Here - EWMA 2013

ORAL PRESENTATIONS
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Free Paper Session: Infection
THE IRRESISTIBLE FORCE OF LONG FIBRE ACTIVATED CARBON CLOTH ON
COLONISED WOUND OUTCOMES
Martin Tadej 1 , Cathie Bree-Aslan 1 , Sylvie Hampton 1 , Aaron Knowles 1
1 Wound Healing Centres CIC (Eastbourne, United Kingdom).
Aim: To ascertain the antimicrobial and overall performance of Long Fibre Carbon dressing on
2 cohorts of patients with non-healing colonised wounds.
Methods:
• Subjects were treated for 4 weeks using Long Fibre Carbon dressing
• Swabs were taken from all wounds on days 1, 3 and 7
• pH was tested on each visit
• Photographs were obtained on each visit.
• Subjects seen twice a week initially until 7th day; visits were then weekly
• Lined buckets of tap water were used for leg cleansing
• Qualitative and quantitative data and wound progress was recorded in CRFs
• Wound measurements were obtained with Digital Planimetry.
Results:
• Exudate level decreased at each visit for all subjects and the number of those subjects with
serous exudate rose from 60% to 85%, demonstrating a reduction in bacterial loading.
• 100% of cohort 2 experienced pain reduction during the first week of using the dressing. One
subject expressed a mild increase of pain on day 1 of the evaluation but this returned to base
level of 1 by the second visit.
• Only 20% of subject yielded swabs negative for any organisms on day 7 though visually all
100% of wounds showed reduced slough presence and greater formation of granulating tissue
over the first week and this continued to improve. The bacteria type in the wound changed rather
than reduced but this colonisation did not affect wound healing.
• Clinicians found it easy to apply and remove and rating of the product was 100% that they would
wish to use it again.
• Malodour was significantly reduced as would be expected when bacterial load is reduced.
• Pseudomonas incidence dropped from 2 subjects to 1 for days 3 and 7
• Two subjects were clear of bacterial cultures on swab results by day 7
• Group C Beta-haemolytic streptococcus bacteria incidences were low, one initially then 2 on day
3 before no trace was found on any subjects on day 7. However, both subjects who had group C
on day 3 developed group G on day 7.
• Purulence was only seen in 2 subjects at the start and was eliminated by day 3 though
reoccurred in one subject by the end of the week. Progression from purulent to haemoserous to
more commonly encountered and healthy serous exudates indicates an improving wound bed
moving towards healing.
• Exudate level decreased significantly at successive visit.
• Significant malodour was only encountered on the first visit before use of the long fibre carbon
began with all reports falling to mild or none by day 3.
Conclusions: This evaluation demonstrated some the effectiveness of Long Fibre Carbon in
chronic wounds and supported the idea that colonisation can be reduced and has the possibility of
changing views of how Long Fibre Carbon should be positioned in wound care.
FREE PAPER SESSION: INFECTION
18
Free Paper Session: Infection
EFFICACY OF VARIOUS TOPICAL ANTIMICROBIAL AGENTS IN DIFFERENT TIME
PERIODS AFTER BACTERIAL CONTAMINATION OF BURN WOUND
Marianna Hajska 1 , Livia Slobodnikova 2 , Helena Hupkova 2 , Jan Koller 1
1 Teaching Department of Burns and Reconstructive Surgery, Medical Faculty of
Comenius University (Bratislava, Slovakia);
2 Institute of Microbiology, Medical Faculty of Comenius University (Bratislava, Slovakia).
Aim: In vitro efficacy evaluation of eleven topical antimicrobial agents frequently used in
our burn centre against six multidrug-resistant bacterial strains isolated from patients´
burn wounds.
Material and Methods: A simple and reproducible in vitro model was used to evaluate
the effects of following topical antimicrobials: 1% silver sulfadiazine, 1% acetic acid,
0,2% nitrofurazone, povidone iodine solution, octenidindihydrochloride solution, chloride
solution, 1% acetic acid+1% silver sulfadiazine, manuka honey dressing, 2 silver
impregnated dressings and 1 dressing impregnated with silver and hyaluronic acid.
Different wound models were created (freshly contaminated, 4hours, 6hours and
24hours from contamination). Survival of 6 bacteria – Pseudomonas aeruginosa
(2strains), Staphylococcus aureus, Staphylococcus haemolyticus, Enterococcus faecalis
and Escherichia coli – was evaluated 24-hours after application of the agents.
Results: The efficacy against all strains in planktonic form (freshly contaminated wound
model) was excellent in the majority of the tested agents. The longer was the period
between contamination and application of topical antimicrobial, the higher infectivity of
the agents was observed. The highest efficacy from all the antimicrobials had povidone
iodine and octenidindihydrochloride.
Conclusions: Topical antimicrobial agents play an important role in treatment of burns,
but they should be used according to their efficacy against bacterial strains in patients’
wounds. According to the results obtained 24 hours after bacterial contamination of the
burn wounds, it was not possible to kill the bacteria using topical antimicrobial therapy
only.
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