Prevention Of Wound Infection Research Articles

USE OF PROPHYLACTIC ANTIBIOTICS IN PATIENTS UNDERGOING CAESAREAN SECTION AT CUT MEUTIA GENERAL HOSPITAL, NORTH ACEH 2021-2022

Caesarean section is a surgical procedure to remove the fetus through an incision in the lining of the abdomen and uterus. Cesarean delivery is performed by considering clinical signs of the mother and fetus, such as placenta previa, abnormal location of the fetus, as well as different signs that may endanger the existence of the mother or embryo. According to the World Health Organization (WHO), the number of cesarean deliveries has increased, which is directly relative to the increase in the contamination rate of surgical wound infection (ILO). Prophylactic antibiotics are one of the prevention of surgical wound infection. The research method used is retrospective descriptive. The sampling technique in this research uses non-probability sampling, namely total sampling. The aftereffects of this review show that the use of prophylactic antibiotics in caesarean section patients, namely ceftriaxone 51.2% and cefotaxime 48.8%, the use of prophylactic antibiotics at the Cut Meutia Aceh General Hospital based on ASHP, the use of antibiotics ceftriaxone, cefotaxime, and reponem is 100% inappropriate and based on PPRA RSU Cut Meutia which is 100% compliant. The aftereffects of this study presumed that the utilization of anti-toxins based on ASHP is not appropriate and based on PPRA Cut Meutia Hospital is appropriate.

Antibacterial Biocomposite Based on Chitosan/Pluronic/Agarose Noncovalent Hydrogel: Controlled Drug Delivery by Alginate/Tetracycline Beads System

Designing a wound dressing with controlled uptake, antibacterial, and proper biocompatibility is crucial for the appropriate wound healing process. In this study, alginate/tetracycline (Alg/TC) beads were produced and embedded into chitosan/pluronic/agarose semi-interpenetrating polymer network hydrogel, which serves as a potential biocompatible dressing for treating skin wounds. The effect of pluronic content on the porosity, swelling, mechanical characteristics, and degradation of the hydrogel was investigated. Furthermore, the impact of Alg beads on TC release was subsequently examined. In the absence of Alg beads, faster release was observed. However, after incorporating beads into the hydrogels, the release was sustained. Particularly, the hydrogel containing Alg beads exhibited a nearly linear release, reaching 74% after 2 days in acidic media. The antimicrobial activity and biocompatibility of the hydrogel were also evaluated to assess the capability of the TC-loaded hydrogels for wound dressing applications. The hydrogel demonstrated efficient antibacterial features against Gram-positive and Gram-negative bacteria. Additionally, the sample behavior was evaluated against exposure to yeast. Furthermore, based on biocompatibility studies using HFF2 cells, the TC-loaded hydrogel exhibited remarkable biocompatibility. Overall, this novel composite hydrogel shows remarkable biocompatibility and antibacterial activities which can be used as a great potential wound dressing to prevent wound infections due to its effective inhibition of bacterial growth.

“All-in-one” tea polyphenol-modified injectable hyaluronic acid-based hydrogel for diabetic wound healing

Refractory diabetic wounds are a devastating and rapidly growing clinical problem, which is associated with high incidence rates, mortality, and recurrence rates. Therapeutic angiogenesis in wound tissues is essential to the healing of diabetic wounds. However, the presence of excessive oxidative stress in diabetic wounds hinders angiogenesis, and conventional anti-oxidative approaches are inefficient to compensate for the systematically impaired angiogenesis. Here, a multifunctional supramolecular hyaluronic acid hydrogel dressing for diabetic wounds is successfully designed and constructed (GHPM). The GHPM hydrogel features outstanding properties, including excellent tissue adhesion, antibacterial ability, conductivity, and antioxidant properties. Based on the dynamic crosslinking structure, the GHPM hydrogel also presents adequate injectable and self-healing capabilities, which play a vital role in covering irregular or deep wounds. Additionally, diabetic wounds treated with GHPM hydrogel showed a significant acceleration of wound closure by preventing wound infection, reducing oxidative stress, and accelerating collagen deposition. More interestingly, the combination of electrical stimulation and GHPM hydrogel can effectively promote angiogenesis and neurogenesis, further accelerating diabetic wound healing in an all-around way. This advanced collaborative strategy opens a new avenue in treating diabetic wounds.

