBO Dressing in treating small-area Ⅱ degree burns in high altitude regions. Results After the treatment of MEBO Wound & Ulcer Dressing, the superficial Ⅱ degree burns healed in 5 ~ 10 days, and the deep Ⅱ degree burns healed in 12 ~ 18days. The healed skin was smooth and even without scar hyperplasia, and the appearance and function were very good, so the efficacy was satisfying. Conclusion MEBO Wound & Ulcer Dressing is easy and convenient to be adopted and should be promoted widely in clinic in that it results in less pain and is effective in countering infection and shortening the healing time as well as realizing good healing effects.%  目的回顾性分析美宝创疡贴在高海拔地区治疗小面积Ⅱ度烧伤创面的临床疗效。方法对120例采用美宝创疡贴治疗的不同部位面积小于5% TBSA 的Ⅱ度烧伤患者的临床资料进行回顾性总结,分析美宝创疡贴换药治疗高海拔地区小面积Ⅱ度烧伤的临床疗效。结果120例烧伤患者创面经美宝创疡贴换药治疗后,浅Ⅱ度烧伤创面5 d ~10 d 愈合,深Ⅱ度烧伤创面12 d ~18 d 愈合,愈合后皮肤平整,无瘢痕增生,外观及功能良好,效果满意。结论本疗法痛苦小,抗感染能力强,愈合时间短,愈后效果满意,方法简便实用,适宜临床广泛推广应用。

  9. What's new in burn microbiology? James Laing Memorial Prize Essay 2000.

    Science.gov (United States)

    Edwards-Jones, Valerie; Greenwood, John E

    2003-02-01

    A variety of factors contribute to the development of infection in burned patients. The role of wound management procedures, risk factors associated with infection, typical bacterial pathogens and associated exotoxins, current problems with antibiotic resistance, wound sampling and rare complications of infection are described. The use of new novel treatments that are currently being developed, such as cell signalling molecules and the increasing use of natural antimicrobial agents, for example honey, papaya fruit and tea-tree oil are discussed. The impact of new methods for earlier detection of infectious agents that could change future practices in burn care is also described. PMID:12543040

  10. Reconstruction of Abdominal Wall of a Chronically Infected Postoperative Wound with a Rectus Abdominis Myofascial Splitting Flap

    Directory of Open Access Journals (Sweden)

    Sung Kyu Bae

    2013-01-01

    Full Text Available Background If a chronically infected abdominal wound develops, complications such asperitonitis and an abdominal wall defect could occur. This could prolong the patient’s hospitalstay and increase the possibility of re-operation or another infection as well. For this reason,a solution for infection control is necessary. In this study, surgery using a rectus abdominismuscle myofascial splitting flap was performed on an abdominal wall defect.Methods From 2009 to 2012, 5 patients who underwent surgery due to ovarian rupture,cesarean section, or uterine myoma were chosen. In each case, during the first week afteroperation, the wound showed signs of infection. Surgery was chosen because the wounds didnot resolve with dressing. Debridement was performed along the previous operation woundand dissection of the skin was performed to separate the skin and subcutaneous tissue fromthe attenuated rectus muscle and Scarpa’s fascial layers. Once the anterior rectus sheath andmuscle were adequately mobilized, the fascia and muscle flap were advanced medially sothat the skin defect could be covered for reconstruction.Results Upon 3-week follow-up after a rectus abdominis myofascial splitting flap operation,no major complication occurred. In addition, all of the patients showed satisfaction in termsof function and esthetics at 3 to 6 months post-surgery.Conclusions Using a rectus abdominis myofascial splitting flap has many esthetic andfunctional benefits over previous methods of abdominal defect treatment, and notably, itenabled infection control by reconstruction using muscle.

