Abstract
ABSTRACT
This case report reviews the effect of combining a 250-cc bottle of standard antimicrobial, buffered sodium hypochlorite with a surgical method, low-pressure jet lavage irrigation in the outpatient setting to control difficult wound contamination. A 73-year-old man had been in treatment for over 8 years, undergoing at least 18 surgical wound debridement procedures for an extensive undermined pelvic pressure injury involving the sacrum, ischium, and greater trochanter. Cultures and polymerase chain reaction diagnostics revealed a multibacterial presence. Autofluorescent imaging (AFI) was used in 21 examinations performed after a 72-hour delay over a long weekend. The AFI contamination exceeded log 4 colony-forming units/g of tissue in all pretreatment examinations and was reduced to less than log 2 colony-forming units in 6 of 21 examinations, with the remaining 15 showing an estimated 80% or higher removal of the bacterial porphyrin “red” appearance. A total of 54 AFI examinations were performed using the combination treatment, and no adverse reactions were encountered. Treatment paradigms can be improved with a multifactorial approach.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Reference17 articles.
1. Biofilms and wounds: an overview of the evidence;Adv Wound Care,2015
2. Antiseptics for treating infected wounds: efficacy on biofilms and effect of pH;Crit Rev Microbiol,2016
3. The role of biofilms: are we hitting the right target?;Plast Reconstr Surg,2011
4. The use of point-of-care bacterial autofluorescence imaging in the management of diabetic foot ulcers: a pilot randomized controlled trial;Diabetes Care,2022
5. Point-of-care fluorescence imaging predicts the presence of pathogenic bacteria in wounds: a clinical study;J Wound Care,2017