Wound Healing and Anti-inflammatory Effects of Topical Hyaluronic Acid Injection in Surgical-Site Infection Caused by Staphylococcus aureus

2017 ◽  
Vol 16 (3) ◽  
pp. 202-207 ◽  
Author(s):  
Jin Hyung Park ◽  
Eon Ju Park ◽  
Hyung Suk Yi
Keyword(s):  
Staphylococcus Aureus ◽  
Wound Healing ◽  
Hyaluronic Acid ◽  
Surgical Site Infection ◽  
Bacterial Count ◽  
Control Group ◽  
Site Infection ◽  
Promote Wound Healing ◽  
Gross Pathology ◽  
Anti Inflammatory

Surgical-site infection (SSI) is a common postoperative complication, primarily caused by Staphylococcus aureus. S aureus produces hyaluronidase which degrades hyaluronic acid (HA). HA prevents bacterial proliferation and has anti-inflammatory effects to promote wound healing. We evaluated the effect of HA injection with systemic antibiotics for prevention and treatment of SSIs caused by S aureus. An open wound was created on the dorsum of 40 rats. The wound bed was sutured with S aureus inoculated thread. The test group was injected with HA (HA group), and the control group received a subcutaneous injection of normal saline (NS group). All groups were then treated with intraperitoneal cefazolin injection. The sutures were removed 2 days after the procedure. Gross pathology, bacterial count, and wound histology were assessed at days 2, 4, 6, and 8 postprocedure. The HA group showed a significant reduction in the wound area compared with the control group on gross pathology (at days 8 postprocedure, 36.54% ± 6.12% vs 50.59% ± 5.50%, P < .001). The HA group showed significantly better wound healing than the control group on histological analysis, including assessment of abscess, neutrophilic infiltration, and necrosis (4.2 ± 1.2 vs 11.5 ± 2.1, P < .001). The HA group showed a lower bacterial count compared with the NS group, but the result was not significant statistically (at days 6 postprocedure, 5.11 ± 0.31 vs 5.91 ± 0.35 logCFU/mL, P = .706). In conclusion, immediate local injection of HA in wounds can reduce SSI occurrence and promote wound healing in an animal model.

Poor Functional Status as a Risk Factor for Surgical Site Infection Due to Methicillin-Resistant Staphylococcus aureus

2008 ◽  
Vol 29 (9) ◽  
pp. 832-839 ◽  
Author(s):  
Deverick J. Anderson ◽  
Luke F. Chen ◽  
Kenneth E. Schmader ◽  
Daniel J. Sexton ◽  
Yong Choi ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Site Infection ◽  
Functional Status ◽  
Surgical Patients ◽  
Control Group ◽  
Site Infection ◽  
Methicillin Resistant ◽  
Increased Risk ◽  
Duration Of Surgery ◽  
Poor Functional Status

Objective.To identify risk factors for surgical site infection (SSI) due to methicillin-resistant Staphylococcus aureus (MRSA).Design.Prospective case-control study.Setting.One tertiary and 6 community-based institutions in the southeastern United States.Methods.We compared patients with SSI due to MRSA with 2 control groups: matched uninfected surgical patients and patients with SSI due to methicillin-susceptible S. aureus (MSSA). Multivariable logistic regression was used to determine variables independently associated with SSI due to MRSA, compared with each control group.Results.During the 5-year study period, 150 case patients with SSI due to MRSA were identified and compared with 231 matched uninfected control patients and 128 control patients with SSI due to MSSA. Two variables were independendy associated with SSI due to MRSA in both multivariable regression models: need for assistance with 3 or more activities of daily living (odds ratio [OR] compared with uninfected patients, 3.97 [95% confidence interval {CI}, 2.18-7.25]; OR compared with patients with SSI due to MSSA, 3.88 [95% CI, 1.91-7.87]) and prolonged duration of surgery (OR compared with uninfected patients, 1.98 [95% CI, 1.11-3.55]; OR compared with patients with SSI due to MSSA, 2.33 [95% CI, 1.17-4.62]). Lack of independence (ie, poor functional status) remained associated with an increased risk of SSI due to MRSA after stratifying by age.Conclusions.Poor functional status was highly associated with SSI due to MRSA in adult surgical patients, regardless of age. A patient's level of independence can be easily determined, and this information can be used preoperatively to target preventive interventions.

scholarly journals In Vivo Assessments of Minocycline combined Hyaluronic Acid-mediated Ultrasound Therapy of Infected Wound in Rats