  11. Advanced Therapeutic Dressings for Effective Wound Healing--A Review.

    Science.gov (United States)

    Boateng, Joshua; Catanzano, Ovidio

    2015-11-01

    Advanced therapeutic dressings that take active part in wound healing to achieve rapid and complete healing of chronic wounds is of current research interest. There is a desire for novel strategies to achieve expeditious wound healing because of the enormous financial burden worldwide. This paper reviews the current state of wound healing and wound management products, with emphasis on the demand for more advanced forms of wound therapy and some of the current challenges and driving forces behind this demand. The paper reviews information mainly from peer-reviewed literature and other publicly available sources such as the US FDA. A major focus is the treatment of chronic wounds including amputations, diabetic and leg ulcers, pressure sores, and surgical and traumatic wounds (e.g., accidents and burns) where patient immunity is low and the risk of infections and complications are high. The main dressings include medicated moist dressings, tissue-engineered substitutes, biomaterials-based biological dressings, biological and naturally derived dressings, medicated sutures, and various combinations of the above classes. Finally, the review briefly discusses possible prospects of advanced wound healing including some of the emerging physical approaches such as hyperbaric oxygen, negative pressure wound therapy and laser wound healing, in routine clinical care.

  12. 中国烧伤医学50年进展%Achievements in burn surgery over the past 50 years in China

    Institute of Scientific and Technical Information of China (English)

    汪仕良; 肖光夏; 杨宗城; 盛志勇

    2008-01-01

    This paper reflects briefly the main advancements of clinical and scientific research in the field of burn surgery over the past 50 years in China. It ineludes emergency care of massive burns, resuscitation, anti-infection, prevention and treatment of internal organ injury, metabolic and nutritional support, repair of wound and rehabilitation, and special types of burns. The article also covers the researches in pathology, microbiology, immunology, cell biology, molecular biology, and tissue engineering pertaining to burn injury.

  13. 小儿烧伤患者感染细菌学调查与感染情况分析%Bacterial flora and characteristics of infections in child burn patients

    Institute of Scientific and Technical Information of China (English)

    陈如俊; 叶胜捷; 张文振

    2009-01-01

    Objective To analyze characteristics of infections,and to investi-gate bacterial flora and antibiotic resistance in child burn patients.Methods Two hundred and eighteen strains of bacteria were isolated from wounds,blood,sputum andurine specimens of the 225 child burn patients in our department from April,which were detected by drug sensitivity test.And charaeteristics of infections in children were summarized through retrospective analysis,Results (1)In 225 infected cases,the most common types of infections were burn wound infections(73,8%),venous catheter infections (14.3%),pneumonia (9.3%),urinary tract infections(8.0%),septice-mia(8.0%).(2)Among all bacteria,Gram-positive cocci accounted for 51.8%,Gram-negative-bacilli accounted for 48.2%..Staphylococcus aureus was the most pre- dominant bacteria from the wounds,venous catheter,and blood infections.(3)MRSA was identified in 100% of Staphyliciccus aureus ,which was sensitive to dantafur,teico-planin and vancomycin(100%).Pseudomonas aeruginosa was highly sensitive to imi-penem(100%).Baumanii exhibited multiple drug resistance .Conclusion Gram-positive bacilli were still dominant and the most comron types of infection were burn wound infections in our child burn patients.And the predominant bacteria exhibited high drug resistance to most antibiotics,%目的 分析小儿烧伤患者感染细菌学及其感染情况,为临床治疗提供参考.方法 从225例小儿烧伤患者创面、血、痰及尿液等标本中分离出218株细菌,对感染病原菌进行药物敏感试验,分析小儿烧伤心者感染情况.结果 (1)225例感染病例中,创面感染占所有感染病例的60.0%,其次是静脉导管感染(14.3%)、呼吸道感染(9.3%)、泌尿道感染(8.0%)和败血症(8.0%).(2) 检出的细菌中革兰阳性球茵113株(51,8%),革兰阴性杆菌105株(48.2%),其中金黄色葡萄球菌73株(33.5%),铜绿假单胞菌50株(22.9%).金黄色葡萄球菌是创面、静脉导管、败血症感染

  14. Grand challenge in Biomaterials-wound healing.

    Science.gov (United States)

    Salamone, Joseph C; Salamone, Ann Beal; Swindle-Reilly, Katelyn; Leung, Kelly Xiaoyu-Chen; McMahon, Rebecca E

