Preventing and Treating Infection
Jan 30, 2013

Preventing and treating infection

A greater amount of exudate and necrotic tissue in a wound increases likelihood of infection by serving as a medium for bacterial growth away from the host’s defenses.9 Since bacteria thrive on dead tissue, wounds are often surgically debrided to remove the devitalized tissue.17 Debridement and drainage of wound fluid are an especially important part of the treatment for diabetic ulcers, which may create the need for amputation if infection gets out of control. Mechanical removal of bacteria and devitalized tissue is also the idea behind wound irrigation, which is accomplished using pulsed lavage.9

Negative pressure wound therapy (NPWT) is a treatment that improves ischemic tissues and removes wound fluid used by bacteria.8,9 This therapy, also known as vacuum-assisted closure, reduces swelling in tissues, which brings more blood and nutrients to the area, as does the negative pressure itself.8 The treatment also decompresses tissues and alters the shape of cells, causes them to express different mRNAs and to proliferate and produce ECM molecules.3,8

 

Reference

1.      Branski LK, Gauglitz GG, Herndon DN, et al. A review of gene and stem cell therapy in cutaneous wound healing. Burns. Jul 4 2008.

2.     Mustoe T (March 17182005). "Dermal ulcer healing: Advances in understanding". Tissue repair and ulcer/wound healing: molecular mechanisms, therapeutic targets and future directions. Paris, France: EUROCONFERENCES.
3.     Snyder, Robert J. (2005). "Treatment of nonhealing ulcers with allografts". Clinics in Dermatology23 (4): 38895.
4.     Taylor, Jennifer E.; Laity, Peter R.; Hicks, John; Wong, Steven S.; Norris, Keith; Khunkamchoo, Peck; Johnson, Anthony F.; Cameron, Ruth E. (2005). "Extent of iron pick-up in deforoxamine-coupled polyurethane materials for therapy of chronic wounds". Biomaterials 26 (30): 602433.
5.     Edwards, J; Howley, P; Cohen, IK (2004). "In vitro inhibition of human neutrophil elastase by oleic acid albumin formulations from derivatized cotton wound dressings". International Journal of Pharmaceutics 284 (12): 112.
6.     Schönfelder, Ute; Abel, Martin; Wiegand, Cornelia; Klemm, Dieter; Elsner, Peter; Hipler, Uta-Christina (2005). "Influence of selected wound dressings on PMN elastase in chronic wound fluid and their antioxidative potential in vitro". Biomaterials 26 (33): 666473.
7.      Augustin, M.; Maier, K. (2003). "Psychosomatic Aspects of Chronic Wounds". Dermatology and Psychosomatics 45.
8.      Moreo, Kathleen (2005). "Understanding and overcoming the challenges of effective case management for patients with chronic wounds". The Case Manager 16 (2): 62367.
9.      Mustoe, Thomas (2004). "Understanding chronic wounds: A unifying hypothesis on their pathogenesis and implications for therapy". The American Journal of Surgery 187 (5): S65.
10.     Velander, Patrik E.; Theopold, Christoph; Gheerardyn, Raphael; Bleiziffer, Oliver; Yao, Feng; Eriksson, Elof (2004). "Autologous cultured keratinocytes suspensions accelerate re-epithelialization in the diabetic pig". Journal of the American College of Surgeons 199 (3): 58.
11.     Supp, Dorothy M.; Boyce, Steven T. (2005). "Engineered skin substitutes: Practices and potentials". Clinics in Dermatology 23 (4): 40312.
12.     Thomas, David R.; Diebold, Marilyn R.; Eggemeyer, Linda M. (2005). "A controlled, randomized, comparative study of a radiant heat bandage on the healing of stage 34 pressure ulcers: A pilot study". Journal of the American Medical Directors Association 6 (1): 469.
13.     Pressure ulcers: Surgical treatment and principles at eMedicine.
14.     Supp, Dorothy M.; Boyce, Steven T. (2005). "Engineered skin substitutes: Practices and potentials". Clinics in Dermatology 23 (4): 40312.
15.     Crovetti, Giovanni; Martinelli, Giovanna; Issi, Marwan; Barone, Marilde; Guizzardi, Marco; Campanati, Barbara; Moroni, Marco; Carabelli, Angelo (2004). "Platelet gel for healing cutaneous chronic wounds". Transfusion and Apheresis Science 30 (2): 14551.
16.     Moreo, Kathleen (2005). "Understanding and overcoming the challenges of effective case management for patients with chronic wounds". The Case Manager 16 (2): 62367.
17.     Velander, Patrik E.; Theopold, Christoph; Gheerardyn, Raphael; Bleiziffer, Oliver; Yao, Feng; Eriksson, Elof (2004). "Autologous cultured keratinocytes suspensions accelerate re-epithelialization in the diabetic pig". Journal of the American College of Surgeons 199 (3): 58.