A dendritic cell-recruiting, antimicrobial blood clot hydrogel for melanoma recurrence prevention and infected wound management

Surgical resection, the mainstay for melanoma treatment, faces challenges due to high tumor recurrence rates and complex postoperative wound healing. Chronic inflammation from residual disease and the risk of secondary infections impede healing. We introduce an innovative, injectable hydrogel system that integrates a multifaceted therapeutic approach. The hydrogel, crosslinked by calcium ions with sodium alginate, encapsulates a blood clot rich in dendritic cells (DCs) chemoattractants and melanoma cell-derived nanovesicles (NVs), functioning as a potent immunostimulant. This in situ recruitment strategy overcomes the limitations of subcutaneous tumor vaccine injections and more effectively achieves antitumor immunity. Additionally, the hydrogel incorporates Chlorella extracts, enhancing its antimicrobial properties to prevent wound infections and promote healing. One of the key findings of our research is the dual functionality of Chlorella extracts; they not only expedite the healing process of infected wounds but also increase the hydrogel's ability to stimulate an antitumor immune response. Given the patient-specific nature of the blood clot and NVs, our hydrogel system offers customizable solutions for individual postoperative requirements. This personalized approach is highlighted by our study, which demonstrates the synergistic impact of the composite hydrogel on preventing melanoma recurrence and hastening wound healing, potentially transforming postsurgical melanoma management.

Antibacterial and antioxidative hydrogel dressings based on tannic acid-gelatin/oxidized sodium alginate loaded with zinc oxide nanoparticles for promoting wound healing

Wound infection resulting in delayed wound healing and wound deterioration remains a clinical challenge. Recently, multifunctional hydrogel dressing was a promising strategy which has attracted wide attention in preventing wound infection and promoting wound healing. In this study, a hybrid hydrogel made of gelatin (GL), tannic acid (TA), oxidized sodium alginate (OSA), and zinc oxide nanoparticles (ZnO NPs) was prepared mainly by double network cross-linking approach, named tannic acid-gelatin/oxidized sodium alginate/zinc oxide (TA-GL/OSA/ZnO). The composite hydrogels exhibited improved mechanical properties, which provided by TA modified the structure of GL network, Schiff base reaction between GL and OSA, and the strengthening effect of ZnO NPs. Meanwhile, the composite hydrogel showed high antibacterial activity against Staphylococcus aureus (S. aureus) (97.8 % ± 0.9 %) and Escherichia coli (E. coli) (96.6 % ± 1.2 %), attributed to the synergistic effect of TA and ZnO NPs. Furthermore, benefiting from the good antioxidative properties of TA, the sustain-released Zn2+ with the good capability to kill bacteria, and promoting the regeneration of skin epithelial tissues in BALB/c mice constantly, the multifunctional hydrogel had a significant therapeutic effect on wound healing and broad application prospects.

Best practices in wound care for gastrointestinal stoma and colorectal cancer patients from a nursing perspective: A meta-analysis.

