Effective method to remove wound bacteria: Comparison of various debridement modalities in an in vivo porcine model

Aron G. Nusbaum, Joel Gil Rodriguez, Marian K. Rippy, Brian Warne, Jose Valdes, Abel Claro, Stephen C Davis

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Background: Debridement is one of the crucial steps for successful wound care. In addition to removing necrotic tissue, debridement has been shown to reduce wound-associated bacteria that delay healing. Using an in vivo porcine model, we compared the effects of various methods of debridement, including hydrosurgery and plasma-mediated bipolar radiofrequency ablation (PBRA), on bacterial removal and wound healing. Methods: One hundred thirty-five deep dermal wounds were inoculated with methicillin resistant Staphylococcus aureus (MRSA) and covered with a polyurethane dressing for 48 h to allow for biofilm formation. Wounds were then treated with either PBRA (at two settings), hydrosurgery, sharp debridement, or no debridement. Biopsies were collected for microbiology and histologic assessment on d 0, 2, 9, and 21 post-treatment. Results: All treatment groups showed a statistically significant reduction in MRSA counts relative to no debridement at all times points (P < 0.05). PBRA at a maximum setting had the lowest MRSA counts at all recovery times and, compared with all other treatment groups, a statistically significant difference was observed on d 21 (P < 0.05). No detrimental effects on the healing process were noted with any of the debridement methods. Conclusion: While sharp debridement has been established as the traditional gold standard for rapid removal of necrotic, infected tissue, our results suggest that novel debridement modalities show clinical promise for the treatment of chronic ulcers and burn wounds, especially when bacteria are present.

Original languageEnglish
Pages (from-to)701-707
Number of pages7
JournalJournal of Surgical Research
Volume176
Issue number2
DOIs
StatePublished - Aug 1 2012

Fingerprint

Debridement
Swine
Bacteria
Wounds and Injuries
Methicillin-Resistant Staphylococcus aureus
Polyurethanes
Bandages
Biofilms
Microbiology
Wound Healing
Ulcer
Biopsy
Skin

Keywords

  • debridement
  • hydrosurgery
  • plasma mediated bipolar radiofrequency ablation
  • wound bacteria
  • wound healing

ASJC Scopus subject areas

  • Surgery

Cite this

Effective method to remove wound bacteria : Comparison of various debridement modalities in an in vivo porcine model. / Nusbaum, Aron G.; Gil Rodriguez, Joel; Rippy, Marian K.; Warne, Brian; Valdes, Jose; Claro, Abel; Davis, Stephen C.

In: Journal of Surgical Research, Vol. 176, No. 2, 01.08.2012, p. 701-707.

Research output: Contribution to journalArticle

Nusbaum, Aron G. ; Gil Rodriguez, Joel ; Rippy, Marian K. ; Warne, Brian ; Valdes, Jose ; Claro, Abel ; Davis, Stephen C. / Effective method to remove wound bacteria : Comparison of various debridement modalities in an in vivo porcine model. In: Journal of Surgical Research. 2012 ; Vol. 176, No. 2. pp. 701-707.
@article{45c74f7a84c7466c96e66bf05e9b406b,
title = "Effective method to remove wound bacteria: Comparison of various debridement modalities in an in vivo porcine model",
abstract = "Background: Debridement is one of the crucial steps for successful wound care. In addition to removing necrotic tissue, debridement has been shown to reduce wound-associated bacteria that delay healing. Using an in vivo porcine model, we compared the effects of various methods of debridement, including hydrosurgery and plasma-mediated bipolar radiofrequency ablation (PBRA), on bacterial removal and wound healing. Methods: One hundred thirty-five deep dermal wounds were inoculated with methicillin resistant Staphylococcus aureus (MRSA) and covered with a polyurethane dressing for 48 h to allow for biofilm formation. Wounds were then treated with either PBRA (at two settings), hydrosurgery, sharp debridement, or no debridement. Biopsies were collected for microbiology and histologic assessment on d 0, 2, 9, and 21 post-treatment. Results: All treatment groups showed a statistically significant reduction in MRSA counts relative to no debridement at all times points (P < 0.05). PBRA at a maximum setting had the lowest MRSA counts at all recovery times and, compared with all other treatment groups, a statistically significant difference was observed on d 21 (P < 0.05). No detrimental effects on the healing process were noted with any of the debridement methods. Conclusion: While sharp debridement has been established as the traditional gold standard for rapid removal of necrotic, infected tissue, our results suggest that novel debridement modalities show clinical promise for the treatment of chronic ulcers and burn wounds, especially when bacteria are present.",
keywords = "debridement, hydrosurgery, plasma mediated bipolar radiofrequency ablation, wound bacteria, wound healing",
author = "Nusbaum, {Aron G.} and {Gil Rodriguez}, Joel and Rippy, {Marian K.} and Brian Warne and Jose Valdes and Abel Claro and Davis, {Stephen C}",
year = "2012",
month = "8",
day = "1",
doi = "10.1016/j.jss.2011.11.1040",
language = "English",
volume = "176",
pages = "701--707",
journal = "Journal of Surgical Research",
issn = "0022-4804",
publisher = "Academic Press Inc.",
number = "2",

