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Wound Infection

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141. Burkholderia thailandensis Isolated from Infected Wound, Arkansas, USA. (PubMed)

Burkholderia thailandensis Isolated from Infected Wound, Arkansas, USA. The bacterium Burkholderia thailandensis, a member of the Burkholderia pseudomallei complex, is generally considered nonpathogenic; however, on rare occasions, B. thailandensis infections have been reported. We describe a clinical isolate of B. thailandensis, BtAR2017, recovered from a patient with an infected wound in Arkansas, USA, in 2017.

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2018 Emerging Infectious Diseases

142. Efficacy and tolerability of a cocktail of bacteriophages to treat burn wounds infected by Pseudomonas aeruginosa (PhagoBurn): a randomised, controlled, double-blind phase 1/2 trial. (PubMed)

Efficacy and tolerability of a cocktail of bacteriophages to treat burn wounds infected by Pseudomonas aeruginosa (PhagoBurn): a randomised, controlled, double-blind phase 1/2 trial. Wound infections are the main cause of sepsis in patients with burns and increase burn-related morbidity and mortality. Bacteriophages, natural bacterial viruses, are being considered as an alternative therapy to treat infections caused by multidrug-resistant bacteria. We aimed to compare the efficacy (...) and tolerability of a cocktail of lytic anti-Pseudomonas aeruginosa bacteriophages with standard of care for patients with burns.In this randomised phase 1/2 trial, patients with a confirmed burn wound infection were recruited from nine burn centres in hospitals in France and Belgium. Patients were eligible if they were aged 18 years or older and had a burn wound clinically infected with P aeruginosa. Eligible participants were randomly assigned (1:1) by use of an interactive web response system to a cocktail

2018 Lancet infectious diseases

143. Psychrobacter sanguinis Wound Infection Associated with Marine Environment Exposure, Washington, USA. (PubMed)

Psychrobacter sanguinis Wound Infection Associated with Marine Environment Exposure, Washington, USA. We report a 26-year-old man with Psychrobacter sanguinis cellulitis of a wound sustained during ocean fishing in Washington, USA, in 2017. Psychrobacter spp. are opportunistic pathogens found in a wide range of environments. Clinicians should be aware of Psychrobacter spp. and perform 16S rRNA sequencing if this pathogen is suspected.

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2018 Emerging Infectious Diseases

144. Use of retrieval bag in the prevention of wound infection in elective laparoscopic cholecystectomy: is it evidence-based? A meta-analysis. (PubMed)

Use of retrieval bag in the prevention of wound infection in elective laparoscopic cholecystectomy: is it evidence-based? A meta-analysis. Surgical site infections complicate elective laparoscopic cholecystectomies in 2,4-3,2% of cases. During the operation the gallbladder is commonly extracted with a retrieval bag. We conducted a meta-analysis to clarify whether its use plays a role in preventing infections.Inclusion criteria: elective cholecystectomy, details about the gallbladder extraction (...) ").The comprehensive literature revealed 279 articles. The eligible studies were 2 randomized trials and a multicentre prospective study. Wound infections were documented in 14 on 334 (4,2%) patients operated using a retrieval bag versus 16 on 271 (5,9%) patients operated without the use of a retrieval bag. The statistical analysis revealed a risk ratio (RR) of 0.82 (0.41-1.63 95% CI). Concerning sensitivity analysis the estimated pooled RR ranged from 0.72 to 0.96, both not statistically significant. Harbord test

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2018 BMC Surgery

145. The use of vacuum-assisted closure in spinal wound infections with or without exposed dura. (PubMed)

The use of vacuum-assisted closure in spinal wound infections with or without exposed dura. The treatment of postoperative deep spinal wound infection involves debridement and intravenous antibiotics. Authors have previously reported success in a small series of patients treated with vacuum-assisted closure (VAC) therapy, but its use over exposed dura is controversial and the outcome has not been reported in large series.To review the outcomes following the treatment of postoperative spinal (...) of antibiotics. We report on the number of visits to theatre required for dressing changes and debridement and the eventual outcomes.Five patients required a flap reconstruction. Two patients died before definitive final closure due to other complications (pneumonia and stroke). In all the other patients, their wounds healed fully. A mean of 2.3 infection surgeries were required to eradicate infection and achieve wound closure.This is one of the largest studies which confirms the safety and efficacy of VAC

2018 European Spine Journal

146. Antimicrobial-Resistant Bacteria in Infected Wounds, Ghana, 2014<sup>1</sup>. (PubMed)

Antimicrobial-Resistant Bacteria in Infected Wounds, Ghana, 20141. Wound infections are an emerging medical problem worldwide, frequently neglected in under-resourced countries. Bacterial culture and antimicrobial drug resistance testing of infected wounds in patients in a rural hospital in Ghana identified no methicillin-resistant Staphylococcus aureus or carbapenem-resistant Enterobacteriaceae but identified high combined resistance of Enterobacteriaceae against third-generation

