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High bacterial load in negative pressure wound therapy ( NPWT ) foams used in the treatment of chronic wounds

2013; Wiley; Volume: 21; Issue: 5 Linguagem: Inglês

10.1111/wrr.12088

1524-475X

Erlangga Yusuf, Xavier Jordan, Martin Clauss, Olivier Borens, Mark Mäder, Andrej Trampuž,

Surgical Sutures and Adhesives

Abstract No earlier study has investigated the microbiology of negative pressure wound therapy ( NPWT ) foam using a standardized manner. The purpose of this study is to investigate the bacterial load and microbiological dynamics in NPWT foam removed from chronic wounds (>3 months). To determine the bacterial load, a standardized size of the removed NPWT foam was sonicated. The resulting sonication fluid was cultured, and the colony‐forming units ( CFU ) of each species were enumerated. Sixty‐eight foams from 17 patients (mean age 63 years, 71% males) were investigated. In 65 (97%) foams, ≥ 1 and in 37 (54%) ≥2 bacterial types were found. The bacterial load remained high during NPWT treatment, ranging from 10 4 to 10 6 CFU /ml. In three patients (27%), additional type of bacteria was found in subsequent foam cultures. The mean bacterial count ± standard deviation was higher in polyvinyl alcohol foam (6.1 ± 0.5 CFU /ml) than in polyurethane (5.5 ± 0.8 CFU /ml) ( p = 0.02). The mean of log of sum of CFU /ml in foam from 125 mmHg (5.5 ± 0.8) was lower than in foam from 100 mmHg pressure (5.9 ± 0.5) ( p = 0.01). Concluding, bacterial load remains high in NPWT foam, and routine changing does not reduce the load.