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Published on: December 4, 2021
Hydrodebridement of wounds: effectiveness in reducing wound bacterial contamination and potential for air bacterial
Frank L Bowling1, Daryl S Stickings, Valerie Edwards-Jones
1Department of Medicine Manchester Royal Infirmary, University of Manchester, Manchester, UK. frank.bowling@manchester.ac.uk.
Background:
The purpose of this study was to assess the level of air contamination with bacteria after surgical hydrodebridement and to determine the effectiveness of hydro surgery on bacterial reduction of a simulated infected wound.
Methods:
Four porcine samples were scored then infected with a broth culture containing a variety of organisms and incubated at 37 degrees C for 24 hours. The infected samples were then debrided with the hydro surgery tool (Versajet, Smith and Nephew, Largo, Florida, USA). Samples were taken for microbiology, histology and scanning electron microscopy pre-infection, post infection and post debridement. Air bacterial contamination was evaluated before, during and after debridement by using active and passive methods; for active sampling the SAS-Super 90 air sampler was used, for passive sampling settle plates were located at set distances around the clinic room.
Results:
There was no statistically significant reduction in bacterial contamination of the porcine samples post hydrodebridement. Analysis of the passive sampling showed a significant (p < 0.001) increase in microbial counts post hydrodebridement. Levels ranging from 950 colony forming units per meter cubed (CFUs/m3) to 16780 CFUs/m3 were observed with active sampling of the air whilst using hydro surgery equipment compared with a basal count of 582 CFUs/m3. During removal of the wound dressing, a significant increase was observed relative to basal counts (p < 0.05). Microbial load of the air samples was still significantly raised 1 hour post-therapy.
Conclusion:
The results suggest a significant increase in bacterial air contamination both by active sampling and passive sampling. We believe that action might be taken to mitigate fallout in the settings in which this technique is used.
Insights
Surgical hydrodebridement did not reduce bacteria in simulated wounds and significantly increased airborne bacteria. Further actions are needed to mitigate bacterial spread during hydro surgery procedures.
Area of Science:
- Surgical Innovation
- Infection Control
- Wound Management
Background:
- Surgical hydrodebridement is a wound cleaning technique.
- Its impact on airborne bacterial contamination is not fully understood.
- Assessing bacterial levels post-procedure is crucial for patient safety.
Purpose of the Study:
- To evaluate bacterial levels in the air after surgical hydrodebridement.
- To determine the efficacy of hydro surgery in reducing bacteria in simulated infected wounds.
Main Methods:
- Porcine samples were infected and debrided using hydro surgery (Versajet).
- Microbiology, histology, and electron microscopy analyzed samples.
- Airborne bacteria were monitored using active (SAS-Super 90) and passive sampling.
Main Results:
- No significant reduction in wound bacterial contamination was observed post-hydrodebridement.
- A significant increase in airborne microbial counts was detected post-procedure (p < 0.001).
- Airborne bacteria remained elevated for at least 1 hour after therapy.
Conclusions:
- Surgical hydrodebridement significantly increases airborne bacterial contamination.
- Mitigation strategies are necessary to control bacterial spread during hydro surgery.
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