A study of biofilm-based wound management in subjects with critical limb ischaemia.

Objective: Bacterial biofilms cause or complicate numerous medical conditions, including chronic wounds. Biofilm-based wound care (BBWC) management strategies that suppress biofilm have been designed and are used extensively at the Southwest Regional Wound Care Center in Lubbock, Texas and are descr...

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Publicado en:Journal of Wound Care Vol. 17; no. 4; pp. 145 - 154
Autores principales: Wolcott RD, Rhoads DD
Formato: algorithm case study pictorial research tables/charts Journal Article
Publicado: Mark Allen Holdings Limited Apr2008
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2008
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        atl: A study of biofilm-based wound management in subjects with critical limb ischaemia.
      aug:
        au:
          Wolcott RD
          Rhoads DD
        affil: Director, Southwest Regional Wound Care Center, Lubbock, Texas, US
      sug:
        subj:
          Biofilms
          Extremities
          Ischemia
          Wounds, Chronic Therapy
          Adolescence
          Adult
          Aged
          Aged, 80 and Over
          Amputation
          Blood Gas Monitoring, Transcutaneous
          Chi Square Test
          Convenience Sample
          Debridement
          Diabetes Mellitus
          Diabetic Patients
          Drug Therapy, Combination
          Female
          Fisher's Exact Test
          Limb Salvage
          Male
          Middle Age
          Null Hypothesis
          Osteomyelitis
          Record Review
          Retrospective Design
          Texas
          Treatment Outcomes
          Ultrasonic Therapy
          Wound Care Methods
          Wounds, Chronic Microbiology
          Wounds, Chronic Pathology
          Xylitol Therapeutic Use
          Human
          Adolescent: 13-18 years
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: Objective: Bacterial biofilms cause or complicate numerous medical conditions, including chronic wounds. Biofilm-based wound care (BBWC) management strategies that suppress biofilm have been designed and are used extensively at the Southwest Regional Wound Care Center in Lubbock, Texas and are described in this article. This retrospective single-centre study was designed to evaluate the frequency of complete healing in subjects with a chronic wound in a limb with critical limb ischaemia (CLI) when managed using BBWC. · Method: Of the 4500 subjects admitted with wounds between August 2002 and January 2006, 1400 subjects' TCpO2 levels were measured, and 266 included were identified as having CLI (TCpO2 <20mmHg). Of these, 190 subjects were considered in the analysis because they received a substantial course of therapy (more than five visits). Each subject was individually managed to reinforce natural healing and suppress bacterial biofilm. Successful healing was defined as complete closure by March 2007. · Results: Of the 190 subjects with CLI, 146 (77%) healed completely, and 44 (23%) were categorised as non-healing. The healed group included 47% (68/146) with osteomyelitis and 69% (101/146) with diabetes mellitus. In the non-healed group, 75% (33/44) had osteomyelitis and 77% (34/44) had diabetes mellitus. Ninety-one per cent (30/33) of the subjects without osteomyelitis or diabetes mellitus healed, and 67% (53/79) of the subjects with both osteomyelitis and diabetes mellitus healed. · Conclusion: When comparing the healing frequency in this study with a previously published study, BBWC strategies significantly improved healing frequency. These findings demonstrate that effectively managing the biofilm in chronic wounds is an important component of consistently transforming 'nonhealable' wounds into healable wounds. · Declaration of interest: Randall Wolcott has patented the combination of lactoferrin and xylitol discussed in this article.
      pubtype: Academic Journal
      doctype:
        algorithm
        case study
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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