Wound infections: an overview

2021 ◽  
Vol 26 (Sup6) ◽  
pp. S22-S25
Author(s):  
Martha Williams
Keyword(s):  
Wound Infection ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Economic Factors ◽  
Ageing Population ◽  
Wound Infections ◽  
The Many ◽  
Systemic Therapies ◽  
Socio Economic Factors

In the ever-changing world of wound care and nursing, it remains apparent that chronic wounds are a growing challenge. Evidence shows that age increases the likelihood of developing a chronic wound, which supports the notion that the burden of these wounds on the NHS is likely to further intensify with the ageing population. There are many reasons why a wound may fail to progress, including wound aetiology, comorbidities and environmental and socio-economic factors. One of the most significant reasons why wounds may fail to progress and become chronic is untreated wound infection. In order for clinicians to be able to treat and manage wound infections, it is vital that they understand how infection develops, the many ways in which infections may present themselves and how and when to initiate appropriate topical and systemic therapies to treat wound bed infections. The present article provides an overview of wound bed infections and their management.

Effect of Topical Oxygen Therapy on Chronic Wounds

2021 ◽  
Vol 39 ◽  
Author(s):  
Crystal James ◽  
◽  
So Park ◽  
Denise Alabi ◽  
John Lantis ◽  
...  
Keyword(s):  
Personal Experience ◽  
Oxygen Therapy ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Treatment Modalities ◽  
Diabetic Foot Ulcers ◽  
Level Of Evidence ◽  
The Past ◽  
Ischemic Ulcers

Over the past three decades, there has been a growing interest in the use of oxygen therapy to promote wound healing. Although the most commonly recognized oxygen therapy for the treatment of chronic wounds is hyperbaric oxygen therapy, topical oxygen therapy has a greater level of evidence supporting its use in chronic wound care. Still, it is imperative that these two treatment modalities be recognized not merely as competitors, but as distinct therapeutic entities. Through personal experience and a thorough literature review, we investigated the use of topical oxygen therapy in the management of chronic wounds. The benefits of using topical oxygen therapy have been demonstrated in patients with diabetic foot ulcers, ischemic ulcers, post-revascularization ulcers, and pressure ulcers. There are several topical oxygen devices currently on the market that are versatile, relatively low-risk, and generally well-tolerated by patients. While these devices have been used in the treatment of chronic wounds at different locations and of different etiologies, other uses of these devices are still being investigated. Topical oxygen therapy is yet another tool in our arsenal to be used in treating difficult to heal chronic wounds and could potentially be used more readily.

Survey of Surgeons’ Perspectives of Wound Care Centers and Chronic Wound Care

2019 ◽  
Vol 85 (12) ◽  
pp. 1369-1375
Author(s):  
Victoria R. Rendell ◽  
Thomas J. Esposito ◽  
Angela Gibson
Keyword(s):  
Online Survey ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Nationwide Survey ◽  
Relationship Status ◽  
Care Pathways ◽  
Multidisciplinary Management ◽  
Career Focus

Multidisciplinary management of chronic wounds using comprehensive wound centers improves outcomes. With an increasing need for wound providers, little is known about surgeons’ roles in wound centers. An online survey of two national surgical organization members covered demographics, wound center characterization, and surgeons’ perspectives of wound centers and wound care. Surgeon perspectives were compared by age, gender, and relationship status. Three hundred sixty-four surgeons responded. Respondents were mostly older than 50 years, male, in practice older than 10 years, and used wound centers. Most respondents reported favorable experiences with wound centers but uncertainty about financial details. Most respondents were interested in formal wound care certification and participation in a wound practice, particularly as a transition to the retirement option for older surgeons. Surgeons are interested in pursuing a career focus in wound care. Further efforts are needed to educate surgeons and create a pathway for surgeons to become wound center directors. In a nationwide survey, surgeon perspectives on wound centers and wound specialization were positive, although financial understanding was limited. The importance of this finding is the support of wound care pathways for surgeons.

scholarly journals Biofilm Formation Reducing Properties of Manuka Honey and Propolis in Proteus mirabilis Rods Isolated from Chronic Wounds