}

TY - JOUR

T1 - Effective method to remove wound bacteria

T2 - Comparison of various debridement modalities in an in vivo porcine model

AU - Nusbaum, Aron G.

AU - Gil Rodriguez, Joel

AU - Rippy, Marian K.

AU - Warne, Brian

AU - Valdes, Jose

AU - Claro, Abel

AU - Davis, Stephen C

PY - 2012/8/1

Y1 - 2012/8/1

N2 - Background: Debridement is one of the crucial steps for successful wound care. In addition to removing necrotic tissue, debridement has been shown to reduce wound-associated bacteria that delay healing. Using an in vivo porcine model, we compared the effects of various methods of debridement, including hydrosurgery and plasma-mediated bipolar radiofrequency ablation (PBRA), on bacterial removal and wound healing. Methods: One hundred thirty-five deep dermal wounds were inoculated with methicillin resistant Staphylococcus aureus (MRSA) and covered with a polyurethane dressing for 48 h to allow for biofilm formation. Wounds were then treated with either PBRA (at two settings), hydrosurgery, sharp debridement, or no debridement. Biopsies were collected for microbiology and histologic assessment on d 0, 2, 9, and 21 post-treatment. Results: All treatment groups showed a statistically significant reduction in MRSA counts relative to no debridement at all times points (P < 0.05). PBRA at a maximum setting had the lowest MRSA counts at all recovery times and, compared with all other treatment groups, a statistically significant difference was observed on d 21 (P < 0.05). No detrimental effects on the healing process were noted with any of the debridement methods. Conclusion: While sharp debridement has been established as the traditional gold standard for rapid removal of necrotic, infected tissue, our results suggest that novel debridement modalities show clinical promise for the treatment of chronic ulcers and burn wounds, especially when bacteria are present.

AB - Background: Debridement is one of the crucial steps for successful wound care. In addition to removing necrotic tissue, debridement has been shown to reduce wound-associated bacteria that delay healing. Using an in vivo porcine model, we compared the effects of various methods of debridement, including hydrosurgery and plasma-mediated bipolar radiofrequency ablation (PBRA), on bacterial removal and wound healing. Methods: One hundred thirty-five deep dermal wounds were inoculated with methicillin resistant Staphylococcus aureus (MRSA) and covered with a polyurethane dressing for 48 h to allow for biofilm formation. Wounds were then treated with either PBRA (at two settings), hydrosurgery, sharp debridement, or no debridement. Biopsies were collected for microbiology and histologic assessment on d 0, 2, 9, and 21 post-treatment. Results: All treatment groups showed a statistically significant reduction in MRSA counts relative to no debridement at all times points (P < 0.05). PBRA at a maximum setting had the lowest MRSA counts at all recovery times and, compared with all other treatment groups, a statistically significant difference was observed on d 21 (P < 0.05). No detrimental effects on the healing process were noted with any of the debridement methods. Conclusion: While sharp debridement has been established as the traditional gold standard for rapid removal of necrotic, infected tissue, our results suggest that novel debridement modalities show clinical promise for the treatment of chronic ulcers and burn wounds, especially when bacteria are present.

KW - debridement

KW - hydrosurgery

KW - plasma mediated bipolar radiofrequency ablation

KW - wound bacteria

KW - wound healing

UR - http://www.scopus.com/inward/record.url?scp=84863987016&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84863987016&partnerID=8YFLogxK

U2 - 10.1016/j.jss.2011.11.1040

DO - 10.1016/j.jss.2011.11.1040

M3 - Article

C2 - 22440935

AN - SCOPUS:84863987016

VL - 176

SP - 701

EP - 707

JO - Journal of Surgical Research

JF - Journal of Surgical Research

SN - 0022-4804

IS - 2

ER -