What's new in wound infection?

NEW EDUCATIONAL RESOURCE

Schofield Healthcare Media to launch Wound International

"Wounds International will be a dynamic, all-inclusive educational resource on wound management for healthcare professionals worldwide"

web: www.woundsinternational.com

WOUND INFECTION ASSOCIATED PAIN

The June  2009 issue of the Journal of Wound Care carries the following paper on wound infection:

• Wound infection associated pain (R. White)

Commentary: "Wound infection and the release of pro-inflammatory modulators result in both local pain and delayed healing...by implication, the treatment ofpain is asimportant as the treatment of infection itself"

OVERUSE OF ANTIBIOTICS

A survey presented at the Norwegian Wound Healing Association in February this year showed that "57.3% of all patients with chronic wounds treated in primary health care in a Southern Norwegian region had received antibiotics prior to referral to a wound healing unit. This overuse of antibiotics, often representing the only therapeutic option taken, underlines the need to discuss the subject of wound infection." Source: Dr Marcus Gurgen, EWMA Journal, May 2009

INFECTION PREVENTION:

Interested in infection prevention strategies in the clinic? the Institute for Healthcare Improvement's web site publishes guides to the prevention of hsopital acquired and surgical site infections

http://www.ihi.org/IHI/Topics/PatientSafety

TNP:

The April 2009 issue of the Journal of Wound Care carries the following paper on wound microbiology:

• Effect of TNP on the microbiology of venous leg ulcers: a pilot study (M. Khashram, P.Huggan, R. Ikram, S. Chambers, J. Roake, D.Lewis)

Commentary: Results of this pilot study suggest that VAC therapy appears to increase the microbiological flora of chronic, non-infected VLUs over the first six days period of treatment

Yeast:

The March 2009 issue of the Journal of Wound Care carries the following paper on wound infection:

• Identification of yeast in chronic wounds using new pathigen detection techniques (J. Leake, S. Dowd, R. Wolcott, A. Zischkau, Y. Sun)

Commentary: While bacteria are the usual focus of chronic wound studies, fungal populations also contribute to chronic wound biofilms. This paper describes how molecular analysis identified the presence of fungi in chronic wound biofilms

MICROBIOLOGICAL PROFILE OF CHRONIC WOUNDS:

The February 2009 issue of  Ostomy Wound Management carries the following paper on wound infection:

• A prospective,descriptive study to identify the microbiological profile of chronic wounds in outpatients (S. Basu et al)

Commentary: The authors conducted a prospective, descriptive cohort study of 50 patients with 52 chronic wounds to helpclinicians provide the most appropriate antibiotics while awaiting culture results. Eighteen per cent of pathogens were found to be drug resistant, which led the authors to encourage judicious use of antibiotic therapy.

EVIDENCE NEEDED FOR SILVER DRESSINGS:

The February 2009 issue of the Journal of Wound Care carries the following paper on wound infection:

• Silver dressings: more evidence is needed to support their widespread clinical use (M. Collier)

Commentary: A systematic review of 9 studies of silver treatments  used for the management of patients with leg ulcers concluded that the current evidence base is limited, both in terms of quantity and quality. There is a clear need for RCTs involving a number of silver dressings in a variety of clinical scenarios (acute and chronic). An evaluation of the antimicrobial effect of silver containing dressings is currently being undertaken within the United Lincolnshire NHS (Acute) in the UK, the results of which are expected in the Autumn.

NICE GUIDELINES FROM THIS SITE:

NICE Guidelines on prevention and treatment of surgical site infections are available to download here! Released in October this year, these guidelines are a comprehensive and highly valuable set of recommendations from the UK. Go to "Useful Documents" to download your free copy today!

BACTERIAL BURDEN IN CHRONIC WOUNDS:

The December 2008 issue of the Journal of Wound Care carries the following papers on wound infection:

• A rapid molecular method for characterising bacterial bioburden in chronic wounds (R.D. Wolcott, S.E. Dowd)

Commentary: This case study describes a culture free alternative to routine diagnostic evaluation (such as swabbing and culture analysis) which could within hours identify the presence of pathogens that have been overlooked in previous culture reports

SOFT SILICONE (JOW, NOV 2008)

• An observational study of the use of a sift silicone silver dressing on a variety of wound types (F. Meuleneire)

MANAGEMENT STRATEGIES FOR BIOFILMS (JOW, NOV 2008)

• Biofilms in wounds - management strategies (D.D. Rhoads, R.D. Wolcott, S.L. Percival)

Commentary: This paper considers management strategies for suppressing biofilms and proposes simultaneous strategies as more effective than single or sequential strategies in the long term. It also distinguishes between antimicrobials (antibiotics and antiseptics as currently used) and "antibiofilm agents", therapies used and under investigation, designed to suppress biofilm activity on the cellular level.

RECENTLY PUBLISHED (USA):

The November 2008 issue of Ostomy Wound Management includes 2 articles on wound infection:

1. Research:Determining the effect of an oak bark formulation on MRSA and wound healing in poricne wound models (Stephen Davis and Patricia Merz)
2. News: Drug-resistant Staph bacteria picked up in ordinary community settings are acquiring “superbug” powers and causing far more serious illnesses than they have in the past (source:Philadelphia Inquirer, October 28)

RECENTLY PUBLISHED (UK):

The December 2008 issue of Wounds-UK includes 3 articles on wound infection:

1. Diagnosing wound infection: the use of C-reactive protein (Andrew Kingsley and Vanessa Jones)
2. The immunology of wound healing: the body as a battlefield (Paul Davis)
3. Surgical site infections: biofilms, dehiscence and delayed healing (Randall Walcott, Keith Cutting and Scot E Dowd)

For more information log onto www.wounds-uk.com

INVITATION:

The EPUAP-NPUAP Pressure Ulcer Guideline Development Group are in the process of updating evidence-based guidelines on pressure ulcer prevention and treatment:

"Assessment and Treatment of Pressure Ulcer Infections". Because this is such an active (and sometimes controversial) area of research and practice, they would appreciate having fellow members of the Wound Infection Institute register as stakeholders and comment on any or all of the draft recommendations.

To register as a stakeholder, go to http://www.pressureulcerguidelines.org/

Draft recommendations for the treatment guideline are available at http://pressureulcerguidelines.org/therapy

NEW WORK:

From EWMA Journal, October 2008 (Subscriber only content):

"A laboratory survey of the antimicrobial properties of honey containing dressings" (Jenkins et al)

"Topical negative pressure pressure versus conventional treatment of deep sternal wound infection in cardiac surgery" (Simek et al)

"Mupirocin ointment for preventing staphylococcus aureus infections in nasal carriers" (van Rijen et al - Cochrane review)

From Ostomy Wound Management:

Cepheid (Sunnale, Calif) received clearance from the US Food and Drug Administration (FDA) to market its Xpert™ MRSA/SA Skin and Soft tissue Infection (SSTI) test, which runs on the GeneXpert® System for the rapid detection of methicillin-resistant Staphylococcus aureus (MRSA) and Staphylococcus aureus (SA, typically methicillin-sensitive) in skin and soft tissue infections.