2020 ◽  
Vol 8 (11) ◽  
pp. 1823
Author(s):  
Joanna Kwiecińska-Piróg ◽  
Jana Przekwas ◽  
Michał Majkut ◽  
Krzysztof Skowron ◽  
Eugenia Gospodarek-Komkowska
Keyword(s):  
Proteus Mirabilis ◽  
Biofilm Formation ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Ethanol Extract ◽  
Minimal Bactericidal Concentration ◽  
Wound Infections ◽  
Manuka Honey ◽  
The Impact ◽  
Chronic Wound Infections

Chronic wound infections are difficult to manage because of the biofilm formation in the wound environment. New measures for eliminating infections are necessary to increase the chance of wound healing. Apitherapy may be the new solution. The aim of this study was to assess the prevalence of wound infection factors and to examine the impact of Manuka honey and ethanol extract of propolis on biofilm formation of Proteus mirabilis isolated from chronic wound infections. According to the findings, the most frequent factors of infection are Staphylococcus aureus (46.1%), Pseudomonas aeruginosa (35.0%), and Proteus mirabilis (10.6%). Minimal inhibitory concentration and minimal bactericidal concentration values were assigned using the microbroth dilution test according to the Clinical and Laboratory Standards Institute. Biofilm of Proteus mirabilis isolates was formed in 96-well polystyrene plates and treated with Manuka honey (concentrations from 1.88% to 30.0%) and ethanol extract of propolis (1.0% to 40.0%). After 24 h, the biofilm viability was expressed by formazan absorbance (λ = 470 nm). Manuka honey reduced the biofilm viability in all, and ethanol extract of propolis in most, of the concentrations tested. Ethanol extract of propolis at the concentrations of 20.0% and 40.0%, reduced biofilm viability stronger than ethanol itself. With these results comes the conclusion that these substances can reduce biofilm formation.

Evidence for person-centred care in chronic wound care: A systematic review and recommendations for practice

2020 ◽  
Vol 29 (Sup9b) ◽  
pp. S1-S22 ◽  
Author(s):  
Georgina Gethin ◽  
Sebastian Probst ◽  
Jan Stryja ◽  
Natalia Christiansen ◽  
Patricia Price
Keyword(s):  
Systematic Review ◽  
Wound Healing ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Patient Knowledge ◽  
Person Centered Care ◽  
Centered Care ◽  
Recommendations For Practice ◽  
The Impact

Background Chronic wounds affect an estimated 2.21 per 1000 population. They are a significant source of morbidity and affect individuals physically, psychologically, socially and financially. Person-centered care is one approach to improve patient outcomes in wound care as it values patients' perspectives, beliefs and autonomy and considers the person as a whole within the cultural context in which care is provided. Aim We aimed to review the evidence on the use of person-centered care (PCC) in chronic wound care management and provide recommendations for practice and future research. Method Using a systematic review methodology, we searched six databases for full-text papers from 2009–2019 published in peer-reviewed journals with no limits on language. Results Eighteen articles on studies involving 3149 patients from nine countries were identified. Studies were conducted under three broad intervention categories: healthcare professional education (n=1); patient education (n=14) and telemedicine (n=3). Studies were equally focused on prevention and treatment of chronic wounds. Significant improvements were reported in patient knowledge, pain and self-care behaviours. Only two studies evaluated the impact on wound healing and one study estimated the cost of implementing person-centered care. Conclusions The evidence base to support PCC in wound management is developing and based on our review has shown improved outcomes in areas of pressure ulcer prevention, patient satisfaction, patient knowledge and quality of life, but clinical outcomes such as wound healing were less well explored. Further research with more objective outcome measures are required.

scholarly journals Prevalence of chronic wounds and structural quality indicators of chronic wound care in Dutch nursing homes

2013 ◽  
Vol 12 (6) ◽  
pp. 630-635 ◽  
Author(s):  
Armand ALM Rondas ◽  
Jos MGA Schols ◽  
Ellen E Stobberingh ◽  
Ruud JG Halfens
Keyword(s):  
Nursing Homes ◽  
Quality Indicators ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Structural Quality

scholarly journals The chronic wound virome: phage diversity and associations with wounds and healing outcomes

