Study on Pressure Ulcer Wound Infection and Its Intervention Effect_West China Medical Journal

Authors：

 GuoChunlan ¹ ,  LiuXu ² , XiZuyang ³ , DengHongyan ⁴

1. Outpatient Department for Wound Treatment;Central People's Hospital of Yichang City & the First Clinical Medical College of China Three Gorges University, Yichang, Hubei 443003, P. R. China;
2. Department of Endocrinology;Central People's Hospital of Yichang City & the First Clinical Medical College of China Three Gorges University, Yichang, Hubei 443003, P. R. China;
3. Human Resources Department;Central People's Hospital of Yichang City & the First Clinical Medical College of China Three Gorges University, Yichang, Hubei 443003, P. R. China;
4. Nursing Department;Central People's Hospital of Yichang City & the First Clinical Medical College of China Three Gorges University, Yichang, Hubei 443003, P. R. China;

Corresponding author：

LiuXu, Email: 1143844994@qq.com

Keywords：

Pressure ulcer; Wound infection; Pathogenic bacteria; Nano-silver dressing; Wound healing

DOI：

10.7507/1002-0179.201600405

Video：

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Objective To research on the types of pathogenic bacteria in wound infection and analyze the effectiveness of long-term use of nano-silver dressing in the treatment of pressure ulcers, in order to provide references for the management of pressure ulcer wound. Methods Fifty-five patients (60 wounds) with stage Ⅲ-Ⅳ pressure ulcer wound treated in all departments between September 2011 and August 2015 were chosen to be our study subjects. Under overall intervention, all the wounds were assessed by the same method, cleansed and debrided, after which nano-silver antimicrobial dressing was used to intervene until the wound healed or the end of 8 weeks. The wounds which were not healed were treated with wet dressing therapy until wound healing. The detection rate of pathogenic bacteria before intervention and 2, 4 and 8 weeks after intervention, change of pressure ulcer healing score and the rate of wound healing were observed. Results Before the intervention, 12 kinds of pathogenic bacteria were detected, including mainly Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, and coagulase negative Staphylococci. The detection rate of pathogenic bacteria was 92.73% (51/55). With the use of nano-silver dressing during different time periods, the detection rate of pathogenic bacteria and the total score of pressure ulcer were lowered by varying degrees (P<0.01). Four and 8 weeks after intervention, wound bed improved significantly and the detection rate of pathogenic bacteria decreased faster. The healing rate during the intervention period was 23.64% (13/55). Conclusion The incidence of pressure ulcer wound infection is high. The use of nano-silver wound dressing can effectively remove pathogenic bacteria and promote wound healing.

Citation： GuoChunlan, LiuXu, XiZuyang, DengHongyan. Study on Pressure Ulcer Wound Infection and Its Intervention Effect. West China Medical Journal, 2016, 31(9): 1484-1487. doi: 10.7507/1002-0179.201600405 Copy

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4.	Chuangsuwanich A, Charnsanti O, Lohsiriwat V, et al. The efficacy of silver mesh dressing compared with silver sulfadiazine cream for the treatment of pressure ulcers[J]. J Med Assoc Thai, 2011, 94(5):559-565.
5.	Zhao G, Usui ML, Lippman, et al. Biofilms and inflammation in chronic wounds[J]. Adv Wound Care, 2013, 2(7):389-399.
6.	Chuangsuwanich A, Chortrakarnkij P, Kangwanpoom J. Cost-effectiveness analysis in comparing alginate silver dressing with silver zinc sulfadiazine cream in the treatment of pressure ulcers[J]. Arch Plast Surg, 2013, 40(7):589-596.
7.	Adhya A, Bain J, Ray O, et al. Healing of burn wounds by topical treatment:a randomized controlled comparison between silver sulfadiazine and nano-crystalline silver[J]. J Basic ClinPharm, 2015, 6(1):29-35.
8.	付向阳, 郭春兰. 纳米银抗菌敷料在糖尿病并发浅表脓肿切开引流伤口换药中的应用[J]. 中华医院感染学杂志, 2011, 21(9):1818-1819.
9.	郭春兰, 邓红艳. 含银敷料辅助治疗糖尿病足溃疡感染的效果观察[J]. 华西医学, 2014, 29(9):1611-1614.
10.	郭春兰, 邓红艳, 席祖洋, 等. 含银敷料用于59例下肢静脉溃疡的效果评价[J]. 重庆医学, 2016, 45(7):999-1001.
11.	Leaper D, Munter C, Meaume S, et al. The use of biatain Ag in hard-to-heal venous leg ulcers:meta analysis of randomized controlled trials[J]. PLoS One, 2013, 8(7):1-7.
12.	郭春兰, 付向阳, 田玉凤, 等. 慢性伤口的风险评估及护理干预[J]. 护理学杂志, 2010, 25(16):40-42.
13.	Lis M, Asbeck F, Post M. Monitoring healing of pressure ulcers:a review of assessment instruments for use in the spinal cord unit[J]. Spinal Cord, 2010, 48(2):92-99.
14.	Kirketerp-Møller K, Jensen PØ, Fazli M, et al. Distribution, organization, and ecology of bacteria in chronic wounds[J]. J Clin Microbiol, 2008, 46(8):2717-2722.
15.	Keast DH, Parslow N, Houghton PE, et al. Best practice recommendations for the prevention and treatment of pressure ulcers:update 2006[J]. Adv Skin Wound Care, 2007, 20(8):447-460.
16.	Smith DM, Snow DE, Rees E, et al. Evaluation of the bacterial diversity of pressure ulcers using bTEFAP pyrosequencing[J]. BMC Med Genomics, 2010, 3(3):41.
17.	Lo SF, Chang CJ, Hu WY, et al. The effectiveness of silver-releasing dressings in the management of non-healing chronic wounds:a meta-analysis[J]. J Clin Nurs, 2009, 18(5):716-728.
18.	Tien DC, Tseng KH, Liao CY, et al. Colloidal silver fabrication using the spark discharge system and its antimicrobial effect on Staphylococcus aureus[J]. Med Eng Phys, 2008, 30(8):948-952.