2018 ◽  
Author(s):  
Hongbo Zhang ◽  
Deshu Zhuang
Keyword(s):  
Staphylococcus Aureus ◽  
Wound Healing ◽  
Hyaluronic Acid ◽  
Visual Inspection ◽  
Control Group ◽  
Ultrasound Therapy ◽  
Infected Wound ◽  
Hematoxylin And Eosin ◽  
Skin Scar

AbstractObjectivesThe purpose of our research was to examine the effects of Minocycline combined hyaluronic acid (HA)-mediated Ultrasound therapy of infected wound in wister rats.Methods40 female wister rats were made wound on the two side of the backbone, then infected in Staphylococcus aureus at the comic for three times. then, they are divided into four groups: control group, minocycline combined HA alone, ultasound alone, minocycline combined HA-mediated ultasound group, respective. After 3 times of treatments, the rats were killed and made into specimens. Assessments consisted of visual inspection in the change of the skin, scar formation pathological morphology by hematoxylin and eosin(HE) stain with optical microscopy, IL-1B assaying and TNF-a were performed.ResultCompared with control group, minocycline combined HA alone, ultasound alone, minocycline combined HA-mediated ultasound group all have effect for wound healing, there was a obvious improvement in all parameters over the duration of the experiment(P<0.05). Compared with the control group, minocycline combined HA-mediated ultasound group indicated less inflammation cells (P<0.001) and the reduce of and IL-1B and TNF-a (P<0.001).ConclusionMinocycline combined HA-mediated ultrasound can accelerate tissue regrowth, which exert significant benefits in healing the wounds.

scholarly journals Feasibility and diagnostic accuracy of Telephone Administration of an adapted wound heaLing QuestiONnaire for assessment for surgical site infection following abdominal surgery in low and middle-income countries (TALON): protocol for a study within a trial (SWAT)

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
◽  
James Glasbey ◽  
Victoria Adeyeye ◽  
Adesoji Ademuyiwa ◽  
Alisha Bhatt ◽  
...  
Keyword(s):  
Wound Healing ◽  
Abdominal Surgery ◽  
Diagnostic Accuracy ◽  
Surgical Site Infection ◽  
Hospital Discharge ◽  
Site Infection ◽  
Middle Income ◽  
Middle Income Countries ◽  
Wound Assessment ◽  
Study Within A Trial

Abstract Background Surgical site infection is the most common complication of abdominal surgery, with a global impact on patients and health systems. There are no tools to identify wound infection that are validated for use in the global setting. The overall aim of the study described in this protocol is to evaluate the feasibility and validity of a remote, digital pathway for wound assessment after hospital discharge for patients in low- and middle-income countries (LMICs). Methods A multi-centre, international, mixed-methods study within a trial, conducted in two stages (TALON-1 and TALON-2). TALON-1 will adapt and translate a universal reporter outcome measurement tool (Bluebelle Wound Healing Questionnaire, WHQ) for use in global surgical research (SWAT store registration: 126) that can be delivered over the telephone. TALON-2 will evaluate a remote wound assessment pathway (including trial retention) and validate the diagnostic accuracy of this adapted WHQ through a prospective cohort study embedded within two global surgery trials. Embedded community engagement and involvement activities will be used to optimise delivery and ensure culturally attuned conduct. TALON-1 and TALON-2 are designed and will be reported in accordance with best practice guidelines for adaptation and validation of outcome measures, and diagnostic test accuracy studies. Discussion Methods to identify surgical site infection after surgery for patients after hospital discharge have the potential to improve patient safety, trial retention, and research efficiency. TALON represents a large, pragmatic, international study co-designed and delivered with LMIC researchers and patients to address an important research gap in global surgery trial methodology.

scholarly journals Standardising intraoperative irrigation with 0.05% chlorhexidine gluconate in caesarean delivery to reduce surgical site infections: A single institution experience

2019 ◽  
Vol 30 (1-2) ◽  
pp. 24-33
Author(s):  
Theresa Mangold ◽  
Erin Kinzel Hamilton ◽  
Helen Boehm Johnson ◽  
Rene Perez
Keyword(s):  
Treatment Group ◽  
Surgical Site Infection ◽  
Infection Rate ◽  
Caesarean Delivery ◽  
Chlorhexidine Gluconate ◽  
Control Group ◽  
Antibiotic Administration ◽  
Site Infection ◽  
Infection Rates ◽  
The Impact

