June, 2004

Dear Readers:

As a young student of wound healing many years ago, it was clear to me that the detection of “wound infection” was a simple matter of the presence of bacteria and the appearance in the wound of pain, heat, erythema, edema, and purulence. This is what the textbooks taught us. As is usually the case, increasing knowledge and experience leads us to a more complicated answer. Both acute and chronic wounds can heal quite nicely in the presence of rather high bacterial colonization. Furthermore, chronic wounds can exhibit some of the symptoms of infection without i

Introduction

During the last 20 years, methicillin-resistant Staphylococcus aureus (MRSA) has become a major nosocomial worldwide pathogen.[1–5] The acquired resistance of S. aureus strains is not limited to methicillin. S. aureus strains, including MRSA, acquire resistance against other antibiotics, such as gentamicin, ciprofloxacin, fusidic acid, mupirocin, and vancomycin.[6–14] Subsequently, infections that until recently could be dealt with by using traditional antibiotics have become uncontrolled and unresponsive to conventional therapeutic regimens.

The selection of resistant o

Introduction

Chronic wounds, such as diabetic, venous, or pressure ulcers, cause severe socioeconomic burden. Diabetic foot ulcers alone, for example, are responsible for more than $1 billion in medical treatment costs in the United States each year.[1] Another common cause for the development of recurrent ulcerations is long-term steroid use.[2] It has been shown that systemic steroid therapy decreases growth factor levels in both blood and wound fluid[3] and reduces the expression of adhesion molecules, cytokines, and chemokines.[4,5] However, growth factors play a key role in wound heali

Collagenase Santyl® Found Effective in Reducing Hypertrophic Scarring and Length of Hospital Stay

Data supporting the use of a collagenase enzymatic debriding agent to reduce the rate of hypertrophic scarring in burn patients was recently presented at the 17th Annual Symposium on Advanced Wound Care by Arnold Luterman, MD, FRSC, medical director of the Regional Burn and Wound Center, University of South Alabama, Mobile. In the 1990s, Harry S. Soroff, MD, and J.F. Hansbrough, MD, found that using collagenase in partial-thickness burn patients showed a reduction in the time to a clean wound