    2016-06-01

    Providing improved health care for wound, burn and surgical patients is a major goal for enhancing patient well-being, in addition to reducing the high cost of current health care treatment. The introduction of new and novel biomaterials and biomedical devices is anticipated to have a profound effect on the future improvement of many deleterious health issues. This publication will discuss the development of novel non-stinging liquid adhesive bandages in healthcare applications developed by Rochal Industries. The scientists/engineers at Rochal have participated in commercializing products in the field of ophthalmology, including rigid gas permeable contact lenses, soft hydrogel contact lenses, silicone hydrogel contact lenses, contact lens care solutions and cleaners, intraocular lens materials, intraocular controlled drug delivery, topical/intraocular anesthesia, and in the field of wound care, as non-stinging, spray-on liquid bandages to protect skin from moisture and body fluids and medical adhesive-related skin injuries. Current areas of entrepreneurial activity at Rochal Industries pertain to the development of new classes of biomaterials for wound healing, primarily in regard to microbial infection, chronic wound care, burn injuries and surgical procedures, with emphasis on innovation in product creation, which include cell-compatible substrates/scaffolds for wound healing, antimicrobial materials for opportunistic pathogens and biofilm reduction, necrotic wound debridement, scar remediation, treatment of diabetic ulcers, amelioration of pressure ulcers, amelioration of neuropathic pain and adjuvants for skin tissue substitutes. PMID:27047680

  15. Grand challenge in Biomaterials-wound healing

    Science.gov (United States)

    Salamone, Joseph C.; Salamone, Ann Beal; Swindle-Reilly, Katelyn; Leung, Kelly Xiaoyu-Chen; McMahon, Rebecca E.

    2016-01-01

    Providing improved health care for wound, burn and surgical patients is a major goal for enhancing patient well-being, in addition to reducing the high cost of current health care treatment. The introduction of new and novel biomaterials and biomedical devices is anticipated to have a profound effect on the future improvement of many deleterious health issues. This publication will discuss the development of novel non-stinging liquid adhesive bandages in healthcare applications developed by Rochal Industries. The scientists/engineers at Rochal have participated in commercializing products in the field of ophthalmology, including rigid gas permeable contact lenses, soft hydrogel contact lenses, silicone hydrogel contact lenses, contact lens care solutions and cleaners, intraocular lens materials, intraocular controlled drug delivery, topical/intraocular anesthesia, and in the field of wound care, as non-stinging, spray-on liquid bandages to protect skin from moisture and body fluids and medical adhesive-related skin injuries. Current areas of entrepreneurial activity at Rochal Industries pertain to the development of new classes of biomaterials for wound healing, primarily in regard to microbial infection, chronic wound care, burn injuries and surgical procedures, with emphasis on innovation in product creation, which include cell-compatible substrates/scaffolds for wound healing, antimicrobial materials for opportunistic pathogens and biofilm reduction, necrotic wound debridement, scar remediation, treatment of diabetic ulcers, amelioration of pressure ulcers, amelioration of neuropathic pain and adjuvants for skin tissue substitutes. PMID:27047680

  16. 湿润烧伤膏与磺胺嘧啶银霜在烧伤创面修复中的疗效比较%Efficacy comparison of Moisture Burn Ointment and Sulfadiazine-Ag Cream in burn wound repair

    Institute of Scientific and Technical Information of China (English)

