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Lookup NU author(s): Professor David Leaper
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Objective: The global impact of surgical site infections (SSIs) on healthcare systems is considerable: many are related to the formation of a microbial biofilm. Biofilm plays a significant role in the pathogenesis of implantable device-related infections and are also important in persistent postoperative skin and soft tissue wound infections.Method: PubMed and OVID databases were searched for relevant articles regarding biofilm-associated infection in surgery, including epidemiology, diagnosis, treatment and management.Results: Biofilm-associated infections increase the use of health-care resources, prolong length of stay, increase cost of antibiotic therapy, result in additional surgical revisions and extend rehabilitation after discharge from health care. Staphylococcus aureus and Staphylococcus epidermidis are the most common isolates recovered from device-related infections. Early infection occurs within two weeks of implantation and is associated with intraoperative wound contamination; late-onset infections are often occult prolonging recognition by weeks, months and in some cases, years. Biofilm is a physical barrier against antibodies and granulocytic cell populations which may also impede the penetration of antibiotics. The ideal strategy for preventing biofilm-associated SSI is to prevent intraoperative contamination through compliance with effective surgical care bundles. Management of postoperative biofilm-associated infections involves surgical debridement followed by irrigation with antimicrobial agents and removal of infected devices, followed by insertion of antimicrobial adjuncts such as antimicrobial spacers, beads or sutures together with selective therapeutic agents that penetrate the mature biofilm.Conclusion: Biofilm-associated infections are a significant source of postoperative morbidity and mortality. Appropriate interventional strategies are warranted to reduce the risk of intraoperative contamination.
Author(s): Edmiston CE, McBain J, Kiernan M, Leaper DJ
Publication type: Review
Publication status: Published
Journal: Journal of Wound Care
Year: 2016
Volume: 25
Issue: 12
Pages: 693-702
Print publication date: 15/12/2016
Online publication date: 15/12/2016
Acceptance date: 01/01/1900
ISSN (print): 0969-0700
ISSN (electronic): 2062-2916
Publisher: MA HEALTHCARE LTD
URL: http://dx.doi.org/10.12968/jowc.2016.25.12.693
DOI: 10.12968/jowc.2016.25.12.693
