Here - EWMA 2013

ORAL PRESENTATIONS
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Free Paper Session: Infection
ASSESSING THE BIOFILM PREVENTION AND ERADICATION ABILITY OF FOUR
ANTIMICROBIAL AGENTS USING SINGLE AND MULTI SPECIES ASSAYS
Keith Cutting 1 , Ojan Assadian 2
1 Buckinghamshire New University (Uxbridge, United Kingdom);
2 Medical University of Vienna (Vienna, Austria).
Aim: To investigate the efficacy of wound antiseptics to eradicate biofilm-embedded
bacteria and to prevent biofilm formation.
Methods: Biofilm eradication – Staphylococcus aureus and Pseudomonas aeruginosa
were used to grow biofilms on the pin lid of a 96-well microtitre plate. The 24 hour
biofilms were challenged using serial dilutions of four topical antiseptics for 5 minutes.
Using an appropriate neutralising agent test organisms were removed and survivors
recovered.
Biofilm prevention – The ability of 4 antiseptics to prevent single and multi-species S.
aureus and P. aeruginosa biofilms was assessed using a 96-well microtitre plate. The
antiseptics were tested at 30 minutes, 3, 24, 48 and 72 hours.
Results: Biofilm eradication: All antiseptics were active against planktonic S. aureus.
Antiseptics 3 and 4 completely inhibited bacterial growth in higher dilutions than
antiseptics 1 and 2. Antiseptics 2, 3 and 4 eradicated biofilm-embedded S. aureus after 5
minutes application time. All antiseptics were active against planktonic P. aeruginosa but
only antiseptics 1 and 4 demonstrated ability to eradicate P. aeruginosa in biofilm.
Biofilm prevention: All antiseptics prevented biofilm formation at 30 minute and 3 hour
application time. The antibacterial activity of the agents decreased with time. From 24
hours onwards only antiseptic 4 effectively prevented single specie biofilm formation of
S. aureus or P. aeruginosa. Only antiseptic 4 effectively prevented mixed species
biofilms.
Conclusion: The tested antiseptics performed differently in their activity against biofilms.
Knowledge on the antimicrobial ability of antiseptics is important when used for
treatment or prevention of wound infection.
FREE PAPER SESSION: INFECTION
22
Free Paper Session: Infection
W.A.R. and W.I.R.E. – NEW PREDICTION SCORES FOR EARLY IDENTIFICATION
OF INFECTION AND CHRONIFICATION
Thomas Wild 1 , Paul Jhass 2 , Matthias Augustin 3 , Thomas Eberlein 1
1 German Wound Academy (Hamburg/Dessau, Germany);
2 NHS Kent (Ashford, United Kingdom);
3 Institute for Health Services Research in Dermatology and Nursing University Medical
Center Hambur (Hamburg, Germany).
Aim: A common issue in the routine clinical management of wounds is to correctly
identify level of, and then put in place correct strategies to manage wound infections as
early as possible. Infection leads to complication, including systemic infection,
amputation and sepsis. No objective tools exist to solve this problem. The aim of the
investigation was to develop such a tool with a visual analogue scale.
Methods: In the assessment phase two main groups were identified. Group one
included unselected patients managed by community nurses and group two escalated
patients for management by specialist tissue viability nurses. After stratification of typical
income and outcome parameters a validation process of the WAR (wounds at risk) and
WIRE (wound infection risk evaluation) score document undertaken by Kent Community
Health NHS Trust UK and in Germany in certified wound healing centres with 100
patients in each country
Results: W.A.R. Score was evaluated and validated for early identification and
prevention of wound infection in the community managed patients. If the W.A.R. Score
was positive and then the W.I.R.E. Score was used to indicate the stage of infection
based of the increased level of scrutiny. This enabled early escalation to wound
managed within agreed care pathway by suitably competent clinician.
Conclusion: The use of these tools – visual scores have lead to better indication and
case management for all wound care patients both at community health care level and
then escalation for higher risk patients to sophisticated wound care centres.
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