Background Surgical site infection is a significant cause of morbidity and mortality following caesarean delivery. Objective To determine whether standardising intraoperative irrigation with 0.05% chlorhexidine gluconate during caesarean delivery could decrease infection rates. Methods This was a process improvement project involving 742 women, 343 of whom received low-pressured 0.05% chlorhexidine gluconate irrigation during caesarean delivery over a one-year period. Infection rates were compared with a standard-of-care control group (399 women) undergoing caesarean delivery the preceding year. Results The treatment group infection rate met the study goal by achieving a lower infection rate than the control group, though this was not statistically significant. A significant interaction effect between irrigation with 0.05% chlorhexidine gluconate and antibiotic administration time existed, such that infection occurrence in the treatment group was not dependent on antibiotic timing, as opposed to the control group infection occurrence, which was dependent on antibiotic timing. Conclusion Intraoperative irrigation with 0.05% chlorhexidine gluconate during caesarean delivery did not statistically significantly reduce the rate of infections. It did render the impact of antibiotic administration timing irrelevant in prevention of surgical site infection. This suggests a role for 0.05% chlorhexidine gluconate irrigation in mitigating infection risk whether antibiotic prophylaxis timing is suboptimal or ideal.

scholarly journals Uji Daya Hambat Air Perasan Buah Jeruk Nipis (Citrus aurantifolia s.) Terhadap Pertumbuhan Bakteri Staphylococcus Aureus Secara In Vitro

2013 ◽  
Vol 2 (1) ◽  
pp. 05 ◽  
Author(s):  
Abdul Razak ◽  
Aziz Djamal ◽  
Gusti Revilla
Keyword(s):  
Staphylococcus Aureus ◽  
Wound Healing ◽  
Contact Time ◽  
Experimental Methods ◽  
Control Group ◽  
Control Group Design ◽  
Citrus Aurantifolia ◽  
Group Design ◽  
Growth Of Bacteria

AbstrakJeruk Nipis (Citrus aurantifolia S.) merupakan salah satu tanaman obat keluarga yang banyak terdapat ditengah masyarkat dan banyak digunakan sebagai ramuan tradisional. Bagian yang sering digunakan adalah air perasannya, dengan salah satu manfaat dapat digunakan untuk menghilangkan jerawat serta penyembuhan luka agar tidak terjadi abses. Jerawat dan abses pada luka merupakan salah satu infeksi yang disebabkan oleh bakteri Staphylococcus aureus.Tujuan Penelitian ini adalah untuk mengetahui daya hambat air perasan buah jeruk nipis (Citrus aurantifolia S.) terhadap pertumbuhan bakteri Staphylococcus aureus secara invitro. Penelitian dilakukan dengan metoda eksperimental laboratorium dengan desain postest only control group design yang dilakukan di Laboratorium Mikrobiologi Fakultas Kedokteran Universitas Andalas.Hasil penelitian menunjukan bahwa air perasan buah jeruk nipis memiliki daya hambat terhadap pertumbuhan bakteri Staphylococcus aureus dengan berbagai konsentrasi yaitu 25%, 50%, 75%, dan 100% dan terdapat pengaruh lama kontak terhadap pertumbuhan bakteri dimana bakteri tidak tumbuh seteleh kontak 5 menit pertama dan diikuti menit-menit berikutnya dengan air perasan buah jeruk nipis konsentrasi 100%. Jadi, semakin tinggi konsentrasi air perasan buah jeruk nipis dan semakin lama kontak dengan bakteri Staphylococcus aureus maka daya hambatnya semakin baik.Kata kunci: Uji Daya Hambat, Air Perasan Buah Jeruk Nipis, Staphylococcus aureus.Abstract Lime (Citrus aurantifolia S.) is kind of family’s herbal medicine, most using in the community is widely used as a traditional herb. The most common used part is the lime fruit squeeze with one of the function is used for removing acne and wound healing to prevent the form of abscess. Pimples and abscesses of the wound is one of the infections caused by the bacterium Staphylococcus aureus.The purpose of this study was to determine the inhibition of lime fruit (Citrus aurantifolia S.) squeeze towards the growth of the bacteria Staphylococcus aureus in vitro condition. The study was conducted with laboratory experimental methods to the design of control group design postest only performed at the Laboratory of Microbiology Faculty of Medicine, University of Andalas.The results showed that the lime fruit (Citrus aurantifolia S.) squeeze has the ability to inhibite the bacterial growth of Staphylococcus aureus with various concentrations of 25%, 50%, 75%, and 100% and there is the effect of contact time on the growth of bacteria which the bacteria do not grow after contact the first 5 minutes and the next minute followed by lime fruit squeeze with 100% concentration lime fruit squeeze. Thus, the higher the concentration of lime fruit squeeze and the longer the contact with the bacteria Staphylococcus aureus is the better towards.Keywords:Inhibition test, The Lime Fruit Squeeze, Staphylococcus Aureus.

scholarly journals COMPARATIVE STUDY OF PRE-CAESAREAN VAGINAL WASH WITH 5% POVIDONE – IODINE SOLUTION VERSUS NO WASH IN PREVENTING POSTOPERATIVE INFECTION.