Colorectal cancer, a type of colon or bowel cancer, poses a major challenge in the treatment of colorectal lesions. Colorectal endoscopic mucosal resection (EMR) is a minimally invasive technique, but the risk of wound infections remains a significant concern. These infections can impede the healing process, affecting daily activities and patient satisfaction. To mitigate the risk of wound infections, various prophylactic measures have been explored, including medication, vaccines, lifestyle adjustments and hygiene practices. This study aims to investigate the prevention of wound infections through prophylactic measures in colorectal EMR. A comprehensive literature review was conducted to identify prophylactic measures that can prevent wound infections. A systematic literature search was conducted using both free words and search terms. The data extraction was performed after a comprehensive literature screening. The meta-analysis was performed using the metabin function of the meta library in R to evaluate the infection incidences in intervention and control groups. A total of 599 infection incidences were considered, with 267 in intervention and 332 in the control group. The results of meta analysis demonstrated significant reduction of wound incidences following the prophylactic measures (risk ratio [RR] = 0.77, 95% confidence interval [CI]: 0.6747; 0.9016, I2 = 78.5%, p < 0.01). The wound infection ratio analysis also exhibited an approximate 6.6% less infection rate in the intervention group, demonstrating significantly less wound infection following the implementation of prophylactic measures. This study highlights the crucial significance of prevention of wound infections by prophylactic measures in colorectal EMR.

REGECEL (an Oxidized Regenerated Cellulose) Provides Superior Bioactivity Effect on Microorganisms.

Patients who need to be readmitted to the hospital because of complications from infections or require long-term care and rehabilitation face substantial financial hardships. To ensure the safety of patients undergoing surgery, it is crucial to implement measures that prevent wound infections before and after the procedure. Antibacterial wound dressings are essential to prevent infections during surgical procedures. There are various types of antibacterial wound dressings available on the market, such as silver-based dressings, hydrocolloid dressings, polyhexamethylene biguanide, alginate dressings, collagen-based dressings, and iodine-based dressings. We used each type (standard, knit, fibril, and non-woven) of a commercial brand of oxidized regenerated cellulose (ORC) called Regecel to test bacterial growth. The choice of antibacterial wound dressing depends on the type of wound being treated. Different bacterial strains require specific culture conditions to thrive and grow in laboratory settings. To obtain accurate and reliable results, it is vital to follow the precise culture conditions required for each bacterial strain. The evaluation of ORC highlighted its potential to inhibit bacterial growth, showing promising results against various bacterial strains and Candida albicans. Different variants of ORC, such as Regecel, have demonstrated impressive capacity to hinder the growth of 32 distinct bacterial strains, with inhibition rates ranging from 40-100%. These bacteria include methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), and penicillin-resistant Streptococcus pneumoniae. This study supports the usage and development of ORC (Regecel) as an innovative approach to treating bacterial infections.

A multifunctional gingival retraction cord with antibacterial and hemostasis properties based on Chitosan/Propolis/Tranexamic acid for dental treatment

A novel gingival retraction cord named P/TA@CSy was prepared using chitosan yarns (CSy) loaded with tranexamic acid (TA) and Propolis (P). P/TA@CSy has good toughness with a breaking strength of 41.3 Pa, benefiting from the twisting structure and Propolis coating. A short coagulation time of 456 s was achieved for P/TA@CSy because of the potent blood absorption ability from the effective attachment of tranexamic acid. Moreover, excellent antibacterial ability was obtained with the antibacterial rates against E. coli of 94.73 %, S. aureus of 99.99 % and S. mutans of 99.99 %, contributing to Propolis's antibacterial ability. In addition, suppression of the expression of pro-inflammatory cytokines (IL-6 and TNF-α) was found, which could prevent wound infection. P/TA@CSy displayed excellent cytocompatibility with the cell activity of 100 % after 24 h. Therefore, P/TA@CSy could rapidly respond to gingival hemostasis and infection prevention, showing excellent potential in dental treatment.

Construction and Performance Study of a Dual-Network Hydrogel Dressing Mimicking Skin Pore Drainage for Photothermal Exudate Removal and On-Demand Dissolution.