2022 ◽  
Author(s):  
Samuel Verbanic ◽  
John Deacon ◽  
Irene A. Chen
Keyword(s):  
Bacterial Community ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Bacterial Community Composition ◽  
Taxonomic Composition ◽  
Metagenomic Sequencing ◽  
Care Clinic ◽  
Before And After ◽  
And Function

Two leading impediments to chronic wound healing are polymicrobial infection and biofilm formation. Recent studies have characterized the bacterial fraction of these microbiomes and have begun to elucidate compositional correlations to healing outcomes. However, the factors that drive compositional shifts are still being uncovered. The virome may play an important role in shaping bacterial community structure and function. Previous work on the skin virome determined that it was dominated by bacteriophages, viruses that infect bacteria. To characterize the virome, we enrolled 20 chronic wound patients presenting at an outpatient wound care clinic in a microbiome survey, collecting swab samples from healthy skin and chronic wounds before and after a single, sharp debridement procedure. We investigated the virome using a virus-like particle enrichment procedure, shotgun metagenomic sequencing, and a k-mer-based, reference-dependent taxonomic classification method. Taxonomic composition, diversity, and associations to covariates are presented. We find that the wound virome is highly diverse, with many phages targeting known pathogens, and may influence bacterial community composition and functionality in ways that impact healing outcomes.

scholarly journals Trichophytonas a Rare Cause of Postoperative Wound Infection Resistant to Standard Empiric Antimicrobial Therapy

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Sheema Gaffar ◽  
John K. Birknes ◽  
Kenji M. Cunnion
Keyword(s):  
Wound Infection ◽  
Tinea Capitis ◽  
Chronic Wound ◽  
Fungal Infections ◽  
Surgical Wound Infection ◽  
Postoperative Wound Infection ◽  
Wound Infections ◽  
Surgical Wound ◽  
Trichophyton Tonsurans ◽  
Chronic Wound Infections

Fungal infections are rare causes of acute surgical wound infections, butCandidais not an infrequent etiology in chronic wound infections.Trichophytonspecies is a common cause of tinea capitis but has not been reported as a cause of neurosurgical wound infection. We report a case ofTrichophyton tonsuranscausing a nonhealing surgical wound infection in a 14-year-old male after hemicraniectomy. His wound infection was notable for production of purulent exudate from the wound and lack of clinical improvement despite empiric treatment with multiple broad-spectrum antibiotics targeting typical bacterial causes of wound infection. Multiple wound cultures consistently grewTrichophytonfungus, and his wound infection clinically improved rapidly after starting terbinafine and discontinuing antibiotics.

Challenges and New Therapeutic Approaches in the Management of Chronic Wounds

2020 ◽  
Vol 21 (12) ◽  
pp. 1264-1275
Author(s):  
Hongmin Sun ◽  
Lakshmi Pulakat ◽  
David W. Anderson
Keyword(s):  
Chronic Wounds ◽  
Chronic Wound ◽  
Wound Care ◽  
Drug Resistant ◽  
Therapeutic Approaches ◽  
New Therapeutic Approaches ◽  
Venous Ulcers ◽  
Obesity And Diabetes ◽  
The Us ◽  
Healing Wounds

Chronic non-healing wounds are estimated to cost the US healthcare $28-$31 billion per year. Diabetic ulcers, arterial and venous ulcers, and pressure ulcers are some of the most common types of chronic wounds. The burden of chronic wounds continues to rise due to the current epidemic of obesity and diabetes and the increase in elderly adults in the population who are more vulnerable to chronic wounds than younger individuals. This patient population is also highly vulnerable to debilitating infections caused by opportunistic and multi-drug resistant pathogens. Reduced microcirculation, decreased availability of cytokines and growth factors that promote wound closure and healing, and infections by multi-drug resistant and biofilm forming microbes are some of the critical factors that contribute to the development of chronic non-healing wounds. This review discusses novel approaches to understand chronic wound pathology and methods to improve chronic wound care, particularly when chronic wounds are infected by multi-drug resistant, biofilm forming microbes.