2020 ◽  
pp. 44-46
Author(s):  
Sonali Deshpande ◽  
Shrinivas Gadappa ◽  
Dhanashree Lahane ◽  
Sandeep Mannikatti
Keyword(s):  
Surgical Site Infection ◽  
Wound Infection ◽  
Povidone Iodine ◽  
Prophylactic Antibiotic ◽  
Control Group ◽  
Site Infection ◽  
Iodine Solution ◽  
Interventional Group ◽  
Vaginal Wash ◽  
Povidone Iodine Solution

Objective: To evaluate the efficacy of pre-cesarean vaginal wash using 5% Povidone Iodine solution on rate of post-cesarean section (CS) surgical site infection and compared with No swabbing. Method: A Prospective Randomized controlled Trial was conducted in department of Obstetrics and Gynecology in Government medical college, Aurangabad. In interventional group, vaginal swabbing with a gauze pieces impregnated with 5% Povidone Iodine solution was done for 30 seconds. The swabbing of vagina was not performed in cases assigned to control group, however the standard surgical preparation of abdomen was done in a usual manner for both group. All subject received prophylactic antibiotic cover. Collected data was complied in pre-designed proforma and analysis was done using SPSS 15. Result: The risk of post operative fever and wound infection was significantly reduced in interventional group. No measure difference was noted in seroma and composite wound infection. Also less duration of hospital stay in interventional group was noted. No adverse effect of use of Povidone iodine was reported in the interventional group. Conclusion: Vaginal swabbing with 5% Povidone-iodine pre- LSCS is inexpensive and simple intervention even for low resource setting to decrease surgical site infection.

Wound photography for evaluation of surgical site infection and wound healing after lower limb trauma

2021 ◽  
Vol 103-B (12) ◽  
pp. 1802-1808
Author(s):  
Julie Bruce ◽  
Ruth Knight ◽  
Nick Parsons ◽  
Ria Betteridge ◽  
Amy Verdon ◽  
...  
Keyword(s):  
Wound Healing ◽  
Surgical Site Infection ◽  
Clinical Assessment ◽  
Lower Limb ◽  
Open Fracture ◽  
Alternative Methods ◽  
Site Infection ◽  
Limb Fracture ◽  
Wound Photography ◽  
Level Of Agreement

Aims Deep surgical site infection (SSI) is common after lower limb fracture. We compared the diagnosis of deep SSI using alternative methods of data collection and examined the agreement of clinical photography and in-person clinical assessment by the Centers for Disease Control and Prevention (CDC) criteria after lower limb fracture surgery. Methods Data from two large, UK-based multicentre randomized controlled major trauma trials investigating SSI and wound healing after surgical repair of open lower limb fractures that could not be primarily closed (UK WOLLF), and surgical incisions for fractures that were primarily closed (UK WHiST), were examined. Trial interventions were standard wound care management and negative pressure wound therapy after initial surgical debridement. Wound outcomes were collected from 30 days to six weeks. We compared the level of agreement between wound photography and clinical assessment of CDC-defined SSI. We are also assessed the level of agreement between blinded independent assessors of the photographs. Results Rates of CDC-defined deep SSI were 7.6% (35/460) after open fracture and 6.3% (95/1519) after closed incisional repair. Photographs were obtained for 77% and 73% of WOLLF and WHiST cohorts respectively (all participants n = 1,478). Agreement between photographic-SSI and CDC-SSI was fair for open fracture wounds (83%; k = 0.27 (95% confidence interval (CI) 0.14 to 0.42)) and for closed incisional wounds (88%; k = 0.29 (95% CI 0.20 to 0.37)) although the rate of photographically detected deep SSIs was twice as high as CDC-SSI (12% vs 6%). Agreement between different assessors for photographic-SSI (WOLLF 88%, k = 0.63 (95% CI 0.52 to 0.72); WHiST 89%; k = 0.61 (95% CI 0.54 to 0.69)); and wound healing was good (WOLLF 90%; k = 0.80 (95% CI 0.73 to 0.86); WHiST 87%; k = 0.57 (95% CI 0.50 to 0.64)). Conclusion Although wound photography was feasible within the research context and inter-rater assessor agreement substantial, digital photographs used in isolation overestimated deep SSI rates, when compared to CDC criteria. Wound photography should not replace clinical assessment in pragmatic trials but may be useful for screening purposes where surgical infection outcomes are paramount. Cite this article: Bone Joint J 2021;103-B(12):1802–1808.

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