In recent years, negative pressure wound dressings have garnered widespread attentions. However, it is challenging to drain the accumulated fluid under negative pressures for hydrogel dressings. To address this issue, this study prepared a chemical/physical duel-network PEG-CMCS/AG/MXene hydrogel composed by chemical disulfide crosslinked network of four-arm polyethylene glycol/carboxymethyl chitosan (4-Arm-PEG-SH/CMCS), and the physical network of hydrogen bond of agar (AG). Under near-infrared light (NIR) irradiation, the PEG-CMCS/AG/MXene hydrogel undergoes photothermal heating due to integrate of MXene, which destructs the hydrogen bond network and allows the removal of exudate through a mechanism mimicking the sweat gland-like effect of skin pores. The photothermal heating effect also enables the antimicrobial activity to prevent wound infections. The excellent electrical conductivity of PEG-CMCS/AG/MXene can promote cell proliferation under the external electrical stimulation (ES) in vitro. The animal experiments of full-thickness skin defect model further demonstrate its ability to accelerate wound healing. The conversion between thioester and thiol achieved with L-cysteine methyl ester hydrochloride (L-CME) can provides the on-demand dissolution of the dressing in situ. This study holds promises to provide a novel solution to the issue of fluid accumulations under hydrogel dressings and offers new approaches to alleviating or avoiding the significant secondary injuries caused by frequent dressing changes.

Development of carboxymethyl cellulose/gelatin hydrogel loaded with Omega-3 for skin regeneration.

Hydrogels have several characteristics, including biocompatibility, physical similarity with the skin's extracellular matrix, and regeneration capacity. Cell migration and proliferation are facilitated by natural polymers such as gelatin (Gel) and carboxymethyl cellulose (CMC). Gelatin dressing acts as a structural framework for cell migration into the wound area, stimulating cell division and promoting granulation tissue formation. Omega-3 fatty acids from fish oil may prevent wound infection and improve the healing of wounds in the early stages. We studied the preparation of wound dressing containing Omega-3 and its ability to heal wounds. In this study, CMC-Gel hydrogels containing different concentrations of Omega-3 were investigated in full-thickness wounds. After the fabrication of the hydrogels by using surfactant (tween 20) and microemulsion method (oil in water), various tests such as SEM, Water uptake evaluation, weight loss, cell viability, blood compatibility, and in vivo study in rat cutaneous modeling during 14 days were performed to evaluate the properties of the fabricated hydrogels. The analysis of the hydrogels revealed that they possess porous structures with interconnected pores, with an average size of 83.23 ± 6.43μm. The hydrogels exhibited a swelling capacity of up to 60% of their initial weight within 24h, as indicated by the weight loss and swelling measurements. Cell viability study with the MTT technique showed that no cytotoxicity was observed at the recommended dosage, however, increasing the amount of omega-3 caused hemolysis, cell death, and inhibition of coagulation activity. An in vivo study in adult male rats with a full-thickness model showed greater than 91% improvement of the primary wound region after 2 weeks of treatment. Histological analysis demonstrated Omega-3 in hydrogels, which is a promising approach for topical skin treatment to prevent scar, and has shown efficacy as wound dressing by improving the repair process at the defect site.

Characterization of Electrospinning Chitosan Nanofibers Used for Wound Dressing.

Wound dressings play a crucial role in promoting wound healing by providing a protective barrier against infections and facilitating tissue regeneration. Electrospun nanofibers have emerged as promising materials for wound dressing applications due to their high surface area, porosity, and resemblance to the extracellular matrix. In this study, chitosan, a biocompatible and biodegradable polymer, was electrospun into nanofibers for potential use in wound dressing. The chitosan nanofibers were characterized by using various analytical techniques to assess their morphology and biocompatibility. Scanning electron microscopy (SEM) revealed the formation of uniform and bead-free nanofibers with diameters ranging from tens to hundreds of nanometers. Structural analysis, including Fourier transform infrared (FTIR) spectroscopy and X-ray diffraction (XRD), elucidated the chemical composition and crystalline structure of the nanofibers. Furthermore, in vitro studies evaluated the cytocompatibility of the chitosan nanofibers with human dermal fibroblasts, demonstrating cell viability and proliferation on the nanofibers. Additionally, antibacterial properties were assessed to evaluate the potential of chitosan nanofibers in preventing wound infections. Overall, the characterization results highlight the promising attributes of electrospun chitosan nanofibers as wound dressings, paving the way for further investigation and development in the field of advanced wound care. This study has been carried out for the first time in our region and has assessed the antibacterial properties of electrospun chitosan nanofiber material. The created mat has shown efficaciousness against bacteria that are both gram-positive and gram-negative.

