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Bacterial bioburden of wounds: influence of debridement and negative-pressure wound therapy (NPWT).
Moog, Philipp; Jensch, Maryna; Betzl, Julia; Bauer, Anna-Theresa; Cerny, Michael K; Schmauss, Daniel; Kükrek, Haydar; Erne, Holger; Machens, Hans-Günther; Megerle, Kai.
Afiliación
  • Moog P; Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany.
  • Jensch M; Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany.
  • Betzl J; Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany.
  • Bauer AT; Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany.
  • Cerny MK; Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany.
  • Schmauss D; Department for Plastic, Reconstructive and Aesthetic Surgery, Ospedale Regionale di Lugano, Lugano, Switzerland.
  • Kükrek H; Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany.
  • Erne H; Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany.
  • Machens HG; Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany.
  • Megerle K; Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technische Universität München, D-81675, Munich, Germany.
J Wound Care ; 30(8): 604-611, 2021 08 02.
Article en En | MEDLINE | ID: mdl-34382852
OBJECTIVE: To clarify the role of microbiological swabs in surgical decision-making, we investigated the effect of negative-pressure wound therapy (NPWT) and serial surgical debridement on bacterial bioburden in hard-to-heal wounds and ultimately correlated them with the success of surgical closure. METHOD: All patients were treated with surgical debridement, jet lavage and NPWT before their wounds were finally closed. The treatment effect was assessed by correlating microbiological swabs obtained immediately after intervention with those obtained after removal of the dressings during the following surgical procedures. The result of the last microbiological swab taken before definitive surgical closure was correlated with the requirement for revision surgery. RESULTS: We included the results of 704 microbiological swabs from 97 patients in 110 wound localisations in this monocentric, retrospective study. NPWT did not improve bacterial bioburden in 77% of cases and the duration of NPWT did not affect the result. Furthermore, no significant effect of NPWT could be found for either anaerobic (p=0.96) or aerobic bacteria (p=0.43). In contrast, surgical debridement decreased bacterial load in approximately 60% of cases. If sterile wound swabs could be obtained at all, it was during the first four surgical debridements in 60% of patients; after that only 10% became sterile. CONCLUSIONS: Sterile microbiological wound swabs before surgical closure were associated with lower rates of revision surgery, while low or medium bacterial loads did not increase revision rates.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia de Presión Negativa para Heridas Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Wound Care Asunto de la revista: ENFERMAGEM Año: 2021 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Terapia de Presión Negativa para Heridas Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Wound Care Asunto de la revista: ENFERMAGEM Año: 2021 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Reino Unido