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2018 Emerging Infectious Diseases

147. Empirical measurement of pressure in NPWT for infected wounds: how long can it really stay under pressure? (PubMed)

Empirical measurement of pressure in NPWT for infected wounds: how long can it really stay under pressure? Surgical site infections represent one of the most common surgical complications. Negative pressure wound therapy is considered an effective wound management system, based on the principle that a negative pressure inside the wound can suction fluids and approximate wound edges. With the negative pressure wound therapy systems commercially available it is assumed that the pressure inside (...) the wound is stable at the set values. We conducted a prospective experimental study to investigate this. The negative pressure level achieved inside the dressing was investigated at a standard distance from the pad of suction and at specific times in patients with surgical site infections. Pressure measurements were performed in 28 dressings in 14 patients admitted to the Emergency Surgery Department between April 2016 and June 2017. In general, the machine was set at a pressure of -100 mmHg. Negative

2018 Wound Repair and Regeneration

148. Effect of Negative Pressure Wound Therapy vs Standard Wound Management on 12-Month Disability Among Adults With Severe Open Fracture of the Lower Limb: The WOLLF Randomized Clinical Trial. (PubMed)

Effect of Negative Pressure Wound Therapy vs Standard Wound Management on 12-Month Disability Among Adults With Severe Open Fracture of the Lower Limb: The WOLLF Randomized Clinical Trial. Open fractures of the lower limb occur when a broken bone penetrates the skin. There can be major complications from these fractures, which can be life-changing.To assess the disability, rate of deep infection, and quality of life in patients with severe open fracture of the lower limb treated with negative (...) solid foam or gauze was placed over the surface of the wound and connected to a suction pump, creating a partial vacuum over the dressing, vs standard dressings not involving application of negative pressure (n = 234).Disability Rating Index score (range, 0 [no disability] to 100 [completely disabled]) at 12 months was the primary outcome measure, with a minimal clinically important difference of 8 points. Secondary outcomes were complications including deep infection and quality of life (score

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2018 JAMA

149. Open vs Closed Negative Pressure Wound Therapy for Contaminated and Dirty Surgical Wounds: A Prospective Randomized Comparison

consented preoperatively, but not entered nor assigned treatment until intraoperative findings were known. Patients were randomly assigned to either open-NPWT or a wound closed with skin staples and external closed-NPWT. Primary outcome was time to complete wound healing, defined as complete epithelization of the wound. Secondary outcomes were wound complications including wound infection, seroma, and dehiscence. Statistical analysis was performed using chi-square test, Fisher exact test, t-test (...) , and Wilcoxon Rank-Sum test with significance of p < 0.05.Twenty-five closed-NPWT and 24 open-NPWT patients were analyzed. There were no significant differences in sex, mean age, BMI, smoking history, steroid use, comorbidities, or indication for surgery in the 2 groups. One patient in the open-NPWT group and 2 patients in the closed-NPWT group developed a wound infection (p = 1.0). Four open-NPWT and 3 closed-NPWT patients died from complications unrelated to the wound. Wound healing occurred at a median

2018 EvidenceUpdates

150. Negative pressure wound therapy for skin grafts and surgical wounds healing by primary intention. (PubMed)

or high risk of bias for one or more of the quality indicators we assessed. Seven trials compared NPWT with a standard dressing (two of these were 'home-made' NPWT devices), one trial compared one 'home-made' NPWT with a commercially available device. In trials where the individual was the unit of randomisation, there were no differences in the incidence of surgical site infections (SSI); wound dehiscence, re-operation (in incisional wounds); seroma/haematoma; or failed skin grafts. Lower re-operation (...) Negative pressure wound therapy for skin grafts and surgical wounds healing by primary intention. Indications for the use of negative pressure wound therapy (NPWT) are broadening with a range of systems now available on the market, including those designed for use on clean, closed incisions and skin grafts. Reviews have concluded that the evidence for the effectiveness of NPWT remains uncertain, however, it is a rapidly evolving therapy. Consequently, an updated systematic review

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2014 Cochrane

151. Prophylactic Negative Pressure Wound Therapy and Wound Complication After Cesarean Delivery in Women With Class II or III Obesity: A Randomized Controlled Trial