Multifunctional skin dressings synthesized via one‐pot photopolymerization: Advancing wound healing and infection prevention strategies

AbstractIn the field of wound healing treatment, the development of new materials is essential to cover multiple functions, such as acceleration of the healing process, prevention of infection and response to stimuli, especially if they present lower costs or are easier to manufacture. These properties are of great importance to prompt skin cicatrization. In this work, new multifunctional skin dressings for wound healing and infection prevention are developed based on new hydrogel materials. The dressings are produced via a straightforward and environmentally friendly one‐pot photopolymerization manufacturing process utilizing vitamin B2 aqueous solutions as sensitizer, and energy‐efficient blue light sources. These dressings exhibit a high swelling capacity, pH and temperature responsiveness, biocompatibility, antimicrobial activity in the absence of conventional antibiotics, and are capable of promoting wound healing. The formulation is based on the combination of three monomers: 2‐((methacryloyloxy)ethyl)trimethylammonium chloride, methacrylic acid and N‐vinyl caprolactam. Collagen, hyaluronic acid, and essential oil of hop are added to enhance antimicrobial properties and stimulate regenerative cellular processes. In vivo experiments have demonstrated that pristine dressings are superior in promoting collagen and fibroblast regeneration and accelerating cicatrization as compared to dressings containing natural products. The dressing embedded with hop also displayed antimicrobial characteristics. The preparation and testing of these new efficient wound dressings are described. This study is distinctive in its integration of environmentally conscious manufacturing techniques with innovative material formulations, resulting in superior wound dressings that are both cost‐effective and highly functional. By achieving enhanced healing and infection prevention without the employment of conventional antibiotics, this work represents a substantial advancement in sustainable and effective wound care management.

Assessment of the Effect of Incisional Negative Pressure Wound Therapy for Prevention of Median Sternotomy Wound Infection

Assessment of the Effect of Incisional Negative Pressure Wound Therapy for Prevention of Median Sternotomy Wound Infection

Citric acid cross-linked pomegranate peel extract-loaded pH-responsive β-cyclodextrin/carboxymethyl tapioca starch hydrogel film for diabetic wound healing

Pomegranate peel extract (PPE) hydrogel films filled with citric acid (CA) and β-cyclodextrin-carboxymethyl tapioca starch (CMS) were designed mainly to prevent wound infections and speed up the healing process. FTIR and NMR studies corroborated the carboxymethylation of neat tapioca starch (NS). CMS exhibited superior swelling behavior than NS. The amount of CA and β-CD controlled the physicochemical parameters of developed PPE/CA/β-CD/CMS films. Optimized film (OF) exhibited acceptable swellability, wound fluid absorptivity, water vapor transmission rate, water contact angle, and mechanical properties. Biodegradable, biocompatible, and antibacterial films exhibited pH dependence in the release of ellagic acid for up to 24 h. In mice model, PPE/CA/β-CD/CMS hydrogel film treatment showed promising wound healing effects, including increased collagen deposition, reduced inflammation, activation of the Wingless-related integration site (wnt) pathway leading to cell division, proliferation, and migration to the wound site. The expression of the WNT3A gene did not show any significant differences among all the studied groups. Developed PPE-loaded CA/β-CD/CMS film promoted wound healing by epithelialization, granulation tissue thickness, collagen deposition, and angiogenesis, hence could be recommended as a biodegradable and antibacterial hydrogel platform to improve the cell proliferation during the healing of diabetic wounds.

Amnion as an Innovative Antiseptic Carrier: A Comparison of the Efficacy of Allogeneic and Xenogeneic Transplantations in the Context of Burn Therapy.

