Surgical Septic Unit, Department of Surgery and Anesthesiology, Lausanne University Hospital, Lausanne.
Wound Repair Regen. 2013 Sep-Oct;21(5):677-81. doi: 10.1111/wrr.12088. Epub 2013 Aug 8.
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.
此前尚无研究采用标准化方法研究负压伤口治疗（NPWT）泡沫的微生物学。本研究旨在调查从慢性伤口（>3 个月）中去除的 NPWT 泡沫中的细菌负荷和微生物动态。为了确定细菌负荷，对去除的 NPWT 泡沫进行了标准化大小的超声处理。对得到的超声处理液进行培养，并对每种细菌的集落形成单位（CFU）进行计数。对 17 名患者（平均年龄 63 岁，71%为男性）的 68 个泡沫进行了研究。在 65 个（97%）泡沫中，发现了≥1 种细菌，在 37 个（54%）泡沫中，发现了≥2 种细菌。NPWT 治疗期间细菌负荷仍然很高，范围从 10(4)到 10(6) CFU/ml。在 3 名患者（27%）中，在随后的泡沫培养中发现了其他类型的细菌。聚乙烯醇泡沫（6.1 ± 0.5 CFU/ml）的平均细菌计数高于聚氨酯泡沫（5.5 ± 0.8 CFU/ml）（p = 0.02）。125mmHg（5.5 ± 0.8）压力下泡沫中 CFU/ml 的对数平均值低于 100mmHg 压力下的泡沫（5.9 ± 0.5）（p = 0.01）。结论是，NPWT 泡沫中的细菌负荷仍然很高，常规更换并不能降低负荷。