    杨伯明

    2011-01-01

    目的:比较湿润烧伤膏(MEBO)暴露再生疗法与磺胺嘧啶银霜(SD-Ag霜)抗炎疗法在修复烧伤创面中的疗效.方法:选择2008年10月~2010年12月我院不同原因、不同分度、于伤后0.5~12.0 h入院的60例烧伤患者,随机分为两组,观察组30例患者烧伤创面采用MEBO暴露再生疗法,对照组30例患者采用磺胺嘧啶银霜抗炎治疗.观察两组不同深度烧伤创面的愈合时间、感染发生率、手术植皮例数及瘢痕发生率.结果:两组患者第3、6、9、12天创面愈合率差异均有统计学意义(均P0.05).结论:在治疗烧伤创面修复中,美宝湿润烧伤膏暴露再生疗法优于磺胺嘧啶银霜抗炎疗法,不仅能明显缩短创面愈合时间,提高创面愈合率,还能降低瘢痕发生率,减少手术植皮患者比例.%Objective: To compare the treatment efficacy of Moisture Burn Ointment (MEBO) exposure regeneration therapy and Sulfadiazine-Ag (SD-Ag) Cream anti-inflammatory therapy in bum wound repair. Methods: 60 cases of bum patients who entered our hospital from October 2008 to December 2010 with different reasons, different types and in hospital 0.5-12.0 hours after injuries were assigned randomly to two groups. 30 patients in the observation group were given MEBO exposure regeneration treatment and the 30 patients in the control group were given SD-Ag Cream anti-inflammatory treatment. The healing time, incidence of infection, cases of surgery graft and incidence of scar formation of wound of different depth were compared between the two groups. Results: There were significant differences between the two groups in wound recovery rate of day 3, 6, 9 and 12 (P<0.05); the wound repair time of the observation group was(16.2±5.47) d and (20.50±5.24) d in the control group, the difference between the two groups was significant (P<0.01); the incidence of scar formation was 30.0% in the observation group and 56.7% in the control group, the difference between

  17. Suppression of scar formation in a murine burn wound model by the application of non-thermal plasma

    Science.gov (United States)

    Hoon Lee, Dae; Lee, Jae-Ok; Jeon, Wonju; Choi, Ihn-Geun; Kim, Jun-Sub; Hoon Jeong, Je; Kang, Tae-Cheon; Hoon Seo, Cheong

    2011-11-01

    Suppression of hypertrophic scar generation in an animal model by treatment with plasma is reported. Contact burn following mechanical stretching was used to induce scar formation in mice. Exposure to the plasma tended to reduce the scar area more rapidly without affecting vitality. The treatment resulted in decreased vascularization in the scar tissue. Plasma-treated scars showed mild decrease in the thickness of hypertrophic tissues as shown by histological assessment. Finally, we showed that plasma treatment induced cell death and reactive oxygen species generation in hypertrophic scar fibroblast. All of the results support that plasma treatment can control scar generation.

  18. Differential induction of acquired resistance and PR gene expression in tobacco by virus infection, ethephon treatment, UV light and wounding

    International Nuclear Information System (INIS)

    Genes for acidic, extracellular and basic, intracellular pathogenesis-related (PR) proteins of tobacco were studied for their response to tobacco mosaic virus (TMV) infection, ethephon treatment, wounding and UV light. The genes encoding the acidic PR proteins (PR-1, PR-2, PR-3, PR-4 and PR-5) responded similarly to the different forms of stress. They appeared to be highly inducible by TMV, moderately inducible by ethephon treatment and UV light and not inducible by wounding. The genes for the basic counterparts of PR-1, PR-2, PR-3 and PR-5 also displayed a common stress response. However, this response was different from that of the acidic PR proteins. Here, the highest induction was obtained upon ethephon treatment, while the other stress conditions resulted in somewhat lower levels of expression. Most genes for acidic PR proteins are systemically induced in the uninfected upper leaves of TMV-infected plants, whereas the genes encoding the basic PR proteins are not. Increased levels of resistance to TMV, comparable to resistance obtained by pre-infection with the virus, were found in UV-irradiated leaves but not in wounded or ethephon-treated leaves. This indicates that the basic PR proteins are not involved in resistance to TMV infection. Tobacco phenylalanine ammonia-lyase genes were not inducible by the various stress conditions. The implications of these findings in relation to the phenomenon of acquired resistance are discussed

  19. Clinical Effects on Mannatide Injection Combined with Silver Sulfadiazine in Treating Burn Wound Healing%甘露聚糖肽注射液联合磺胺嘧啶银对烧伤创面愈合的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    雷英; 张兰芳; 雷丹