Background and Objectives: The amniotic membrane is widely used in the treatment of chronic wounds, in toxic epidermal necrolysis (TEN), and in the treatment of burns. In our clinical practice, we use amniotic dressings on shallow skin wounds caused by burns. Counteracting infections is an important aspect of working with burn wounds. Therefore, the main goals of this work are to demonstrate the usefulness of amniotic membrane soaked in antiseptics for the prevention of wound infections and to compare the antibacterial efficacy of selected variants of allogeneic and xenogeneic amniotic membrane grafts soaked in specific antiseptic agents. Materials and Methods: The studied material consisted of human and pig placenta. The human and animal amnions were divided in two parts. The first part consisted of amniotic discs placed on rigid mesh discs and preparing the fresh amnion. The second part of the amnion was frozen at a temperature of -80 °C for 24 h. Then, it was radio-sterilized with a dose of 35 kGy. The amniotic discs were placed on rigid mesh to prepare the radiation-sterilized amnion. The amniotic discs were placed in a 12-well plate and immersed in 3 mL of the appropriate antiseptic solutions: Prontosan, Braunol, Borasol, Microdacyn, Octenilin, Sutrisept, and NaCl as a control. The amniotic discs were incubated in antiseptics for 3 h. The microbiological tests were conducted by placing the antiseptic-infused amniotic discs on microbiological media inoculated with hospital strains. Results: The largest average zone of growth inhibition was observed in dressings soaked with Sutrisept, Braunol, and Prontosan. The greatest inhibition of bacterial growth was achieved for radiation-sterilized porcine amnion impregnated with Braunol and Sutrisept, as well as for radiation-sterilized human amnion impregnated with Braunol. Conclusions: Human and porcine amniotic membrane is effective in carrying antiseptics. Radiation-sterilized amnion seems to inhibit the growth of microorganisms better than fresh amnion.

Rare case of assault with knife penetrating base of the skull – Retrieval and management

Addressing a penetrating injury in the maxillofacial region poses significant challenges for oral and maxilofacial surgeons due to the presence or critical structures. Damage to these structures can lead to varying degrees of impairment and a decreased quality of life for the patient. A 48-year-old individual sustained a stabbing injury to the left side of their face. The knife remained lodged inside for 7 h until they were admitted to the trauma unit. The assailant had unsuccessfully attempted to remove the weapon by bending its handle. Following thorough examinations to pinpoint the exact location of the knife, it was safely removed under sedation. The patient experienced successful healing without major complications. The minimisation of scar tissue was achieved through proper debridement and layered linear wound closure. Subsequently, the patient was transferred to the general ward for monitoring and prescribed antibiotics to prevent wound infection. This report includes a detailed account of the weapon retrieval process and is management, along with a review of relevant literature Reconstruction of complicated facial wounds is difficult for surgeons, and early treatment is necessary to avoid additional harm.

Ta4C3 Nanosheets as a Novel Therapeutic Platform for Photothermal-Driven ROS Scavenging and Immune Activation against Antibiotic-Resistant Infections in Diabetic Wounds.

The accumulation of excessive reactive oxygen species (ROS) and recurrent infections with drug-resistant bacteria pose significant challenges in diabetic wound infections, often leading to impediments in wound healing. Addressing this, there is a critical demand for novel strategies dedicated to treating and preventing diabetic wounds infected with drug-resistant bacteria. Herein, 2D tantalum carbide nanosheets (Ta4C3 NSs) have been synthesized through an efficient and straightforward approach, leading to the development of a new, effective nanoplatform endowed with notable photothermal properties, biosafety, and diverse ROS scavenging capabilities, alongside immunogenic attributes for diabetic wound treatment and prevention of recurrent drug-resistant bacterial infections. The Ta4C3 NSs exhibit remarkable photothermal performance, effectively eliminating methicillin-resistant Staphylococcus aureus (MRSA) and excessive ROS, thus promoting diabetic wound healing. Furthermore, Ta4C3 NSs enhance dendritic cell activation, further triggering T helper 1 (TH1)/TH2 immune responses, leading to pathogen-specific immune memory against recurrent MRSA infections. This nanoplatform, with its significant photothermal and immunomodulatory effects, holds vast potential in the treatment and prevention of drug-resistant bacterial infections in diabetic wounds.