Prophylactic Negative Pressure Wound Therapy and Wound Complication After Cesarean Delivery in Women With Class II or III Obesity: A Randomized Controlled Trial To compare the occurrence of superficial surgical site infections in obese women using prophylactic negative pressure therapy with standard dressings after cesarean delivery.We conducted a randomized controlled, nonblinded, two-center study of prophylactic negative pressure therapy compared with standard surgical dressings placed (...) January 5, 2015, and January 7, 2017, from two sites. The mean BMI on admission was 44.9 (±8) for the prophylactic negative wound therapy group and 43.4 (±7) for the standard dressing group. There were no differences in the occurrence of observed superficial surgical site infections between women using prophylactic negative pressure wound therapy (12/80 [15%]) compared with women who received the standard dressing (8/81 [10%], P=.35, relative risk 1.52, 95% CI 0.66-3.52). There were no differences

2018 EvidenceUpdates

152. PICO negative pressure wound dressings for closed surgical incisions

surgical incisions in the NHS. They are associated with fewer surgical site infections and seromas compared with standard wound dressings. 1.2 PICO negative pressure wound dressings should be considered as an option for closed surgical incisions in people who are at high risk of developing surgical site infections. Risk factors for surgical site infections are described in section 4.2. 1.3 Cost modelling suggests that PICO negative pressure wound dressings provide extra clinical benefits at a similar (...) overall cost compared with standard wound dressings. Wh Why the committee made these recommendations y the committee made these recommendations PICO negative pressure wound dressings are designed to allow an even distribution of negative pressure on the surface of a closed surgical incision. The system is also designed to be portable. Clinical evidence shows that using PICO dressings for closed surgical incisions can lead to fewer surgical site infections. Evidence also shows that using PICO dressings

2019 National Institute for Health and Clinical Excellence - Medical technologies

153. Negative Pressure Wound Therapy (NPWT)

: pressure ulcers; venous leg ulcers; burns; open traumatic wounds; open abdomen; wounds healing by primary intention (including split-thickness skin grafts, caesarean section wounds and closed incision wounds); surgical wounds healing by secondary intention; and sternal wound infections after cardiothoracic surgery. Consensus statements to guide best practice • Exploratory work by SHTG highlighted the need for guidance on the appropriate and safe use of NPWT in NHSScotland. Therefore consensus (...) research to consolidate the existing evidence. Trauma wounds ? For open fracture wounds, a good quality systematic review reported no statistically significant difference between NPWT and standard care in the proportion of wounds healed at 6 weeks (based on one robust RCT). ? The same systematic review concluded that it was uncertain whether there was a difference in risk of wound infection, adverse events, time to closure or coverage surgery, pain or health-related quality of life between NPWT

2019 SHTG Advice Statements

154. Effects of Aloe Vera and Chitosan Nanoparticle Thin-Film Membranes on Wound Healing in Full Thickness Infected Wounds with Methicillin Resistant Staphylococcus Aureus (PubMed)

Effects of Aloe Vera and Chitosan Nanoparticle Thin-Film Membranes on Wound Healing in Full Thickness Infected Wounds with Methicillin Resistant Staphylococcus Aureus To assess effect of Aleo vera with chitosan nanoparticle biofilm on wound healing in full thickness infected wounds with antibiotic resistant gram positive bacteria.Thirty rats were randomized into five groups of six rats each. Group I: Animals with uninfected wounds treated with 0.9% saline solution. Group II: Animals (...) with infected wounds treated with saline. Group III: Animals with infected wounds were dressed with chitosan nanoparticle thin-film membranes. Group IV: Animals with infected wounds were treated topically with Aloe vera and Group V: Animals with infected wounds were treated topically with Aloe vera and dressed with chitosan nanoparticle thin-film membranes. Wound size was measured on 6, 9, 12, 15, 18 and 21days after surgery.Microbiology, reduction in wound area and hydroxyproline contents indicated

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2018 Bulletin of emergency & trauma

155. Mixing two different propolis samples potentiates their antimicrobial activity and wound healing property: A novel approach in wound healing and infection (PubMed)

Mixing two different propolis samples potentiates their antimicrobial activity and wound healing property: A novel approach in wound healing and infection The study aimed to investigate whether mixing two different propolis samples can potentiate their biological activity. This hypothesis was tested by studying the effect of mixed propolis on microbial growth and wound healing and compared with the effect of each propolis individually.The effect of mixing two different propolis extracts (...) (A and B) collected from different locations in Iraq on Escherichia coli, Staphylococcus aureus, and Candida albicans was studied by minimum inhibitory concentration assessment and compared with the effect of each propolis. Wound healing effect of the mixed propolis was studied. Twenty-four rabbits were used for the experiment, and they were assigned to four groups. Wounds were created on the dorsum of each rabbit and treated by topical application of 1 mL of either mixed propolis, propolis

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2018 Veterinary world

156. Wound healing and infection in surgery. The clinical impact of smoking and smoking cessation: a systematic review and meta-analysis

