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Wound Infection

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1. The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system predicts wound healing better than direct angiosome perfusion in diabetic foot wounds

The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system predicts wound healing better than direct angiosome perfusion in diabetic foot wounds Previous studies show conflicting results in wound healing outcomes based on angiosome direct perfusion (DP), but few have adjusted for wound characteristics in their analyses. We have previously shown that the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification correlates (...) with wound healing in diabetic foot ulcers (DFUs) treated by a multidisciplinary team. The aim of this study was to compare WIfI classification vs DP and pedal arch patency as predictors of wound healing in patients presenting with DFU and peripheral arterial disease.We performed a retrospective review of a prospectively maintained database of all patients with peripheral arterial disease presenting to our multidisciplinary DFU clinic who underwent angiography. An angiosome was considered directly

2018 EvidenceUpdates

2. International Consolidated Wound Infection Guideline (ICWIG)

International Consolidated Wound Infection Guideline (ICWIG) Major Recommendations for the International Consolidated Wound Infection Guideline (ICWIG) Legend For International Consolidated Wound Infection Guideline (ICWIG) Recommendations Below 1. First entry is final recommendation based on evidence incorporating Validation Survey Respondent comments to assure multidisciplinary relevance. 2. Second entry is the letter indicating the standardized ICWIG Strength of Evidence described below (...) as a bona fide recommendation and was listed in normal font, not italicized. A. Results of a meta- analysis or two or more clinical wound infection-related randomized controlled trials (RCT) on humans provide support. Alternatively for diagnostics , screening or risk assessment, A-level evidence included prospective cohort (CO) studies and/or controlled studies reporting recognized diagnostic validity measures, e.g. sensitivity or specificity; or screening validity measures, such as positive or negative

2018 Association for the Advancement of Wound Care

3. Intracavity lavage and wound irrigation for prevention of surgical site infection. (PubMed)

Intracavity lavage and wound irrigation for prevention of surgical site infection. Surgical site infections (SSIs) are wound infections that occur after an operative procedure. A preventable complication, they are costly and associated with poorer patient outcomes, increased mortality, morbidity and reoperation rates. Surgical wound irrigation is an intraoperative technique, which may reduce the rate of SSIs through removal of dead or damaged tissue, metabolic waste, and wound exudate (...) . Irrigation can be undertaken prior to wound closure or postoperatively. Intracavity lavage is a similar technique used in operations that expose a bodily cavity; such as procedures on the abdominal cavity and during joint replacement surgery.To assess the effects of wound irrigation and intracavity lavage on the prevention of surgical site infection (SSI).In February 2017 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid

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2017 Cochrane

4. Absorbable sutures containing triclosan decrease wound infection rates in children

Absorbable sutures containing triclosan decrease wound infection rates in children Las suturas absorbibles que contienen triclosán disminuyen las tasas de infección de la herida quirúrgica en los niños - Evidencias en pediatría Buscando, por favor espere. Mostrar menú Gestión de biblioteca Aún no ha añadido ningún artículo a su biblioteca. | Buscar Toma de decisiones clínicas basadas en pruebas científicas Toma de decisiones clínicas basadas en pruebas científicas Mostrar menú Gestión de (...) | Artículos Valorados Críticamente Renko M, Paalanne N, Tapiainen T, Hinkkainen M, Pokka T, Kinnula S, et al . Triclosan-containing sutures versus ordinary sutures for reducing surgical site infections in children: a double-blind, randomized controlled trial. Revisores: Ruiz-Canela Cáceres J 1 , García Vera C 2 . 1 CS Virgen de África. Sevilla. España. 2 CS José Ramón Muñoz Fernández. Zaragoza. España. Correspondencia: Juan Ruiz-Canela Cáceres. Correo electrónico: Fecha de recepción: 11/05/2017 Fecha de

2017 Evidencias en Pediatría

5. Negative pressure wound therapy for surgical wounds healing by primary closure. (PubMed)

Negative pressure wound therapy for surgical wounds healing by primary closure. Indications for the use of negative pressure wound therapy (NPWT) are broad and include prophylaxis for surgical site infections (SSIs). While existing evidence for the effectiveness of NPWT remains uncertain, new trials necessitated an updated review of the evidence for the effects of NPWT on postoperative wounds healing by primary closure.To assess the effects of negative pressure wound therapy for preventing (...) surgical site infection in wounds healing through primary closure.We searched the Cochrane Wounds Specialised Register, CENTRAL, Ovid MEDLINE (including In-Process & Other Non-Indexed Citations), Ovid Embase, and EBSCO CINAHL Plus in February 2018. We also searched clinical trials registries for ongoing and unpublished studies, and checked reference lists of relevant included studies as well as reviews, meta-analyses, and health technology reports to identify additional studies. There were

