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Introduction
Open tibial fractures are complex injuries that often lead to complications, poor functional out- comes and a lower quality of life. Initial surgical debridement has been described as the most important step to prevent future complications. The aim of this study is to evaluate the asso- ciation between timing of surgical debridement an...
Contexts in source publication
Context 1
... There are no universal definitions for superficial and deep infection following open fracture injuries, however, these can be adjusted from the Centre's for Disease Control original definitions for surgical site infections. 110 A superficial infection (Figure 14) can be defined as any infection which involves the skin and subcutaneous tissue (Figure 15), and causes infectious signs including, but not limited to, purulent discharge, pain or tenderness, swelling, redness local heat or fever. A deep infection (Figure 14) can be defined as any infection which involves the deep soft tissue or bone (Figure 15), and causes infectious signs including, but not limited to, purulent discharge, pain or tenderness, swelling, redness local heat or fever. ...
Context 2
... A superficial infection (Figure 14) can be defined as any infection which involves the skin and subcutaneous tissue (Figure 15), and causes infectious signs including, but not limited to, purulent discharge, pain or tenderness, swelling, redness local heat or fever. A deep infection (Figure 14) can be defined as any infection which involves the deep soft tissue or bone (Figure 15), and causes infectious signs including, but not limited to, purulent discharge, pain or tenderness, swelling, redness local heat or fever. Positive microbiology cultures are not typically needed for diagnosis and infection can be confirmed by the attending surgeon. ...
Citations
Intro
Removal of necrotic tissue is a vital step in the treatment of full-thickness burn wounds, with surgical debridement being the most effective method. Since minor burn wounds are typically treated on an outpatient basis where surgical capabilities can be limited there is a need for alternative treatment options. In this study we aim to evaluate the use of amino acid buffered hypochlorite (AABH) as a chemical enhancement for wound debridement in a porcine infected burn wound model.
Method
A total of 60 full-thickness burn wounds, 3 cm in diameter, were created on four pigs using a standardized burn device. The wounds were inoculated with 10⁷ colony-forming units (CFU) of S. aureus. The experimental groups included wounds debrided with a plastic curette, wounds debrided after pretreatment with AABH, and control wounds wiped with gauze. Wounds were treated twice per week for three weeks. Debridement, healing, and infection parameters were evaluated over time.
Results
After one week, but not after two and three weeks, the curette and AABH groups had higher debrided weights compared to control (p<0.05). Percentage of wound area adequately cleared from necrotic tissue was higher in the AABH-group compared to the curette-group and control, after one week. The earliest healing was measured in the AABH group after two weeks (5% of wounds), which also had the most healed wounds after three weeks (55%). In both the AABH and the curette groups, bacterial load had fallen below 10⁵ CFU/g after two weeks. No CFU were detectable in the AABH group after three weeks. The AABH-group was also the easiest to debride.
Conclusion
Our results indicate that AABH facilitates wound debridement and could be a helpful addition to an effective treatment modality for removal of necrotic tissue in full-thickness burns.
