gms | German Medical Science

Background: Negative pressure wound therapy (NPWT) has established successfully as a treatment strategy to support wound healing in a number of clinical indications. However, systematic research investigating the bacterial kinetics on wounds is lacking and just a few studies are available comparing the microbiological difference of antiseptic dressings or rinsing solutions in combination with NPWT. The aim of this study was to investigate the antimicrobial effect of different antiseptic options (dressing or rinsing solution) in combination with negative pressure wound therapy on standardized experimental porcine wounds colonized with Gr+ bacteria (Staphylococcus aureus).

Materials and methods: Wounds were treated with a NPWT system capable to instill liquid solutions (V.A.C. Ulta^TM), and negative pressure was applied in combination with antiseptic dressings (silver, polyhexanide) or intermitted instillation of a wound irrigation solution (octenidine). The device was operated at 125 mm Hg sub-atmospheric pressure. In the silver and polyhexanide group continuous negative pressure was applied, whereas in the octenidine group automated intermittent instillation for about 3 minutes every 240 minutes were performed. Bacterial load per gram tissue were measured before intervention and after 24 or 48 hours, respectively.

Results: In this artificial wound model, no treatment option was able to reduce bacterial burden, but a significant reduced bacterial growth compared to traditional NPWT was observed after 48 hours, when silver dressings or instillation of octenidine were used.

Conclusion: This study demonstrated that management of wounds with NPWT plus instillation of octenidine or silver dressings significantly delay the growth of S. aureus in artificial wounds compared to other antiseptic dressings after 48 hours.