    2014-01-01

    [ABSTRACT]Objective: To observe the clinical therapeutic effect and safety of Mannatide combined with silver sulfadiazine on burn wound healing.Methods:204 burn patients treated in our hospital was selected during the period of 2013 January to 2014 April, which were divided into A,B,C three groups randomly with 68 cases in each group: group A was with Mannatide Injection single treatment group, group B was Mannatide injection combined with silver sulfadiazine treatment group, group C was control group. Group A was given wet dressing with Mannatide Injection,B group was wet dressing with Mannatide Injection after coating silver sulfadiazine evenly on the wound, Group C was wet dressing iodophor.Then the three groups of patients were observed respectively on average wound healing time,exudates,pain,infection rate and adverse reaction index.Results:(1) The average wound healing time of group A was significantly shorter than group C (P<0.05);Compared with group C,group B shortened the average wound healing time more significantly(P<0.01).(2) The burn wound exudate of patients in group A significantly reduced(P<0.05),compared to group C;The exudate of group B released much more obviously than group C(P<0.01).(3)Compared with group C,the burn wound infection rate of group A decreased significantly(P<0.05);The burn wound infection rate of group B diminished more obviously (P<0.01)in contrast with group C.(4) The patients treated with Mannatide Injection alone had no obvious adverse reaction, the patients treated with Mannatide Injection combined with silver sulfadiazine had no clear adverse effect as well.Conclusion:Mannatide Injection combined with silver sulfadiazine had more significant effect than Mannatide Injection alone on burn wound healing of burn patients with no obvious adverse reaction,fast healing burn wound and satisfactory effect.%目的:观察甘露聚糖肽联合磺胺嘧啶银对烧伤创面愈合的临床治疗效果及安全性。方法:选择2013

  20. Evaluation of the Larval Therapy in the Healing Process of Infected Wounds with Pseudomonas Aeruginosa in Rabbits

    Directory of Open Access Journals (Sweden)

    Mauricio Rey

    2008-08-01

    Full Text Available Introduction. During the last two decadesthe larval therapy has reemerged as a safe andreliable alternative for the healing of cutaneousulcers that do not respond to the conventionaltreatments.Objective. To evaluate the use of the larvaeof Lucilia sericata as a treatment for infectedwounds with Pseudomonas aeruginosa in ananimal model.Materials and methods. Twelve rabbits wererandomly distributed in 3 groups: the firstgroup was treated with larval therapy; the secondwas treated with antibiotics therapy and to thethird no treatment was applied, therefore wasestablished as a control group. To each animala wound was artificially induced, and then asuspension of P. aeruginosa was inoculated intothe lesion. Finally, every rabbit was evaluateduntil the infection development was recognizedand treatment was set up for the first twogroups according with the protocols mentionedabove. Macroscopic evaluation of the woundswas based on the presence of edema, exudates,bad odor, inflammation around the wound andthe presence of granulation tissue. The healingprocess was evaluated by monitoring histologicalchanges in the dermal tissue.Results. Differences in the time requiredfor wound healing were observed between thefirst group treated with larval therapy (10 daysand the second group treated with conventionalantibiotics therapy (20 days.Conclusion. The L. sericata larva is and efficienttool as a therapy for infected wounds withP. aeruginosa.

  1. Difficult wounds: radiation wounds

    International Nuclear Information System (INIS)

    In an era of modern radiotherapy, problems associated with the indiscriminate treatment of benign disease have largely disappeared. Skin sparing effects of super voltage radiation equipment make the problems previously seen with orthovoltage equipment less frequent. Vigilance on the part of the workers in the field, in general, protects from the disasters that befell Thomas Edison's laboratory assistant. Despite these modern advances, the reconstructive surgeon often faces problems of managing acute local radiation injury from accident following planned therapeutic radiation or the ulcerations and breakdowns seen months or years after radiation therapy. The single most serious hazard to surgery in radiated tissue is the lodgment of bacteria in this tissue rendered avascular by the radiation and secondary necrosis from the infection itself. The principles of management are no different from those used for other chronic granulating wounds: local wound care, appropriate topical antibacterial therapy, systemic antibiotics during the perioperative period and, most importantly, adequate soft tissue coverage

