Rapid bacterial screening in the treatment of civilian wounds

Robson, Martin C.; Duke, William F.; Krizek, Thomas J.

doi:10.1016/0022-4804(73)90049-8

Cited by 169 publications

(47 citation statements)

References 7 publications

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“…Twenty out of twenty-four patients with bacterial counts greater than 10 5 organisms per gram of tissue developed infection. The critical inoculum size of 10 5 organisms per gram of tissue has been supported by other studies (Robson et al 1973;Marshall et al 1976).…”

Section: Natural History Of Contaminationmentioning

confidence: 55%

“…Consequently, wounds with a relatively small number of contaminants, given agreeable conditions for bacterial growth may, over a period of time, accumulate 10 5 organisms per gram of tissue, which increases the likelihood of infection. Robson et al (1973) studied bacterial counts in civilian wounds at various time intervals. Wounds that were treated within two hours of injury contained less than one hundred organisms per gram of tissue, whereas those that were treated within three hours contained 10 2 -10 5 organisms, whilst those that were treated up to five hours after injury contained more than 10 5 organisms per gram of tissue.…”

Section: Natural History Of Contaminationmentioning

confidence: 99%

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Small Fragment Wounds: Biophysics, Pathophysiology and Principles of Management

2001

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Military surgical doctrine has traditionally taught that all ballistic wounds should be formally managed by surgical intervention. There is now, however, both experimental and clinical evidence supporting the nonoperative treatment of selected small fragment wounds. Low energy-transfer wounds affecting the soft tissues, without neuro-vascular compromise and with stable fracture patterns, may be suitable for early antibiotic treatment. The management of ballistic wounds to the gastrointestinal tract requires surgical intervention but, advances in the treatment of these wounds, especially those involving the colon, may allow more effective treatment with a reduced morbidity.

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Section: Natural History Of Contaminationmentioning

confidence: 55%

Section: Natural History Of Contaminationmentioning

confidence: 99%

Small Fragment Wounds: Biophysics, Pathophysiology and Principles of Management

2001

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“…Some claim that it stems from an 1898 experiment during the Spanish-American war by German military surgeon Friedrich [4], in which guinea pigs with contaminated soft-tissue wounds had lower rates of infection when debridement was performed within six hours. Others however point to a 1973 study by Robson et al, who reported that 105 organisms per gram of tissue was the open-fracture infection threshold, which was reached in an average of 5.17 hours [5]. …”

Section: Introductionmentioning

confidence: 99%

Infection Rates in Open Fractures of the Tibia: Is the 6-Hour Rule Fact or Fiction?

Kamat

2011

Advances in Orthopedics

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Aims. Emergency debridement has long been the standard of care for open fractures of the tibia as infection is an important complication. The timing of operative debridement can be debated. We review open fractures of the tibia and compare infection rates in those that were operated on within and after 6-hours. Method. 103 consecutive open fractures of the tibia were reviewed. The data was analysed retrospectively with regard to severity of fracture and incidence of infection. Infection rates over a three-month period were compared between the two groups. Results. 12 (11.6%) patients developed an infection within the first 3 months of injury. 7 of which were taken to theatre within 6-hours, and 5 after 6-hours. No significant differences were found between these two groups. Conclusion. There is no significant difference in timing of surgery. Initial basic interventions may play more of a role in limiting the risk of infection.

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“…Previous studies have shown bacteria levels exceeding 1 x 10 5 colony forming units per gram of tissue dramatically increase the risk of infection and skin graft failure. [23, 24] Hence, the concentration of staphylococci used in these studies is representative of the bioburden typically found in wounds prone to infection and provides a rigorous test for efficacy. The rapid reduction of viable bacteria within an hour of exposure to the iodine-doped hydrogel indicates the potential bactericidal activity of the composites.…”

Section: Resultsmentioning

confidence: 99%

A shape memory foam composite with enhanced fluid uptake and bactericidal properties as a hemostatic agent

et al. 2017

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Uncontrolled hemorrhage accounts for more than 30% of trauma deaths worldwide. Current hemostatic devices focus primarily on time to hemostasis, but prevention of bacterial infection is also critical for improving survival rates. In this study, we sought to improve on current devices used for hemorrhage control by combining the large volume-filling capabilities and rapid clotting of shape memory polymer (SMP) foams with the swelling capacity of hydrogels. In addition, a hydrogel composition was selected that readily complexes with elemental iodine to impart bactericidal properties to the device. The focus of this work was to verify that the advantages of each respective material (SMP foam and hydrogel) are retained when combined in a composite device. The iodine-doped hydrogel demonstrated an 80% reduction in bacteria viability when cultured with a high bioburden of Staphylococcus aureus. Hydrogel coating of the SMP foam increased fluid uptake by 19X over the uncoated SMP foam. The composite device retained the shape memory behavior of the foam with more than 15X volume expansion after being submerged in 37°C water for 15 minutes. Finally, the expansion force of the composite was tested to assess potential tissue damage within the wound during device expansion. Expansion forces did not exceed 0.6 N, making tissue damage during device expansion unlikely, even when the expanded device diameter is substantially larger than the target wound site. Overall, the enhanced fluid uptake and bactericidal properties of the shape memory foam composite indicate its strong potential as a hemostatic agent to treat non-compressible wounds.

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Rapid bacterial screening in the treatment of civilian wounds

Cited by 169 publications

References 7 publications

Small Fragment Wounds: Biophysics, Pathophysiology and Principles of Management

Small Fragment Wounds: Biophysics, Pathophysiology and Principles of Management

Infection Rates in Open Fractures of the Tibia: Is the 6-Hour Rule Fact or Fiction?

A shape memory foam composite with enhanced fluid uptake and bactericidal properties as a hemostatic agent

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