Clinic-based debridement of chronic ulcers has minimal impact on bacteria

Paul J. Kim, Christopher E. Attinger, Thomas Bigham, Robert Hagerty, Samantha Platt, Ersilia Anghel, John S. Steinberg, Karen K. Evans

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Outpatient-based sharp debridement is considered an important element for the care of a chronic ulcer. Objective. The aim of this study is to evaluate the change in bacterial amounts with sharp debridement in a clinical setting. Materials and Methods. Bacterial autofluorescence, quantitative cultures, semiquantitative cultures, and qualitative speciation were performed predebridement and postdebridement during a single clinic visit. Results. Thirty-six wounds were included in the analysis. The mean patient age was 62 years (range, 27-83 years), and there were 13 (36.11%) women and 23 (63.89%) men with an average body mass index of 33.8 kg/m2 (range, 16.7-55.9 kg/m2). Of the 36 patients, 24 (66.67%) had type 2 diabetes and 19 (52.78%) had a prior history of lower extremity amputation. Majority of the ulcers were diabetic neuropathic (27, 75%); the most common location was on the plantar aspect of the foot (14, 41.67%) with a mean ulcer duration of 10 months (range, 1-36), mean ulcer area of 6.3 ± 12.8 cm2 (range, 0.18-62.06 cm2), and mean volume of 2.2 ± 4.4 cm3 (range, 0.05-9.66 cm3). There was no statistically significant difference in bacterial autofluorescence between the predebridement (4.15 ± 8.82) and the postdebridement (4.65 ± 9.48) images (P = .32). There was a statistically significant difference in quantitative culture results between the predebridement (6.7 x 104 ± 1.4 x 106 CFU/cm2) and the postdebridement (1.7 x 104 ± 3.1 x 106 CFU/cm2) cultures (P = .04), although this is not a log reduction. Conclusions. There is no statistically significant difference between the predebridement versus postdebridement semiquantitative culture results or a detectable pattern of change for the most common bacterial species encountered. These results suggest little impact of clinic-based sharp debridement on bacteria.

Original languageEnglish (US)
Pages (from-to)114-119
Number of pages6
JournalWounds
Volume30
Issue number5
StatePublished - May 2018
Externally publishedYes

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Debridement
Ulcer
Bacteria
Ambulatory Care
Amputation
Type 2 Diabetes Mellitus
Foot
Lower Extremity
Body Mass Index
Outpatients
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery
  • Medical–Surgical

Cite this

Kim, P. J., Attinger, C. E., Bigham, T., Hagerty, R., Platt, S., Anghel, E., ... Evans, K. K. (2018). Clinic-based debridement of chronic ulcers has minimal impact on bacteria. Wounds, 30(5), 114-119.

Clinic-based debridement of chronic ulcers has minimal impact on bacteria. / Kim, Paul J.; Attinger, Christopher E.; Bigham, Thomas; Hagerty, Robert; Platt, Samantha; Anghel, Ersilia; Steinberg, John S.; Evans, Karen K.

In: Wounds, Vol. 30, No. 5, 05.2018, p. 114-119.

