tetracycline and Pressure-Ulcer

In this retrospective investigation, we documented the bacterial colonization of 79 patients with chronic wounds, who had been treated between January 2002 and May 2003 in an outpatient wound healing clinic of a university dermatology program. We isolated 106 facultative pathogenic bacterial strains of which 56 were Staphylococcus aureus, 19 Pseudomonas aeruginosa, 11 Escherichia coli, 4 Proteus mirabilis, 4 Enterobacter cloacae, 2 Serratia marcescens, 2 Streptococcus group G und 8 further species. 68 of these bacterial strains were gram-positive and 46 gram-negative. Moreover we identified one patient with Candida parapsilosis. Therefore, 70.8% of all patients showed Staphylococcus aureus in their chronic wounds. Determination of the specific resistances showed 17 patients to be colonized with oxacillin- resistant Staphylococcus aureus (ORSA) strain; this corresponds to 21.5% of all patients. Consequently, 30.4% of all Staphylococcus aureus isolates were ORSA strains. All of the ORSA isolates were sensitive to vancomycin. Sensitivity to tetracycline was documented in 15, to amikacin in 13, to clindamycin in 7, to gentamicin and erythromycin in 6 of the ORSA-positive patients. In the case of trimethoprim/sulfamethoxazole, 10 were sensitive and 3 were intermediate in sensitivity. Beside the obligate resistance to oxacillin, penicillin G, ampicillin, cefuroxime and imipenem, none of the ORSA was sensitive to ofloxacin. The results of our investigations demonstrate the actual spectrum of bacterial colonization in chronic wounds of patients in an university dermatologic wound clinic and underline the growing problem of ORSA.

Topics: Aged; Aged, 80 and over; Bacteriological Techniques; Chronic Disease; Clindamycin; Drug Resistance, Multiple, Bacterial; Erythromycin; Female; Foot Ulcer; Gentamicins; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Oxacillin; Penicillin Resistance; Pressure Ulcer; Radiodermatitis; Skin Diseases, Bacterial; Skin Ulcer; Staphylococcal Skin Infections; Tetracycline; Trimethoprim, Sulfamethoxazole Drug Combination; Vancomycin; Vancomycin Resistance; Varicose Ulcer; Wound Infection

Using more of the true musculocutaneous (or proximal) portion of the tensor fascia lata enables the surgeon to augment its bulk, include bone in the flap, close the donor site primarily, and use the flap even if the distal fascial compartment has been damaged. Alternative designs, inclusion of bone in the flap, and tetracycline bone labeling are discussed.

Topics: Fascia Lata; Fasciotomy; Forearm Injuries; Humans; Male; Methods; Middle Aged; Oxytetracycline; Pressure Ulcer; Surgical Flaps; Tetracycline

Topics: Ascorbic Acid; Ascorbic Acid Deficiency; Aspirin; Barbiturates; Common Cold; Humans; Hypercholesterolemia; Phenylbutazone; Pressure Ulcer; Tetracycline

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Bacteroides; Bacteroides Infections; Breast Neoplasms; Child; Colonic Neoplasms; Female; Genital Neoplasms, Female; Hospitals, Special; Humans; Leukemia; Lymphoma; Male; Middle Aged; Neoplasms; Pressure Ulcer; Sepsis; Surgical Wound Infection; Tetracycline; Time Factors

Topics: Abortion, Septic; Anti-Bacterial Agents; Bile Ducts; Chloramphenicol; Emetine; Escherichia coli Infections; Female; Humans; Kanamycin; Neomycin; Oxytetracycline; Paraplegia; Penicillins; Peritonitis; Pregnancy; Pressure Ulcer; Pseudomonas Infections; Pyelonephritis; Pyoderma; Staphylococcal Infections; Streptococcal Infections; Streptomycin; Tetracycline

The comparative value of nitrofurazone-hydrocortisone cream, of saline solution soaks and of a dry method of care in preventing or curing surface infections was studied in 86 patients. Of a total of 117 discrete lesions treated, 59 were infected, most of these being chronically infected decubital ulcers in paraplegic patients. The other lesions were burns, avulsive and wringer injuries, orthopedic surgical wounds and various abrasions. Excellent results were obtained with the nitrofurazone-hydrocortisone cream in infected lesions: infection rapidly cleared in all 37 lesions treated although only 29 healed completely and promptly. Five lesions were improved, and in three instances healing was unduly delayed. Among 22 infected lesions treated twice daily with saline solution soaks, only five were cured, two improved, seven had delayed healing, and eight had no improvement. In the non-infected wounds, saline soaks or plain dry care after surgical debridement and hexachlorophene cleansing gave results generally more comparable to those obtained in similar cases treated with the nitrofurazone-hydrocortisone cream.

Topics: Administration, Topical; Anti-Bacterial Agents; Bacitracin; Biomedical Research; Burns; Chloramphenicol; Debridement; Hexachlorophene; Humans; Hydrocortisone; Neomycin; Nitrofurazone; Ointments; Penicillins; Pressure Ulcer; Surgical Wound Infection; Tetracycline; Wound Healing; Wound Infection

Topics: Abscess; Air Microbiology; Antisepsis; Bacteriological Techniques; Bacteriophage Typing; Burns; Chloramphenicol; Drug Resistance; Drug Resistance, Microbial; Empyema; Enteritis; Epidemiology; Osteomyelitis; Penicillins; Pneumonia; Postoperative Complications; Pressure Ulcer; Pyelonephritis; Sepsis; Staphylococcal Infections; Staphylococcus; Staphylococcus Phages; Tetracycline; Toxicology; Wound Infection