Effect of antiseptic irrigation on infection rates of traumatic soft tissue wounds: a longitudinal cohort study
Autor: | R Neuenschwander, B. Roth, Christian Wegner, F.H.H. Brill, F Wurmitzer, Ojan Assadian, Axel Kramer |
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Rok vydání: | 2017 |
Předmět: |
0301 basic medicine
medicine.medical_specialty Irrigation Nursing (miscellaneous) medicine.drug_class 030106 microbiology Preoperative care Cohort Studies Wound irrigation 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Antiseptic Preoperative Care medicine Humans Surgical Wound Infection Longitudinal Studies Longitudinal cohort Povidone-Iodine Wound Healing integumentary system business.industry Soft tissue Anti-Bacterial Agents Surgery Anesthesia Anti-Infective Agents Local Fundamentals and skills Wound healing business Cohort study |
Zdroj: | Journal of Wound Care. 26:79-87 |
ISSN: | 2052-2916 0969-0700 |
DOI: | 10.12968/jowc.2017.26.3.79 |
Popis: | Objective: Acute traumatic wounds are contaminated with bacteria and therefore an infection risk. Antiseptic wound irrigation before surgical intervention is routinely performed for contaminated wounds. However, a broad variety of different irrigation solutions are in use. The aim of this retrospective, non-randomised, controlled longitudinal cohort study was to assess the preventive effect of four different irrigation solutions before surgical treatment, on wound infection in traumatic soft tissue wounds. Method: Over a period of three decades, the prophylactic application of wound irrigation was studied in patients with contaminated traumatic wounds requiring surgical treatment, with or without primary wound closure. The main outcome measure was development of wound infection. From 1974–1983, either 0.04 % polihexanide (PHMB), 1 % povidone-iodine (PVP-I), 4 % hydrogen peroxide, or undiluted Ringer's solution were concurrently in use. From 1984–1996, only 0.04 % PHMB or 1 % PVP-I were applied. From 1997, 0.04 % PHMB was used until the end of the study period in 2005. Results: The combined rate for superficial and deep wound infection was 1.7 % in the 0.04 % PHMB group (n=3264), 4.8 % in the 1 % PVP-I group (n=2552), 5.9 % in the Ringer's group (n=645), and 11.7 % in the 4 % hydrogen peroxide group (n=643). Compared with all other treatment arms, PHMB showed the highest efficacy in preventing infection in traumatic soft tissue wounds (pConclusion: The large patient numbers in this study demonstrated a robust superiority of 0.04 % PHMB to prevent infection in traumatic soft tissue wounds. These retrospective results may further provide important information as the basis for power calculations for the urgently needed prospective clinical trials in the evolving field of wound antisepsis. |
Databáze: | OpenAIRE |
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