  2. Study on the changes of serum complement C 3 and IL-10 after burn injury and infection%烧伤感染后血清补体 C3 IL-10的变化

    Institute of Scientific and Technical Information of China (English)

    高敏; 刘鲲; 刘宁; 戴军; 王文军

    2015-01-01

    目的:探究机体烧伤感染后免疫因子的水平变化。方法选取2013年4月至2014年2月我院收治的200例烧伤患者,分别于烧伤后第3、7、14天检测观察外周血补体C3、IL‐10水平并进行比较。结果随着时间的推移,患者创面感染率升高;烧伤后患者补体C3和IL‐10的水平均呈现先上升后下降的变化;感染患者体内的补体C3水平均高于未感染患者;烧伤后脓毒血症患者机体补体C3和IL‐10水平均高于单独创面感染患者。结论烧伤后感染可影响患者血清补体C3和 IL‐10水平的改变,可通过对相应免疫因子水平的调节进行治疗以维持患者体内免疫反应平衡,防止感染加重。%Objective To explore the changes of serum complement C3 and IL‐10 after the burn infection .Meth‐ods Burn patients were selected from April 2013 to February 2014 in our hospital ,and the levels of serum comple‐ment C3 and IL‐10 in the peripheral blood were detected on days 3 ,7 ,14 after burns .Results Wound infection rate of patients elevated in a time‐dependent manner .Complement factor C3 and IL‐10 levels of all patients increased then declined after burn .Complement C3 levels of infected patients were higher than those of uninfected patients in different periods .Complement C3 and IL‐10 levels of sepsis patients were higher than those of patients with a single wound infection at different periods .The results have statistically significant ( P<0.05) .Conclusion Burn infec‐tion can affect the serum levels of immune factors .We can regulate levels of immune factors in order to maintain immune balance and prevent the aggravation of infection .

  3. Association between early airway damage-associated molecular patterns and subsequent bacterial infection in patients with inhalational and burn injury.

    Science.gov (United States)

    Maile, Robert; Jones, Samuel; Pan, Yinghao; Zhou, Haibo; Jaspers, Ilona; Peden, David B; Cairns, Bruce A; Noah, Terry L

    2015-05-01

    Bacterial infection is a major cause of morbidity affecting outcome following burn and inhalation injury. While experimental burn and inhalation injury animal models have suggested that mediators of cell damage and inflammation increase the risk of infection, few studies have been done on humans. This is a prospective, observational study of patients admitted to the North Carolina Jaycee Burn Center at the University of North Carolina who were intubated and on mechanical ventilation for treatment of burn and inhalational injury. Subjects were enrolled over a 2-yr period and followed till discharge or death. Serial bronchial washings from clinically indicated bronchoscopies were collected and analyzed for markers of tissue injury and inflammation. These include damage-associated molecular patterns (DAMPs) such as hyaluronic acid (HA), double-stranded DNA (dsDNA), heat-shock protein 70 (HSP-70), and high-mobility group protein B-1 (HMGB-1). The study population was comprised of 72 patients who had bacterial cultures obtained for clinical indications. Elevated HA, dsDNA, and IL-10 levels in bronchial washings obtained early (the first 72 h after injury) were significantly associated with positive bacterial respiratory cultures obtained during the first 14 days postinjury. Independent of initial inhalation injury severity and extent of surface burn, elevated levels of HA dsDNA and IL-10 in the central airways obtained early after injury are associated with subsequent positive bacterial respiratory cultures in patients intubated after acute burn/inhalation injury.