Wound healing and infection in surgery. The clinical impact of smoking and smoking cessation: a systematic review and meta-analysis Wound healing and infection in surgery. The clinical impact of smoking and smoking cessation: a systematic review and meta-analysis Wound healing and infection in surgery. The clinical impact of smoking and smoking cessation: a systematic review and meta-analysis Sorensen LT CRD summary The authors concluded that across all specialties smokers had a higher (...) of perioperative smoking cessation on postoperative healing complications were also eligible. Trials with more than 40% drop-out were excluded. Eligible outcomes included all types of adverse healing events after surgical procedures with access through a skin incision, short-term healing outcomes (wound and tissue flap necrosis, healing delay, dehiscence of wounds and sutured tissue, surgical site infections, non-specified wound complications) and long-term healing outcomes (hernias and lack of fistula or bone

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2012 DARE.

157. Wound protectors reduce surgical site infection: a meta-analysis of randomized controlled trials

Wound protectors reduce surgical site infection: a meta-analysis of randomized controlled trials Wound protectors reduce surgical site infection: a meta-analysis of randomized controlled trials Wound protectors reduce surgical site infection: a meta-analysis of randomized controlled trials Edwards JP, Ho AL, Tee MC, Dixon E, Ball CG CRD summary The authors concluded that wound protectors reduced the rate of surgical site infection after gastrointestinal or biliary tract surgery (...) , and they recommended their routine use in clinical practice. This was a well-conducted review, and the authors' conclusions seem reliable. Authors' objectives To evaluate whether wound protectors reduce the risk of surgical site infection, in patients undergoing gastrointestinal or biliary tract surgery. Searching MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to March 2011, without limits on language or publication status. Search terms were reported

2012 DARE.

158. Systematic review of the clinical effectiveness of wound-edge protection devices in reducing surgical site infection in patients undergoing open abdominal surgery

Systematic review of the clinical effectiveness of wound-edge protection devices in reducing surgical site infection in patients undergoing open abdominal surgery Systematic review of the clinical effectiveness of wound-edge protection devices in reducing surgical site infection in patients undergoing open abdominal surgery. Systematic review of the clinical effectiveness of wound-edge protection devices in reducing surgical site infection in patients undergoing open abdominal surgery. Gheorghe (...) A, Calvert M, Pinkney TD, Fletcher BR, Bartlett DC, Hawkins WJ, Mak T, Youssef H, Wilson S CRD summary This review concluded that wound–edge protection devices may have been efficient for reducing postoperative surgical site infections in patients who underwent open abdominal surgery, compared with standard care. The poor quality of the evidence indicated a need for a large good quality randomised controlled trial. This seems a reliable conclusion from a well-conducted review. Authors' objectives

2012 DARE.

159. Closure methods for laparotomy incisions for preventing incisional hernias and other wound complications. (PubMed)

with multifilament sutures (RR 0.76, 95% CI 0.59 to 0.98, I2 = 30%, moderate-quality evidence).For our secondary outcomes, we found that none of the interventions reduced the risk of wound infection, whether based on suture absorption (absorbable versus non-absorbable sutures, RR 0.99, 95% CI 0.84 to 1.17, moderate-quality evidence; or slow versus fast absorbable sutures, RR 1.16, 95% CI 0.85 to 1.57, moderate-quality evidence), closure method (mass versus layered, RR 0.93, 95% CI 0.67 to 1.30, low-quality (...) Closure methods for laparotomy incisions for preventing incisional hernias and other wound complications. Surgeons who perform laparotomy have a number of decisions to make regarding abdominal closure. Material and size of potential suture types varies widely. In addition, surgeons can choose to close the incision in anatomic layers or mass ('en masse'), as well as using either a continuous or interrupted suturing technique, of which there are different styles of each. There is ongoing debate

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2017 Cochrane

160. Systemic antibiotics for treating malignant wounds. (PubMed)

on alleviating pain, controlling infection and odour from the wound, managing exudate and protecting the surrounding skin from further deterioration. In malignant wounds, with tissue degradation and death, there is proliferation of both anaerobic and aerobic bacteria. The aim of antibiotic therapy is to successfully eliminate these bacteria, reduce associated symptoms, such as odour, and promote wound healing.To assess the effects of systemic antibiotics for treating malignant wounds.We searched (...) Systemic antibiotics for treating malignant wounds. Malignant wounds are a devastating complication of cancer. They usually develop in the last six months of life, in the breast, chest wall or head and neck regions. They are very difficult to treat successfully, and the commonly associated symptoms of pain, exudate, malodour, and the risk of haemorrhage are extremely distressing for those with advanced cancer. Treatment and care of malignant wounds is primarily palliative, and focuses

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2017 Cochrane

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