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

Bowler, Philip G; Welsby, Sarah; Hogarth, Andrea; Towers, Victoria

doi:10.1016/j.jhin.2012.11.018

Cited by 19 publications

(10 citation statements)

References 15 publications

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“…91 The mechanisms underlying this include binding to thiol enzymes, cell membranes, and nucleic acids with multifocal microbial injury including structural and functional abnormalities alongside inhibited cell division. Epstein 92 reported the use of silver-impregnated dressings in multilevel lumbar laminectomy with instrumented fusion patients.…”

Section: Silver-impregnated Dressingsmentioning

confidence: 99%

Prevention of Surgical Site Infection in Spine Surgery

et al. 2017

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BACKGROUND: Spine surgery is complicated by an incidence of 1% to 9% of surgical site infection (SSI). The most common organisms are gram-positive bacteria and are endogenous, that is are brought to the hospital by the patient. Efforts to improve safety have been focused on reducing SSI using a bundle approach. The bundle approach applies many quality improvement efforts and has been shown to reduce SSI in other surgical procedures. OBJECTIVE: To provide a narrative review of practical solutions to reduce SSI in spine surgery. METHODS: Literature review and synthesis to identify methods that can be used to prevent SSI. RESULTS: SSI prevention starts with proper patient selection and optimization of medical conditions, particularly reducing smoking and glycemic control. Screening for staphylococcus organisms and subsequent decolonization is a promising method to reduce endogenous bacterial burden. Preoperative warming of patients and timely administration of antibiotics are critical to prevent SSI. Skin preparation using chlorhexidine and alcohol solutions are recommended. Meticulous surgical technique and maintenance of sterile techniques should always be performed. Postoperatively, traditional methods of tissue oxygenation and glycemic control remain essential. Newer wound care methods such as silver impregnation dressing and wound-assisted vacuum dressing are encouraging but need further investigation. CONCLUSION: Significant reduction of SSIs is possible, but requires a systems approach involving all stakeholders. There are many simple and low-cost components that can be adjusted to reduce SSIs. Systematic efforts including understanding of pathophysiology, prevention strategies, and system-wide quality improvement programs demonstrate significant reduction of SSI.

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Section: Silver-impregnated Dressingsmentioning

confidence: 99%

Prevention of Surgical Site Infection in Spine Surgery

et al. 2017

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“…There are some biomaterials, such as silver containing wound dressing, collagen gel wound dressing, silicone derivative foam dressing, biologic dressing, and artificial dermis, which not only promote wound healing, but also alleviate pain and decrease infection. Unfortunately, these materials are not available in our practice.…”

Section: Discussionmentioning

confidence: 99%

Vacuum assisted closure therapy for treatment of complex wounds in replanted extremities

Zhou

et al. 2013

Microsurgery

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The object of this study was to compare the outcomes of the vacuum assisted closure (VAC) therapy and conventional wound care with dressing change for treatment of complex wounds in patients with replantation of amputated upper and lower extremities. Data of 43 patients with replantation of amputated extremities from May 2004 to December 2011 were reviewed. There were 18 wounds of 18 patients with replantation, which were treated by dressing change and 26 wounds of 25 patients by VAC therapy. The outcomes were evaluated by the survival rate of replanted extremities, growth of granulation tissue, interval between wound treatment and secondary procedure and eventual secondary wound coverage methods. Vascular thromboses were found in 3 patients with wound treatment by dressing change and 5 by VAC. All replants of two groups of patients survived after salvage procedures. The wound score was 3.6 ± 0.7 in the conventional dressing change group and 5.8 ± 0.7 in the VAC group at the sixth day after treatment, respectively. The intervals between wound treatment and secondary wound coverage procedure were 12.0 ± 1.7 days in the dressing change group and 6.1 ± 0.7 days in the VAC group. Flaps were applied for wound coverage in 9 out of 18 (50.0%) wounds in the dressing change group and 5 out of 26 (19.2%) in the VAC group (P < 0.05), when the wounds of rest of patients were covered by the skin graft. The results showed that VAC could promote the growth of granulation tissue of wound, decrease the need of flap for wound coverage, and did not change the survival of replantation.

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“…Propionibacterium acnes is recognized increasingly as a SSIcausing organism, particularly in infections happening after spinal procedures and joint replacements [44,45]. An in vitro study found a silver-containing wound dressing to be active against this microorganism over seven days, and suggests that this dressing may help minimize the risk of SSI in patients undergoing such procedures [44].…”

Section: Neurological and Spine Surgerymentioning

confidence: 99%

“…An in vitro study found a silver-containing wound dressing to be active against this microorganism over seven days, and suggests that this dressing may help minimize the risk of SSI in patients undergoing such procedures [44].…”

Section: Neurological and Spine Surgerymentioning

confidence: 99%