Research output: Contribution to journalArticle

Kim, PJ, Attinger, CE, Bigham, T, Hagerty, R, Platt, S, Anghel, E, Steinberg, JS & Evans, KK 2018, 'Clinic-based debridement of chronic ulcers has minimal impact on bacteria', Wounds, vol. 30, no. 5, pp. 114-119.
Kim PJ, Attinger CE, Bigham T, Hagerty R, Platt S, Anghel E et al. Clinic-based debridement of chronic ulcers has minimal impact on bacteria. Wounds. 2018 May;30(5):114-119.
Kim, Paul J. ; Attinger, Christopher E. ; Bigham, Thomas ; Hagerty, Robert ; Platt, Samantha ; Anghel, Ersilia ; Steinberg, John S. ; Evans, Karen K. / Clinic-based debridement of chronic ulcers has minimal impact on bacteria. In: Wounds. 2018 ; Vol. 30, No. 5. pp. 114-119.
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abstract = "Outpatient-based sharp debridement is considered an important element for the care of a chronic ulcer. Objective. The aim of this study is to evaluate the change in bacterial amounts with sharp debridement in a clinical setting. Materials and Methods. Bacterial autofluorescence, quantitative cultures, semiquantitative cultures, and qualitative speciation were performed predebridement and postdebridement during a single clinic visit. Results. Thirty-six wounds were included in the analysis. The mean patient age was 62 years (range, 27-83 years), and there were 13 (36.11{\%}) women and 23 (63.89{\%}) men with an average body mass index of 33.8 kg/m2 (range, 16.7-55.9 kg/m2). Of the 36 patients, 24 (66.67{\%}) had type 2 diabetes and 19 (52.78{\%}) had a prior history of lower extremity amputation. Majority of the ulcers were diabetic neuropathic (27, 75{\%}); the most common location was on the plantar aspect of the foot (14, 41.67{\%}) with a mean ulcer duration of 10 months (range, 1-36), mean ulcer area of 6.3 ± 12.8 cm2 (range, 0.18-62.06 cm2), and mean volume of 2.2 ± 4.4 cm3 (range, 0.05-9.66 cm3). There was no statistically significant difference in bacterial autofluorescence between the predebridement (4.15 ± 8.82) and the postdebridement (4.65 ± 9.48) images (P = .32). There was a statistically significant difference in quantitative culture results between the predebridement (6.7 x 104 ± 1.4 x 106 CFU/cm2) and the postdebridement (1.7 x 104 ± 3.1 x 106 CFU/cm2) cultures (P = .04), although this is not a log reduction. Conclusions. There is no statistically significant difference between the predebridement versus postdebridement semiquantitative culture results or a detectable pattern of change for the most common bacterial species encountered. These results suggest little impact of clinic-based sharp debridement on bacteria.",
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AU - Platt, Samantha

AU - Anghel, Ersilia

AU - Steinberg, John S.

AU - Evans, Karen K.

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N2 - Outpatient-based sharp debridement is considered an important element for the care of a chronic ulcer. Objective. The aim of this study is to evaluate the change in bacterial amounts with sharp debridement in a clinical setting. Materials and Methods. Bacterial autofluorescence, quantitative cultures, semiquantitative cultures, and qualitative speciation were performed predebridement and postdebridement during a single clinic visit. Results. Thirty-six wounds were included in the analysis. The mean patient age was 62 years (range, 27-83 years), and there were 13 (36.11%) women and 23 (63.89%) men with an average body mass index of 33.8 kg/m2 (range, 16.7-55.9 kg/m2). Of the 36 patients, 24 (66.67%) had type 2 diabetes and 19 (52.78%) had a prior history of lower extremity amputation. Majority of the ulcers were diabetic neuropathic (27, 75%); the most common location was on the plantar aspect of the foot (14, 41.67%) with a mean ulcer duration of 10 months (range, 1-36), mean ulcer area of 6.3 ± 12.8 cm2 (range, 0.18-62.06 cm2), and mean volume of 2.2 ± 4.4 cm3 (range, 0.05-9.66 cm3). There was no statistically significant difference in bacterial autofluorescence between the predebridement (4.15 ± 8.82) and the postdebridement (4.65 ± 9.48) images (P = .32). There was a statistically significant difference in quantitative culture results between the predebridement (6.7 x 104 ± 1.4 x 106 CFU/cm2) and the postdebridement (1.7 x 104 ± 3.1 x 106 CFU/cm2) cultures (P = .04), although this is not a log reduction. Conclusions. There is no statistically significant difference between the predebridement versus postdebridement semiquantitative culture results or a detectable pattern of change for the most common bacterial species encountered. These results suggest little impact of clinic-based sharp debridement on bacteria.

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