1. European Pressure Ulcer Advisory Panel, National Pressure Ulcer Advisory Panel. Treatment of pressure ulcers:quick reference Guide[M]. Washington DC:National Pressure Ulcer Advisory Panel, 2009.
2. 蒋琪霞, 管晓萍, 苏纯音, 等. 综合性医院压疮现患率多中心联合调研[J]. 中国护理管理, 2013, 13(1):26-30.
3. Wound Ostomy and Continence Nurses Society. Guideline for prevention and management of pressure ulcers[M]. 15000 Commerce Parkway, Suite C, Mount Laurel, 2010.
4. Chuangsuwanich A, Charnsanti O, Lohsiriwat V, et al. The efficacy of silver mesh dressing compared with silver sulfadiazine cream for the treatment of pressure ulcers[J]. J Med Assoc Thai, 2011, 94(5):559-565.
5. Zhao G, Usui ML, Lippman, et al. Biofilms and inflammation in chronic wounds[J]. Adv Wound Care, 2013, 2(7):389-399.
6. Chuangsuwanich A, Chortrakarnkij P, Kangwanpoom J. Cost-effectiveness analysis in comparing alginate silver dressing with silver zinc sulfadiazine cream in the treatment of pressure ulcers[J]. Arch Plast Surg, 2013, 40(7):589-596.
7. Adhya A, Bain J, Ray O, et al. Healing of burn wounds by topical treatment:a randomized controlled comparison between silver sulfadiazine and nano-crystalline silver[J]. J Basic ClinPharm, 2015, 6(1):29-35.
8. 付向阳, 郭春兰. 纳米银抗菌敷料在糖尿病并发浅表脓肿切开引流伤口换药中的应用[J]. 中华医院感染学杂志, 2011, 21(9):1818-1819.
9. 郭春兰, 邓红艳. 含银敷料辅助治疗糖尿病足溃疡感染的效果观察[J]. 华西医学, 2014, 29(9):1611-1614.
10. 郭春兰, 邓红艳, 席祖洋, 等. 含银敷料用于59例下肢静脉溃疡的效果评价[J]. 重庆医学, 2016, 45(7):999-1001.
11. Leaper D, Munter C, Meaume S, et al. The use of biatain Ag in hard-to-heal venous leg ulcers:meta analysis of randomized controlled trials[J]. PLoS One, 2013, 8(7):1-7.
12. 郭春兰, 付向阳, 田玉凤, 等. 慢性伤口的风险评估及护理干预[J]. 护理学杂志, 2010, 25(16):40-42.
13. Lis M, Asbeck F, Post M. Monitoring healing of pressure ulcers:a review of assessment instruments for use in the spinal cord unit[J]. Spinal Cord, 2010, 48(2):92-99.
14. Kirketerp-Møller K, Jensen PØ, Fazli M, et al. Distribution, organization, and ecology of bacteria in chronic wounds[J]. J Clin Microbiol, 2008, 46(8):2717-2722.
15. Keast DH, Parslow N, Houghton PE, et al. Best practice recommendations for the prevention and treatment of pressure ulcers:update 2006[J]. Adv Skin Wound Care, 2007, 20(8):447-460.
16. Smith DM, Snow DE, Rees E, et al. Evaluation of the bacterial diversity of pressure ulcers using bTEFAP pyrosequencing[J]. BMC Med Genomics, 2010, 3(3):41.
17. Lo SF, Chang CJ, Hu WY, et al. The effectiveness of silver-releasing dressings in the management of non-healing chronic wounds:a meta-analysis[J]. J Clin Nurs, 2009, 18(5):716-728.
18. Tien DC, Tseng KH, Liao CY, et al. Colloidal silver fabrication using the spark discharge system and its antimicrobial effect on Staphylococcus aureus[J]. Med Eng Phys, 2008, 30(8):948-952.

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