The detection of wound infection by ion mobility chemical analysis

Surgical site infection represents a large burden of care in the National Health Service. Current methods for diagnosis include a subjective clinical assessment and wound swab culture that may take several days to return a result. Both techniques are potentially unreliable and result in delays in using targeted antibiotics. Volatile organic compounds (VOCs) are produced by micro-organisms such as those present in an infected wound. This study describes the use of a device to differentiate VOCs produced by an infected wound vs. colonised wound. Malodourous wound dressings were collected from patients, these were a mix of post-operative wounds and vascular leg ulcers. Wound microbiology swabs were taken and antibiotics commenced as clinically appropriate. A control group of soiled, but not malodorous wound dressings were collected from patients who had a split skin graft (SSG) donor site. The analyser used was a G.A.S. GC-IMS. The results from the samples had a sensitivity of 100% and a specificity of 88%, with a positive predictive value of 90%. An area under the curve (AUC) of 91% demonstrates an excellent ability to discriminate those with an infected wound from those without. VOC detection using GC-IMS has the potential to serve as a diagnostic tool for the differentiation of infected and non-infected wounds and facilitate the treatment of wound infections that is cost effective, non-invasive, acceptable to patients, portable, and reliable

ANTI-INFECTIVE AND WOUND HEALING PROPERTIES OF FLABELLARIA PANICULATA

The methanol leaf extract of Flabellaria paniculala was studied for its potency on normal wounds and infected wounds in rats. Wounds were inflicted on Wistar rats using excision model. Local infection was introduced into rat abdominal wounds using a 108 bacteria/ml inoculum. Two groups of infection were used: Staphylococcus aureus Pseudomonas aeruginosa . Rate of wound healing was assessed by contraction and p of epithelisation. Crude extract of F. paniculala demonstrated sic wound contraction and decrease in epithelisation period (p <0.05). On day 14, extract achieved 100% wound contraction in non-infected and Staphylococcus aureus while 100% wound contraction was recorded in Pseudomonas aeruginosa group on day 18. This drug is anti-infective as well as wound healing agent thus justifying the local uses of the plant for the treatment of skin diseases and sores. Key Words: Flabellaria paniculala, infected wounds, wound contraction, wound healing

Exploring quality of life, physical and psychosocial morbidity for patients with non-infected wounds: a pilot study

This article reports on the results of a pilot study exploring health-related quality of life and the experience of being resilient in patients who develop acute, non-infected surgical wounds. By investigating this under-researched area of wound management, the project team intended to highlight the aspects of patient empowerment in healing post-surgery, encompassing the physical, social and psychological domains. Participants were recruited from patients who had undergone a surgical procedure resulting in an acute non-infected healing wound, and who met the inclusion criteria of the study. Patients were excluded if they had a chronic wound in addition to their acute surgical wound. Valid scores on the physical health (PCS) and mental health (MCS) domains of the SF-12 could only be obtained from six patients pre-operatively. A further six patients completed the SF12 instrument pre-operatively (five valid sets of scores obtained); these patients did not complete the HADS scale. Paired samples t-tests conducted on patients from whom both pre- and postoperative scores were obtained found no significant difference between pre-operative and postoperative PCS scores (p=0.468) or MCS scores (0.806); or between pre-operative and postoperative scores on the anxiety subscale on the HADS scale (p=0.951) or the depression subscale (p=0.951). However, as a pilot study, the study was not powered to detect significant differences. Higher levels of anxiety were revealed in this pilot study than in the wider population. No differences were observed between pre-operative and postoperative scores for physical and mental wellbeing. The findings, while from a small sample set, indicate anxiety is experienced by people living with a wound, and needs to be a consideration in care management plans to enhance adaptation

Uji Efektivitas Salep Ekstrak Daun Binahong (Anredera cordifolia (Ten.) Steenis) pada Kelinci (Oryctolagus cuniculus) yang Terinfeksi Bakteri Staphylococcus aureus

ABSTRACT Binahong leaf as traditional medicine possess antibacterial activity. The aims of this research were to study the effectivity of Binahong (Anredera cordifolia (Ten.) Steenis) leaf extract ointment on wound infected with Staphylococcus aureus, and to study the differences effectivity of Binahong leaf extract ointment (Anredera cordifolia (Ten.) Steenis) as antibacterial with concentration 10%, 20% and 40%. This research using laboratory experimental method. The subjects in these research were 5 rabits which divided into 5 groups, namely negative control, positive control and treatments group with concentration 10%, 20% and 40% of Binahong leaf extract ointment. Rabits back were wounded 2,5 cm and infected with Staphylococcus aureus. Research and statistical results shows that Binahong leaf extract ointment possess wound healing effectivity to the wound infected with Staphylococcus aureus. At concentration 10%, it already exhibit healing effectivity, although concentration 20% and 40% shows more healing effectivity. The increases of concentration of Binahong leaf extract ointment effectively heal the wound infected with Staphylococcus aureus.   Key words : Binahong (Anredera cordifolia (Ten.) Steenis), ointment, extract, wound healing, rabit

