Continuous topical irrigation for severely infected wound healing

Continuous topical irrigation for severely infected wound healing – Journal of Surgical Research.

Early but interesting work from Tao and coworkers. It marries well with previous works from our unit as well as our SALSAmigos Fleischmann and Kim, et al.

Abstract

Background

Management of severely infected wound is a formidable challenge. The pilot prospective cohort study is to investigate the influence of continuous topical irrigation on the outcomes of severely infected wound.

Methods

This pilot study was performed on 17 patients with a single severely infected wound treated with continuous topical irrigation (CTI), compared with a control group of 15 patients treated with standard of care from January 2011 to January 2013. Bates-Jensen Wound Assessment Tool (BWAT) severity scores and the clinical outcomes were recorded. Profiles of cytokines/proteinase in wound fluid were quantified weekly.

Results

Comparing with the control, the CTI-treated patients required fewer days for wound infection clearance (8 ± 2 versus 19 ± 5 days, P < 0.001), had wounds closed earlier (17± 4 versus 36 ± 7 days, P < 0.001) and had fewer in-hospital stay days (23 ± 5 versus 42 ± 8days, P < 0.001). BWAT severity scorings, pro-inflammatory cytokines (TNF-α, IL-1β and IL-6) and matrix metalloproteinase-8 (MMP-8) were significantly decreased in response to CTI.

Conclusion

This pilot study demonstrates that continuous topical irrigation improves severely infected wound healing through partly inhibiting pro-inflammatory cytokines and improving tissue regeneration.