  4. 进一步重视特殊部位与特殊原因深度烧伤创面的美容修复%Lay further emphasis on the cosmetic repair of deep burn wounds in extraordinary regions or caused by uncommon agents

    Institute of Scientific and Technical Information of China (English)

    刘毅

    2014-01-01

    Along with the vigorous development of medical science and other related subjects,a lot of new techniques,concepts,materials,and methods continuously sprung up.The techniques of plastic and cosmetic surgery have already been used to repair burn wound at the early stage,especially to those wounds in extraordinary regions or caused by uncommon agents.These advances made burn wound treatment change from simply covering wound to save the patient's life to repairing wound and reconstructing function at the same time,which might achieve the aim of cosmetic repair in the future.Because of the hard work of burn surgeons,some progresses on the cosmetic repair of deep burn wounds in extraordinaru regions or caused by uncommon agents have been achieved,but there is still a long way to go for the aim of cosmetic repair.Clinical practice has proved that as long as the basic principles of cosmetic repair are followed,the techniques and methods of plastic and cosmetic surgery are employed correctly,and the role of burn rehabilitation is highly emphasized,it is practicable to achieve cosmetic repair of deep burn wounds in extraordinary regions or caused by uncommon agents.

  5. Poly(L-lactide)/halloysite nanotube electrospun mats as dual-drug delivery systems and their therapeutic efficacy in infected full-thickness burns.

    Science.gov (United States)

    Zhang, Xiazhi; Guo, Rui; Xu, Jiqing; Lan, Yong; Jiao, Yanpeng; Zhou, Changren; Zhao, Yaowu

    2015-11-01

    In this study, poly(L-lactide) (PLLA)/halloysite nanotube (HNT) electrospun mats were prepared as a dual-drug delivery system. HNTs were used to encapsulate polymyxin B sulphate (a hydrophilic drug). Dexamethasone (a hydrophobic drug) was directly dissolved in the PLLA solution. The drug-loaded HNTs with optimised encapsulation efficiency were then mixed with the PLLA solution for subsequent electrospinning to form composite dual-drug-loaded fibre mats. The structure, morphology, degradability and mechanical properties of the electrospun composite mats were characterised in detail. The results showed that the HNTs were uniformly distributed in the composite PLLA mats. The HNTs content in the mats could change the morphology and average diameter of the electrospun fibres. The HNTs improved both the tensile strength of the PLLA electrospun mats and their degradation ratio. The drug-release kinetics of the electrospun mats were investigated using ultraviolet-visible spectrophotometry. The HNTs/PLLA ratio could be varied to adjust the release of polymyxin B sulphate and dexamethasone. The antibacterial activity in vitro of the mats was evaluated using agar diffusion and turbidimetry tests, which indicated the antibacterial efficacy of the dual-drug delivery system against Gram-positive and -negative bacteria. Healing in vivo of infected full-thickness burns and infected wounds was investigated by macroscopic observation, histological observation and immunohistochemical staining. The results indicated that the electrospun mats were capable of co-loading and co-delivering hydrophilic and hydrophobic drugs, and could potentially be used as novel antibacterial wound dressings.

  6. Dual-functional Polyurea Microcapsules for Chronic Wound Care Dressings: Sustained Drug Delivery and Non-leaching Infection Control

    Science.gov (United States)

    He, Wei

    A new design of dual-functional polyurea microcapsules was proposed for chronic wound dressings to provide both non-leaching infection control and sustained topical drug delivery functionalities. Quaternary ammonium functionalized polyurea microcapsules (MCQs) were synthesized under mild conditions through an interfacial crosslinking reaction between branched polyethylenimine (PEI) and 2,4-toluene diisocyanate (TDI) in a dimethylformamide/cyclohexane emulsion. An in-situ modification method was developed to endow non-leaching surface antimicrobial properties to MCQs via bonding antimicrobial surfactants to surface isocyanate residues on the polyurea shells. The resultant robust MCQs with both non-leaching antimicrobial properties and sustained drug releasing properties have potential applications in medical textiles, such as chronic wound dressings, for infection control and drug delivery.

