Abstract: Objective. This study examined the impact of diabetes on inflammatory responses among individuals with infected chronic wounds. The findings provide evidence of the extent to which infection may go unrecognized among persons with diabetes. Methods. This study was a secondary analysis of another study. Chronic wounds were assessed for signs of infection and classified as infected or noninfected based on quantitative cultures of wound tissue. Infected wounds were those with greater than 105 organisms per gram of wound tissue or containing b-hemolytic Streptococcus. Diabetes status was determined through medical record review. The classical signs of inflammation (ie, pain, erythema, edema, heat, and purulent exudate) were identified using the Clinical Signs and Symptoms Checklist (CSSC). Clinical assessments were blinded to the infection status. Results. Seventeen subjects with infected, nondiabetic foot ulcer wounds were included in the sample. Seven (41%) had type 2 diabetes;

Abstract: Free tissue transfer is a well established tool for the reconstruction of large, complicated wounds of the extremities. However, when free flap reconstruction is contraindicated or in cases where it has failed, the management of this type of wound presents a formidable task. Although negative pressure wound therapy (NPWT) plays an increasing role in the treatment of complex open wounds, there are only a few reports of successful management of wounds with areas of exposed tendon or bone. The authors present their experience with the use of NPWT in the treatment of open wounds of the extremities with relatively large areas of exposed bone.

Abstract: In order to ensure normal wound repair, the widespread use of topical antiseptics to control bacterial infections requires these chemicals to exhibit minimal interference with the physiological process of wound healing. Therefore, the influence of a topical antiseptic, ethacridine lactate, on the immune system was investigated in a whole-blood culture model. The effects of ethacridine lactate on the co-stimulated synthesis of a wide pattern of products and mediators (prostaglandin E2, transforming growth factor beta 1, interleukin-6, interleukin-10, interleukin-12, interferon-gamma, interleukin-5, and monocyte chemoattractant protein-1) were examined. Additionally, an immunosuppressive environment to simulate a condition that slows wound healing was generated by adding hydrocortisone to the cultures. The results revealed highly differentiated modifications of the leukocyte response caused by ethacridine lactate. The synthesis of some of the cytokines was strongly stimulated (

Abstract: Silver-containing dressings are widely used to assist with management of infected wounds and those at risk of infection. However, such dressings have varied responses in clinical use due to technological differences in the nature of their silver content and release and in properties of the dressings themselves. This study examines the relationship between silver content, rate of silver release, and antibacterial activity in a simulated wound fluid model against Staphylococcus aureus and Pseudomonas aeruginosa. The study also looks at other important measures for the clinical performance of dressings including fluid-handling properties and dressing pH. Seven proprietary silver-containing dressings (AQUACEL® Ag [Hydrofiber®; “nonwoven A”], Acticoat™ Absorbent [alginate; “nonwoven B”], SILVERCEL™ [alginate-carboxymethylcellulose nylon blended fibers; “nonwoven C”], Contreet® Foam [nonadhesive; “foam A”], PolyMem® Silver [“foam B”], Urgotul® S.Ag [“gauze”], and SilvaSorb® [“hydro

Abstract: Orthopedic trauma wounds with extensive soft tissue damage can be costly and time consuming to heal. This case report illustrates a positive outcome using negative pressure wound therapy in tandem with a silicone gel liner to treat a nonhealing, dehisced incision following a below-the-knee amputation. The primary goal of using the 2 therapies together was to close the wound while actively reshaping and shrinking the residual limb for a prosthesis. The simultaneous use of these therapies resulted in quicker limb maturation and a reduction in the time for prosthetic fitting compared to the previous standard of care at the authors’ institution.