2019 Cochrane

6. The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification independently predicts wound healing in diabetic foot ulcers

The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification independently predicts wound healing in diabetic foot ulcers Previous studies have reported correlation between the Wound, Ischemia, and foot Infection (WIfI) classification system and wound healing time on unadjusted analyses. However, in the only multivariable analysis to date, WIfI stage was not predictive of wound healing. Our aim was to examine the association between WIfI classification and wound (...) healing after risk adjustment in patients with diabetic foot ulcers (DFUs) treated in a multidisciplinary setting.All patients presenting to our multidisciplinary DFU clinic from June 2012 to July 2017 were enrolled in a prospective database. A Cox proportional hazards model accounting for patients' sociodemographics, comorbidities, medication profiles, and wound characteristics was used to assess the association between WIfI classification and likelihood of wound healing at 1 year.There were 310 DFU

2018 EvidenceUpdates

7. Topical antibiotics for preventing surgical site infection in wounds healing by primary intention. (PubMed)

Topical antibiotics for preventing surgical site infection in wounds healing by primary intention. Surgical site infections (SSI) can delay wound healing, impair cosmetic outcome and increase healthcare costs. Topical antibiotics are sometimes used to reduce microbial contaminant exposure following surgical procedures, with the aim of reducing SSIs.The primary objective of this review was to determine whether the application of topical antibiotics to surgical wounds that are healing by primary (...) intention reduces the incidence of SSI and whether it increases the incidence of adverse outcomes (allergic contact dermatitis, infections with patterns of antibiotic resistance and anaphylaxis).In May 2015 we searched: the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid Embase and EBSCO CINAHL. We also searched clinical trial registries for ongoing

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2016 Cochrane

8. Disposable surgical face masks for preventing surgical wound infection in clean surgery. (PubMed)

Disposable surgical face masks for preventing surgical wound infection in clean surgery. Surgical face masks were originally developed to contain and filter droplets containing microorganisms expelled from the mouth and nasopharynx of healthcare workers during surgery, thereby providing protection for the patient. However, there are several ways in which surgical face masks could potentially contribute to contamination of the surgical wound, e.g. by incorrect wear or by leaking air from (...) identified no new trials for this latest update.From the limited results it is unclear whether the wearing of surgical face masks by members of the surgical team has any impact on surgical wound infection rates for patients undergoing clean surgery.

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2016 Cochrane

9. Komodo dragon-inspired synthetic peptide DRGN-1 promotes wound-healing of a mixed-biofilm infected wound (PubMed)

Komodo dragon-inspired synthetic peptide DRGN-1 promotes wound-healing of a mixed-biofilm infected wound Cationic antimicrobial peptides are multifunctional molecules that have a high potential as therapeutic agents. We have identified a histone H1-derived peptide from the Komodo dragon (Varanus komodoensis), called VK25. Using this peptide as inspiration, we designed a synthetic peptide called DRGN-1. We evaluated the antimicrobial and anti-biofilm activity of both peptides against Pseudomonas (...) aeruginosa and Staphylococcus aureus. DRGN-1, more than VK25, exhibited potent antimicrobial and anti-biofilm activity, and permeabilized bacterial membranes. Wound healing was significantly enhanced by DRGN-1 in both uninfected and mixed biofilm (Pseudomonas aeruginosa and Staphylococcus aureus)-infected murine wounds. In a scratch wound closure assay used to elucidate the wound healing mechanism, the peptide promoted the migration of HEKa keratinocyte cells, which was inhibited by mitomycin C

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2017 NPJ biofilms and microbiomes

10. A systematic review of randomized and non-randomized studies for a meta-analysis of incisional negative pressure wound therapy versus regular surgical dressings for the prevention of surgical site infection, wound dehiscence, skin necrosis, seroma, and he

A systematic review of randomized and non-randomized studies for a meta-analysis of incisional negative pressure wound therapy versus regular surgical dressings for the prevention of surgical site infection, wound dehiscence, skin necrosis, seroma, and he Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied

2019 PROSPERO

11. Deep sternal wound infection after cardiac surgery: a comparison of three different wound infection types and an analysis of antibiotic resistance (PubMed)