  7. Rhinovirus infection induces cytotoxicity and delays wound healing in bronchial epithelial cells

    Directory of Open Access Journals (Sweden)

    Constantopoulos Andreas G

    2005-10-01

    Full Text Available Abstract Background Human rhinoviruses (RV, the most common triggers of acute asthma exacerbations, are considered not cytotoxic to the bronchial epithelium. Recent observations, however, have questioned this knowledge. The aim of this study was to evaluate the ability of RV to induce epithelial cytotoxicity and affect epithelial repair in-vitro. Methods Monolayers of BEAS-2B bronchial epithelial cells, seeded at different densities were exposed to RV serotypes 1b, 5, 7, 9, 14, 16. Cytotoxicity was assessed chromatometrically. Epithelial monolayers were mechanically wounded, exposed or not to RV and the repopulation of the damaged area was assessed by image analysis. Finally epithelial cell proliferation was assessed by quantitation of proliferating cell nuclear antigen (PCNA by flow cytometry. Results RV1b, RV5, RV7, RV14 and RV16 were able to induce considerable epithelial cytotoxicity, more pronounced in less dense cultures, in a cell-density and dose-dependent manner. RV9 was not cytotoxic. Furthermore, RV infection diminished the self-repair capacity of bronchial epithelial cells and reduced cell proliferation. Conclusion RV-induced epithelial cytotoxicity may become considerable in already compromised epithelium, such as in the case of asthma. The RV-induced impairment on epithelial proliferation and self-repair capacity may contribute to the development of airway remodeling.

  8. Biobased silver nanocolloid coating on silk fibers for prevention of post-surgical wound infections

    Science.gov (United States)

    Dhas, Sindhu Priya; Anbarasan, Suruthi; Mukherjee, Amitava; Chandrasekaran, Natarajan

    2015-01-01

    Bombyx mori silk fibers are an important biomaterial and are used in surgical sutures due to their remarkable biocompatibility. The major drawback to the application of biomaterials is the risk of bacterial invasion, leading to clinical complications. We have developed an easy and cost-effective method for fabrication of antibacterial silk fibers loaded with silver nanoparticles (AgNPs) by an in situ and ex situ process using an aqueous extract of Rhizophora apiculata leaf. Scanning electron microscopy revealed that well dispersed nanoparticles impregnated the silk fibers both in situ and ex situ. The crystalline nature of the AgNPs in the silk fibers was demonstrated by X-ray diffraction. The thermal and mechanical properties of the silk fibers were enhanced after they were impregnated with AgNPs. The silver-coated silk fibers fabricated by the in situ and ex situ method exhibited more than 90% inhibition against Pseudomonas aeruginosa and Staphylococcus aureus. Silk fibers doped with AgNPs were found to be biocompatible with 3T3 fibroblasts. The results obtained represent an important advance towards the clinical application of biocompatible AgNP-loaded silk fibers for prevention of surgical wound infections. PMID:26491317

  9. Calmodulin Gene Expression in Response to Mechanical Wounding and Botrytis cinerea Infection in Tomato Fruit

    Directory of Open Access Journals (Sweden)

    Hui Peng

    2014-08-01

    Full Text Available Calmodulin, a ubiquitous calcium sensor, plays an important role in decoding stress-triggered intracellular calcium changes and regulates the functions of numerous target proteins involved in various plant physiological responses. To determine the functions of calmodulin in fleshy fruit, expression studies were performed on a family of six calmodulin genes (SlCaMs in mature-green stage tomato fruit in response to mechanical injury and Botrytis cinerea infection. Both wounding and pathogen inoculation triggered expression of all those genes, with SlCaM2 being the most responsive one to both treatments. Furthermore, all calmodulin genes were upregulated by salicylic acid and methyl jasmonate, two signaling molecules involved in plant immunity. In addition to SlCaM2, SlCaM1 was highly responsive to salicylic acid and methyl jasmonate. However, SlCaM2 exhibited a more rapid and stronger response than SlCaM1. Overexpression of SlCaM2 in tomato fruit enhanced resistance to Botrytis-induced decay, whereas reducing its expression resulted in increased lesion development. These results indicate that calmodulin is a positive regulator of plant defense in fruit by activating defense pathways including salicylate- and jasmonate-signaling pathways, and SlCaM2 is the major calmodulin gene responsible for this event.