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Clinical Research
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A comparison of an antimicrobial wound cleanser to normal saline in reduction of bioburden and its effect on wound healing Julie Lindfors, RN, CWCCN, Hollywood Pres MC, Los Angeles, CA Microbial bioburden in both acute and chronic wounds is considered to be an important factor in wound healing. Consequently, the reduction of bioburden to host-manageable levels, as well as the elimination of certain virulent forms of wound pathogens (regardless of their number), has become a goal of the wound care professional. A prospective, controlled clinical study using accepted sampling methods was conducted to compare the use of an antimicrobial wound cleanser (0.057% Sodium hypochlorite in an isotonic saline solution) to normal saline on the reduction of bioburden and wound size. During the two month study 100% of the wounds cleansed with the antimicrobial wound cleanser (n = 9) demonstrated aerobic bioburden reduction from baseline in a range from one to four logs per wound; however, 56% of the wounds cleansed with normal saline (n = 9) showed an increase in aerobic bioburden levels. The proportion of wounds exhibiting a reduction in wound size was higher in the antimicrobial wound cleanser group than in the saline group. Further research to increase understanding of the relationship between wound bioburden, healing, and cleansing agents is needed Bendy RH, Nuccio PA, Wolfe E, Collins B, Tamburro C, Class W, Martin CM. Relationship of quantitative wound bacterial counts to healing of decubiti. Effect of topical gentamicin. Antimicrob Agents Chemo Ther. 1964;4:147Ð155 Robson MC, Lea CE, Dalton JB, Heggers JP. Quantitative bacteriology and delayed wound closure. Surg Forum. 1968; XX(roman numeral 20):501Ð2. Robson M., Duke W, Krizek T. Rapid bacterial screening in the treatment of civilian wounds. J Surg Res. 1973;14:14:420 Robson M, Heggers J. Surgical infection II: the beta hemolytic streptococcus J Surg Res. 1969;9:289..Sapico F, Canawati H, Witte J, Montgomerie J, et al. Quantitative aerobic and anaerobic bacteriology of infected diabetic feet. J Clin Microbiol. 1980;12:413..Deresinski S. Infections in the diabetic patient strategies for the clinician. Infectious Disease Reports. 1995;January(1):1 Meleney FL. Bacterial synergism in disease process. Ann Surg. 1931;22:961Ð981 Puhvel S, Reisner R. Anaerobic Bacteria Role in Disease; Dermatologic Anaerobic Infections. [Charles C. Thomas Publisher;Springfield, Il. 1974:442 Bohnen J, Matlow A, Nohr C, et al. Pathogenicity of enterococcus in a rat model of fecal peritonitis. Program abstract 276. The Interscience Conference Antimicrobial Agents Chemotherapy;1983 Hartley P. Obituaries. Dr. H.D. Dakin. Nature. 1952:169:481Ð482 |
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