PVA/gelatin nanofibrous scaffold with high anti-bacterial activity for skin wound healing applications

Developing biocompatible and biodegradable skin wound dressings with enhanced antibacterial and healing properties, in addition to appropriate mechanical, biological, and physical characteristics, remains a formidable challenge. This research focuses on fabricating a covalently crosslinked nanofibrous scaffold using PVA, gelatin, and gentamicin, specifically designed to exhibit potent antibacterial activity against a broad spectrum of gram-negative and gram-positive bacteria. Comprehensive evaluations were conducted to characterize the nanofibrous scaffold, including chemical, physical, biological, and antibacterial activity assays against various bacteria. Furthermore, the wound-healing performance of the scaffold was evaluated using an in vivo ICR mouse model. The results demonstrate that the scaffold possesses an extracellular matrix-mimicking structure, excellent swelling, appropriate mechanical stability, and in vitro biocompatibility. In vitro antibacterial tests reveal the scaffold's high efficacy against both gram-positive and gram-negative bacteria, highlighting its potential in preventing wound infections and promoting wound healing. In vivo experiments illustrate that the PVA/gelatin nanofibrous scaffold significantly accelerates the wound healing process compared to control groups. In conclusion, the developed scaffold exhibits substantial potential as an efficient and effective wound dressing for skin wound healing applications. Its biocompatibility, antibacterial activity, and ability to enhance wound healing make it a promising scaffold for further development.

Topical Negative Pressure Wound Therapy to Prevent Wound Complications Following Cesarean Delivery in High-Risk Obstetric Patients: A Randomized Controlled Trial

(Aust N Z J Obstet Gynaecol. 2023;63:516–520) The prevalence of cesarean deliveries (CD) has surged in recent decades, paralleling an uptick in medical complications during pregnancy linked to delayed childbearing and rising obesity rates. Consequently, post-CD wound complications have become a significant health concern. Mitigating these complications is a priority, with various wound vacuum systems available. While concerns persist about their effectiveness compared to standard treatments, some evidence suggests modest benefits, particularly in nonobstetric settings. The PICO wound vacuum system has shown promise for clean, noninfected surgical wounds, including cesarean incisions, though data is mainly from small trials or retrospective cohorts. Our study explores the use of PICO in preventing wound infections and breakdown in women with risk factors for complications postcesarean delivery.

Current Knowledge and Perspectives of Phage Therapy for Combating Refractory Wound Infections

Wound infection is one of the most important factors affecting wound healing, so its effective control is critical to promote the process of wound healing. However, with the increasing prevalence of multi-drug-resistant (MDR) bacterial strains, the prevention and treatment of wound infections are now more challenging, imposing heavy medical and financial burdens on patients. Furthermore, the diminishing effectiveness of conventional antimicrobials and the declining research on new antibiotics necessitate the urgent exploration of alternative treatments for wound infections. Recently, phage therapy has been revitalized as a promising strategy to address the challenges posed by bacterial infections in the era of antibiotic resistance. The use of phage therapy in treating infectious diseases has demonstrated positive results. This review provides an overview of the mechanisms, characteristics, and delivery methods of phage therapy for combating pathogenic bacteria. Then, we focus on the clinical application of various phage therapies in managing refractory wound infections, such as diabetic foot infections, as well as traumatic, surgical, and burn wound infections. Additionally, an analysis of the potential obstacles and challenges of phage therapy in clinical practice is presented, along with corresponding strategies for addressing these issues. This review serves to enhance our understanding of phage therapy and provides innovative avenues for addressing refractory infections in wound healing.