Deep sternal wound infection after cardiac surgery: a comparison of three different wound infection types and an analysis of antibiotic resistance Deep sternal wound infection (DSWI) is a severe complication following cardiac surgery. We compared epidemiology, clinical features, and microbiology of three types of DSWI and examined the antibiotic resistance in DSWI patients.From 2011 to 2015, 170 adult post-cardiac surgery DSWI patients were recruited for this study and underwent the pectoralis (...) major muscle flap transposition in our department.Of 170 adult patients with DSWI (mean age of 54 years), the majority (99 patients, 58.2%) had type II DSWI. The three types of DSWI patients showed significant differences in terms of gender, smoking history, chronic obstructive pulmonary disease (COPD), length of intensive care unit (ICU) stay, and hospitalization cost (P<0.05). The most common symptoms of DSWI patients were fever and wound dehiscence accompanied by purulent secretions. Types I

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2018 Journal of thoracic disease

12. Negative pressure wound therapy for open traumatic wounds. (PubMed)

) is used as a treatment. This medical device involves the application of a wound dressing through which negative pressure is applied and tissue fluid drawn away from the area. The treatment aims to support wound management, to prepare wounds for further surgery, to reduce the risk of infection and potentially to reduce time to healing (with or without surgical intervention). There are no systematic reviews assessing the effectiveness of NPWT for traumatic wounds.To assess the effects of NPWT (...) to identify additional studies. There were no restrictions with respect to language, date of publication or study setting.Published and unpublished randomised controlled trials that used NPWT for open traumatic wounds involving either open fractures or soft tissue wounds. Wound healing, wound infection and adverse events were our primary outcomes.Two review authors independently selected eligible studies, extracted data, carried out a 'Risk of bias' assessment and rated the certainty of the evidence. Data

2018 Cochrane

13. The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system predicts wound healing but not major amputation in patients with diabetic foot ulcers treated in a multidisciplinary setting

The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification system predicts wound healing but not major amputation in patients with diabetic foot ulcers treated in a multidisciplinary setting The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) threatened limb classification has been shown to correlate well with risk of major amputation and time to wound healing in heterogeneous diabetic and nondiabetic populations. Major amputation (...) continues to plague the most severe stage 4 WIfI patients, with 1-year amputation rates of 20% to 64%. Our aim was to determine the association between WIfI stage and wound healing and major amputation among patients with diabetic foot ulcers (DFUs) treated in a multidisciplinary setting.All patients presenting to our multidisciplinary DFU clinic from July 2012 to December 2015 were enrolled in a prospective database. Wound healing and major amputation were compared for patients stratified by WIfI

2017 EvidenceUpdates

14. Culture results from wound biopsy versus wound swab: does it matter for the assessment of wound infection? (PubMed)

Culture results from wound biopsy versus wound swab: does it matter for the assessment of wound infection? The aim of this study was to determine whether assessment of wound infection differs when culture results from wound biopsy versus wound swab are available in clinical practice.For 180 eligible patients, a swab and biopsy were taken from one wound during a regular appointment at a wound care facility in eastern Netherlands. Culture results from both methods were supplemented with clinical (...) information and provided to a panel of six experts who independently assessed each wound as infect or not, separately for swab and biopsy. Assessments for biopsy and swab were compared for the complete expert panel, and for individual experts.The complete expert panel provided the same wound assessment based on (clinical information and) culture results from wound biopsy and wound swab in 158 of 180 wounds (87.8%, kappa 0.67). For individual experts, agreement between biopsy and swab varied between 77

2018 Clinical Microbiology and Infection

15. Are silver dressings clinically effective and cost effective for the healing of infected wounds and the prevention of wound infection relative to other types of dressing?

Are silver dressings clinically effective and cost effective for the healing of infected wounds and the prevention of wound infection relative to other types of dressing? Are silver dressings clinically effective and cost effective for the healing of infected wounds and the prevention of wound infection relative to other types of dressing? Are silver dressings clinically effective and cost effective for the healing of infected wounds and the prevention of wound infection relative to other types (...) of dressing? Abbotts J Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Abbotts J. Are silver dressings clinically effective and cost effective for the healing of infected wounds and the prevention of wound infection relative to other types of dressing? . Glasgow: Healthcare Improvement Scotland. Technologies scoping report 12. 2013 Authors

2013 Health Technology Assessment (HTA) Database.

16. [Superficial wound infections after colorectal surgery and appendectomy-favourable effect of Alexis wound edge protector]

