Culture results from wound biopsy versus wound swab: does it matter for the assessment of wound infection?

Objectives: The aim of this study was to determine whether assessment of wound infection differs when culture results from wound biopsy versus wound swab are available in clinical practice.

Methods: For 180 eligible patients, a swab and biopsy were taken from one wound during a regular appointment at a wound care facility in eastern Netherlands. Culture results from both methods were supplemented with clinical information and provided to a panel of six experts who independently assessed each wound as infect or not, separately for swab and biopsy.

Clinical Biofilms: A Challenging Frontier in Wound Care.

Biofilms have been implicated in a variety of wound complications. Research has confirmed that biofilms form in wounds of patients experiencing delayed healing and may be a precursor to infection. Research into the strength of this association is still in its infancy.

A real-life clinical evaluation of a next-generation antimicrobial dressing on acute and chronic wounds.

Objective: To assess the effectiveness of a new, next-generation antimicrobial dressing (AQUACEL Ag+ dressing) in facilitating healing in a variety of hard-to-heal wounds that may have been compromised by infection and/or biofilm.

Method: This was an international, multi-centred, real-life, non-randomised evaluation involving patients with a wide variety of slow-, non-healing or deteriorating chronic and acute wounds. There were no strict inclusion or exclusion criteria and the clinicians were asked to use their discretion in the selection of patients.

Clinician perceptions of wound biofilm.

In wound care today, biofilm is a subject area of great interest and debate. There is an increasing awareness that biofilm exists in the majority of non-healing wounds, and that it is implicated in both recalcitrance and infection. Together with the presence of devitalised host tissue, biofilm is recognised as a component of the wound environment that requires removal to enable wound progression.

In vitro antimicrobial efficacy of a silver-containing wound dressing against mycobacteria associated with atypical skin ulcers.

Mycobacterium ulcerans, the etiological agent in Buruli and related ulcers, is a major threat to public health in many tropical countries. Recommended treatment that is accessible and affordable for affected individuals includes surgical debridement and combination antibiotics. The potential benefits in the use of antimicrobial wound dressings has not been demonstrated to date, and consequently the efficacy of a silver-containing absorbent dressing was investigated against a pathogenic wound mycobacterium using stringent in vitro models.

Topical antimicrobial protection of postoperative surgical sites at risk of infection with Propionibacterium acnes: an in-vitro study.

Background: Propionibacterium acnes is an increasingly recognized pathogen in surgical site infections, particularly in relation to joint replacements and spinal procedures. Due to its low virulence and slow-growing nature, clinical signs of infection may be prolonged, and diagnosis is often challenging. As a consequence, appropriate presurgical skin preparation and postsurgical protection of the wound using antimicrobial dressings are important considerations in the prevention of surgical site infections caused by P.

The biological fate of silver ions following the use of silver-containing wound care products - a review.

Ionic silver has a long history as an antimicrobial in human health care. This article is a review of the published literature on how ionic silver may enter the body from exposure to silver-containing wound care products and its eventual metabolic fates, in an assessment of the safety during normal use of these products in wound care. Following the application to breached skin, there appears to be little evidence of localised or systemic toxicity, and this is borne out by the continuous use of silver sulfadiazine formulations for more than 50 years.

Multidrug-resistant organisms, wounds and topical antimicrobial protection.

Multidrug-resistant organisms (MDROs) are increasingly implicated in both acute and chronic wound infections. The limited therapeutic options are further compromised by the fact that wound bacteria often co-exist within a biofilm community which enhances bacterial tolerance to antibiotics. As a consequence, topical antiseptics may be an important consideration for minimising the opportunity for wound infections involving MDROs.

Microbicidal properties of a silver-containing hydrofiber dressing against a variety of burn wound pathogens.

Partial-thickness burns are often characterized by microbial contamination and copious exudate produced during the early postburn period. Consequently, topical wound management often relies on the use of antimicrobial agents and absorbent dressings, and an AQUACEL Hydrofiber Dressing containing ionic silver has been designed to meet such needs. To assess the antimicrobial properties of the AQUACEL Hydrofiber dressing, samples were challenged with a wide variety of recognized burn wound pathogens in a simulated wound fluid model.

The 10(5) bacterial growth guideline: reassessing its clinical relevance in wound healing.

The microbiology of wounds is a key determinant in healing and clinicians generally accept that a level of microbial (ie, bacterial) growth greater than 100,000 viable organisms per gram of tissue can be used to diagnose infection. Although other factors that predispose a wound to infection are widely recognized, today's wound care practitioners are influenced primarily by the 10 5 guideline, with treatment being based on the microbial count in deep or superficial tissue. However, to appropriately manage microbially challenged wounds (eg, heavily colonized and clinically infected), a more balanced awareness of the broader issues relating to micro-organisms and wounds is needed.

Wound pathophysiology, infection and therapeutic options.

Wound healing is a complex and highly regulated process that can be compromised by both endogenous factors (pathophysiological) and exogenous factors (micro-organisms). Microbial colonisation of both acute and chronic wounds is inevitable, and in most situations endogenous bacteria predominate, many of which are potentially pathogenic in the wound environment. The risk of wound infection increases as local conditions favour bacterial growth rather than host defence.