Here - EWMA 2013

E-POSTER: DRESSINGS
E-Poster: Dressings
EP 474
Treatment of a severe horse bite at the top of the thigh by
reconstructive surgery and application of a new wound dressing
technology* until healing
Laetitia Thomassin 1 , Sonia Sebire 2
1 Laboratoires Urgo (Chenove, France);
2 Medical (Hérouville Saint Clair, France).
Aim: Horse bites are usually of moderate severity, usually presenting as pinching of the
skin with haematoma, but more rarely causing tearing of the skin. Here we report the
case of a severe bite in a 29 year-old woman. Strong, prolonged biting had caused
extensive detachment of an area of tissue following the shape of the horse’s jaw on the
anterior lateral surface of the left thigh (8 cm x 7 cm). Initial surgical treatment involved
repositioning the flap of detached skin and preventing the risk of local infection.
However, necrosis of the free edge of the flap then progressed to extensive sloughy, raw
ulceration requiring prolonged desloughing over a three-week period.
Methods: The extent of the loss of substance, the time since the initial injury and the
persistent inflammatory context of the wound prompted the use of a new wound
dressing technology* to speed up wound healing.
Results: In this study, we describe and provide rich chronological iconographic
illustrations of the different phases in the management of this wound – rare in terms of
its severity – and its favourable course under the wound dressing*, leading to complete
healing in five weeks, after the desloughing phase, pending corrective surgery for
scarring at a later stage.
Conclusions: This shows the interest of such dressing in these types of rare wounds.
* TLC-NOSF
EP 475
E-Poster: Dressings
A new anti-biofilm dressing: in vitro determination of microbial
kill rate in biofilms
Samantha Jones 1 , David Parsons 1 , Victoria Rowlands 1
1 ConvaTec Global Development Centre (Deeside, United Kingdom).
Aim: To measure the anti-biofilm properties of a new absorbent enhanced-antimicrobial
silver dressing (EASH) against bacterial biofilms.
Methods: Surface-attached colonies of Pseudomonas aeruginosa (PA01),
Staphylococcus aureus (Sa) or Candida albicans (Ca) were established on cotton gauze
substrates. Substrates were then challenged with EASH or EASH without the
antimicrobial components (non-EASH) or non-EASH with silver (SH). Dressings were
removed after 4, 24 or 48 hours and the substrates processed to quantitatively recover
the surviving bacteria. The method was further developed by applying a
polyhexamethylene biguanide (PHMB) non-adherent gauze dressing to the colonized
substrate for 48 hours to ensure the maintenance of a predominantly biofilm population.
PA01 biofilms prepared in this way were treated with an EASH or non-EASH or PHMB
dressing for 1, 2, 3, or 4 days before surviving bacteria enumerated.
Results: The EASH dressing began killing surface-attached PA01 and Sa within 4
hours, whereas Ca was more tolerant. After 48 hours all three organisms showed a
≥10,000,000-fold reduction in population. EASH was effective against a PA01 biofilm
reducing the bioburden by >10,000-fold in 24 hours and complete kill by 48 hours. All
other dressings were slower and less effective than EASH.
Conclusion: In this in-vitro study, EASH dressing was shown to have rapid broadspectrum
anti-biofilm activity and may therefore provide benefits in infection control and
removing biofilm bacteria which is a barrier to healing.
EWMA 2013
COPENHAGEN
15-17 May · 2013
Danish Wound
Healing Society
273