[Superficial wound infections after colorectal surgery and appendectomy-favourable effect of Alexis wound edge protector] Ytliga sårinfektioner efter kolorektal kirurgi och appendektomi – gynnsam effekt av Alexis sårkantsskydd [Superficial wound infections after colorectal surgery and appendectomy-favourable effect of Alexis wound edge protector] Ytliga sårinfektioner efter kolorektal kirurgi och appendektomi – gynnsam effekt av Alexis sårkantsskydd [Superficial wound infections after (...) colorectal surgery and appendectomy-favourable effect of Alexis wound edge protector] Lennmarken C, Persson E, Brorsson B Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Lennmarken C, Persson E, Brorsson B. Ytliga sårinfektioner efter kolorektal kirurgi och appendektomi – gynnsam effekt av Alexis sårkantsskydd. [Superficial wound infections after

2014 Health Technology Assessment (HTA) Database.

17. Use of Closed Incisional Negative Pressure Wound Therapy After Revision Total Hip and Knee Arthroplasty in Patients at High Risk for Infection: A Prospective, Randomized Clinical Trial

Use of Closed Incisional Negative Pressure Wound Therapy After Revision Total Hip and Knee Arthroplasty in Patients at High Risk for Infection: A Prospective, Randomized Clinical Trial Continuous wound drainage after arthroplasty can lead to the development of a periprosthetic joint infection. Closed incisional negative pressure wound therapy (ciNPWT) has been reported to help alleviate drainage and other wound complications. The purpose of this prospective randomized controlled trial (...) joint infection and inflammatory arthritis, the ciNPWT cohort had a significantly decreased wound complication rate (odds ratio 0.28, 95% confidence interval 0.11-0.68).ciNPWT may decrease the rate of postoperative wound complications in patients who are at an increased risk of such wound issues after revision arthroplasty.Copyright © 2019 The Authors. Published by Elsevier Inc. All rights reserved.

2019 EvidenceUpdates

18. Differentiation between infected and non-infected wounds using an electronic nose. (PubMed)

Differentiation between infected and non-infected wounds using an electronic nose. The aim of this study was to explore whether an electronic nose, Aetholab, is able to discriminate between infected versus non-infected wounds, based on headspace analyses from wound swabs.A total of 77 patients participated in this pilot study. Each wound was assessed for infection based on clinical judgment. Additionally, two wound swabs were taken, one for microbiological culture and one for measurement (...) a promising diagnostic tool for wound infection given the diagnostic properties presented in this pilot study. A larger study is needed to confirm our results.Copyright © 2019 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

2019 Clinical Microbiology and Infection

19. Assessment of Severe Extremity Wound Bioburden at the Time of Definitive Wound Closure or Coverage: Correlation With Subsequent Postclosure Deep Wound Infection (Bioburden Study). (PubMed)

Assessment of Severe Extremity Wound Bioburden at the Time of Definitive Wound Closure or Coverage: Correlation With Subsequent Postclosure Deep Wound Infection (Bioburden Study). Infection remains the most common and significant complication after high-energy fractures. The Bioburden Study is a multicenter, prospective, observational cohort study of wound bacterial bioburden and antibiotic care in severe open lower extremity fractures. The aims of this study are to (1) characterize (...) the contemporary extremity wound "bioburden" at the time of definitive wound closure; (2) determine the concordance between polymerase chain reaction results and hospital microbiology; (3) determine, among those who develop deep infections, the concordance between the pathogens at wound closure and at deep infection; and (4) compare the probability of deep infection between those who did and did not receive an appropriate course of antibiotics based on bioburden at the time of wound closure. To address

2017 Journal of Orthopaedic Trauma

20. Synthesis of graphene oxide-quaternary ammonium nanocomposite with synergistic antibacterial activity to promote infected wound healing (PubMed)

Synthesis of graphene oxide-quaternary ammonium nanocomposite with synergistic antibacterial activity to promote infected wound healing Bacterial infection is one of the most common complications in burn, trauma, and chronic refractory wounds and is an impediment to healing. The frequent occurrence of antimicrobial-resistant bacteria due to irrational application of antibiotics increases treatment cost and mortality. Graphene oxide (GO) has been generally reported to possess high antimicrobial (...) indicated that GO-QAS did not exhibit obvious toxicity towards mammalian cells or organs at low concentrations. Notably, GO-QAS topically applied on infected wounds maintained highly efficient antibacterial activity and promoted infected wound healing in vivo.The GO-QAS nanocomposite exhibits excellent synergistic antibacterial activity and good biocompatibility both in vitro and in vivo. The antibacterial mechanisms involve both mechanical membrane perturbation and oxidative stress induction

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2018 Burns & trauma

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