Here - EWMA 2013

P 312
Management of topical infected wounds or potential risk of
infection
Poster: Infection
Thomas Wild 1 , Michael Schmitz 2 , Martin Abel 3 , M. Softic 4 , Thomas Eberlein 1
1 Wound Consulting (Wien, Austria);
2 MCS Medical Consulting (Oberahr, Germany);
3 Lohmann & Rauscher (Rengsdorf, Germany);
4 Bosnian-Herzegovinian Heart Center Tuzla (Tuzla, Bosnia and Herzegovina).
Aim: Management of topical infected wounds as well as wounds with potential risk of
infection are challenging in both ways identification and handling. The outcome is a
special need for a sufficient, cost-effective and easy-to-use procedure for handling of
such situations.
Methods: In a case study with 13 patients with wounds of various aetiologies and a
problematical bacterial load we have them undertaken the following treatment concept:
1. wound cleansing (mechanical debridement) using a microfiber pad*
2. antimicrobial topical therapy according to exudation level either using an phmbcontaining
biocellulose dressing** or a silver alginate dressing***
3. Visual control of the reduction of signs of infection and subjective control of the
reduction of odour
4. control of clinical success by electronical analysis of the percentage of slough and
granulation by WHAT wound healing analysing tool
The primary endpoint was to detect a granulation shift (>50% granulation tissue) within 8
days.
Results: In all cases, the treatment outlined above resulted in total reduction of odour (8
days in median) and signs of infection (7,57 days in median). Granulation shift was
reached in 5 days, as well in all cases a granulation tissue of more than 90% in 10 days.
Conclusion: The selected treatment is effective and able to reduce the signs of infection
and odour and does not harm the granulation tissue. The described procedure seems to
be an interesting and efficient management concept for sloughy wounds with high risk or
topical signs of infection.
References not available.
Poster: Infection
P 311
SURGICAL DEBRIDEMENT ALONE DEBRIDEMENT ALONE DOES NOT
ADEQUATELY REDUCE PLANKTONIC BIOBURDEN IN CHRONIC LOWER
EXTREMITY WOUNDS
John Lantis 1 , Jamie Schwartz 1 , Ema Avdagic 1 , Cynthia Gendics 1
1 St. Luke’s-Roosevelt Hospital; Columbia University (New York, United States).
Aim: Many surgeons feel that sharp surgical debridement is adequate bacterial control
for the local wound bed. We undertook a prospective study to look at the reduction in
quantitative planktonic bacteria before and after operating room debridement.
Methods: Fourteen patients who underwent debridement under regional or general
anesthetic were randomized to either Hydrodebridement (HD)1or sharp steel (SS)
debridement followed by 80 PSI pulse irrigation. Quantitative cultures were taken before
and after treatment.
Results: There was no significant difference in the two groups for wound etiology (DFU,
VLU, Vasculitis and post surgical). The wounds had been present for (HD) 13.9 mo vs
(SS) 18.8 mo for the SS group. The HD vs SS wound area was 75.28 cm 2 (±98.37cm 2 )
vs 20.27cm 2 (±33.62 cm 2 ) (p=0.26). The bacterial counts before debridement were
1x107 (HD) vs 1.4x107(SS), after debridement 2.5x106 (HD) vs 7.5x105(SS) (p=0.41).
The reduction in bacteria by the two types of therapy were 7.5x106(HD) vs 1.3x107(SS)
(p=0.37). However, as a percentage 75% of bacteria killed by HD was statistically less
than the 93% killed by SS (p