Challenges with Wound Infection Models in Drug Development

2020 ◽  
Vol 21 (13) ◽  
pp. 1301-1312 ◽  
Author(s):  
Sandeep K. Shukla ◽  
Ajay K. Sharma ◽  
Vanya Gupta ◽  
Aman Kalonia ◽  
Priyanka Shaw
Keyword(s):  
Wound Healing ◽  
Wound Infection ◽  
Chronic Wound ◽  
Wound Care ◽  
Infection Model ◽  
In Vivo Models ◽  
Infection Models

: Wound research is an evolving science trying to unfold the complex untold mechanisms behind the wound healing cascade. In particular, interest is growing regarding the role of microorganisms in both acute and chronic wound healing. Microbial burden plays an important role in the persistence of chronic wounds, ultimately resulting in delayed wound healing. It is therefore important for clinicians to understand the evolution of infection science and its various etiologies. Therefore, to understand the role of bacterial biofilm in chronic wound pathogenesis, various in vitro and in vivo models are required to investigate biofilms in wound-like settings. Infection models should be refined comprising an important signet of biofilms. These models are eminent for translational research to obtain data for designing an improved wound care formulation. However, all the existing models possess limitations and do not fit properly in the model frame for developing wound care agents. Among various impediments, one of the major drawbacks of such models is that the wound they possess does not mimic the wound a human develops. Therefore, a novel wound infection model is required which can imitate the human wounds. : This review article mainly discusses various in vitro and in vivo models showing microbial colonization, their advantages and challenges. Apart from these models, there are also present ex vivo wound infection models, but this review mainly focused on various in vitro and in vivo models available for studying wound infection in controlled conditions. This information might be useful in designing an ideal wound infection model for developing an effective wound healing formulation.

scholarly journals Evaluation of the impact of six different DNA extraction methods for the representation of the microbial community associated with human chronic wound infections using a gel-based DNA profiling method

AMB Express ◽  
2017 ◽  
Vol 7 (1) ◽  
Author(s):  
Ayomi Dilhari ◽  
Asanga Sampath ◽  
Chinthika Gunasekara ◽  
Neluka Fernando ◽  
Deepaka Weerasekara ◽  
...  
Keyword(s):  
Microbial Community ◽  
Dna Extraction ◽  
Genomic Dna ◽  
Chronic Wounds ◽  
Chronic Wound ◽  
Extraction Methods ◽  
Wound Infections ◽  
Dna Extraction Methods ◽  
The Impact ◽  
Chronic Wound Infections

AbstractInfected chronic wounds are polymicrobial in nature which include a diverse group of aerobic and anaerobic microorganisms. Majority of these communal microorganisms are difficult to grow in vitro. DNA fingerprinting methods such as polymerase chain reaction-denaturation gradient gel electrophoresis (PCR-DGGE) facilitate the microbial profiling of complex ecosystems including infected chronic wounds. Six different DNA extraction methods were compared for profiling of the microbial community associated with chronic wound infections using PCR-DGGE. Tissue debris obtained from chronic wound ulcers of ten patients were used for DNA extraction. Total nucleic acid was extracted from each specimen using six DNA extraction methods. The yield, purity and quality of DNA was measured and used for PCR amplification targeting V2–V3 region of eubacterial 16S rRNA gene. QIAGEN DNeasy Blood and Tissue Kit (K method) produced good quality genomic DNA compared to the other five DNA extraction methods and gave a broad diversity of bacterial communities in chronic wounds. Among the five conventional methods, bead beater/phenol–chloroform based DNA extraction method with STES buffer (BP1 method) gave a yield of DNA with a high purity and resulted in a higher DGGE band diversity. Although DNA extraction using heat and NaOH had the lowest purity, DGGE revealed a higher bacterial diversity. The findings suggest that the quality and the yield of genomic DNA are influenced by the DNA extraction protocol, thus a method should be carefully selected in profiling a complex microbial community.

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