Honey: Antimicrobial actions and role in disease management

The ancient treatment of dressing infected wounds with honey is rapidly becoming re-established in professional medicine, especially where wounds are infected with antibiotic-resistant bacteria. This is because of the demonstrated sensitivity of such bacteria to the antibacterial activity of honey, which is not influenced by whether or not strains are resistant to antibiotics. Honey has been found to have a very broad spectrum of activity, but its potency of antibacterial activity can vary greatly. In most honeys the antibacterial activity is due to enzymatically produced hydrogen peroxide and thus the potency of its antibacterial activity can be decreased by catalase present in an open wound. Manuka honey has an antibacterial component derived from the plant source. Manuka honey with a quality-assured level of antibacterial activity is being used by companies marketing honey products for wound care that are registered with the medical regulatory authorities in various countries. Such honey can be diluted IO-fold or more and still completely inhibit the usual wound-infecting species. There is a large amount of clinical evidence for the effectiveness of honey in clearing infection in wounds, and some clinical evidence of its effectiveness in treating other infections. Although the antibacterial potency of honey is insufficient to allow its use systemically, there are various clinical applications besides wound care in which it is used topically or where it does not get excessively diluted, such as for treatment of gastritis, enteritis, gingivitis, ophthalmological infections and bronchial infections. In most of these applications the anti-inflammatory activity of honey is of additional benefit in decreasing the inflammation resulting from infection. Additional clinical research is needed to provide better evidence of the effectiveness of honey in these therapeutic applications of honey

Federal Regulation

Introduction Infected wounds are difficult to treat and there are no standardized protocols. Presentation of case We report a case of infected postoperative wound and entero-cutaneous fistula in a 83 years-old woman. An innovative treatment protocol for Human amniotic membrane (HAM)-assisted dressing of infected wound as the Idea Stage following the IDEAL recommendations is presented. The development of amnion preparation and the involved treatment steps are described. No adverse events and no graft rejection have been detected. Discussion Favorable results confirm the technical simplicity, safety and efficacy of this procedure. HAM has been shown to promote wound healing and to have antibacterial characteristics, which was supported by the presented case. Conclusion We are able to report a successful treatment of an infected wound caused by entero-cutaneous fistula with HAM dressing. Following the IDEAL recommendations, consecutive prospective cohort trials are justified

Development of a deep learning-based tool to assist wound classification

This paper presents a deep learning-based wound classification tool that can assist medical personnel in non-wound care specialization to classify five key wound conditions, namely deep wound, infected wound, arterial wound, venous wound, and pressure wound, given color images captured using readily available cameras. The accuracy of the classification is vital for appropriate wound management. The proposed wound classification method adopts a multi-task deep learning framework that leverages the relationships among the five key wound conditions for a unified wound classification architecture. With differences in Cohen's kappa coefficients as the metrics to compare our proposed model with humans, the performance of our model was better or non-inferior to those of all human medical personnel. Our convolutional neural network-based model is the first to classify five tasks of deep, infected, arterial, venous, and pressure wounds simultaneously with good accuracy. The proposed model is compact and matches or exceeds the performance of human doctors and nurses. Medical personnel who do not specialize in wound care can potentially benefit from an app equipped with the proposed deep learning model

Well-promising outcomes with vacuum-assisted closure in an infected wound following laparotomy: A case report

Introducation: Negative pressure wound therapy (NPWT) represents an alternative method to optimize conditions for wound healing. Delayed wound closure is a significant health problem, which is directly associated with pain and suffering from patient's aspect, as well with social and financial burden. Presentation of case: We report a case of vacuum-assisted wound therapy with hypertonic solution distillation and continuous negative pressure application, in an infected wound after laparotomy for incisional hernia reconstruction with mesh placement. Negative pressure was initiated at the wound margins after failure of conventional treatment with great outcomes, achieving a total closure of the incision within two weeks. Discussion: Each wound has particular characteristics which must be managed. Vacuum assisted closure (VAC) with continuous negative pressure and simultaneous wound instillation and cleanse can provide optimum results, reducing the cavity volume, by newly produced granulated tissue. Conclusion: The simultaneous use of instillation and constant pressure seemed to be superior in comparison with NPWT alone. Compared to conventional methods, the use of VAC ends to better outcomes, in cases of infected wounds following laparotomy