title: Healing outcomes of MRSA-infected wounds with a protocol combining Oakin dressing with elements of the de-escalation theory.
abstract: OBJECTIVE
  This paper presents a novel wound healing protocol for the treatment of MRSA-infected lower extremity wounds of various etiologies, and describes the healing rate at 30, 60 and 90 days.
  
  
  METHODS
  A total of 40 participants with singular wounds were enrolled and treated with a specially designed protocol, which involves elements of the de-escalation theory together with a wound dress containing Oakin, in a private practice setting or a wound care center. The primary endpoint was the number of participants who achieved wound closure at 90 days. Data analysed and collected included wound etiology, wound size, gender, healing time by setting, and days to heal overall. Due to the anticipated small cohort of wound types, several statistical calculations were considered, including one-way ANOVA, Pearson correlation, and Levene's test.
  
  
  RESULTS
  All wounds were classified by etiology: 58% (n=23), diabetic neuropathic ulcers (DNU), 25% (n=10) venous insufficiency ulcers (VU), and 17% (n=7) pressure ulcers (PU). Overall, 35% (n=14) healed within 30 days (22.14 ± 4.47), 60% (n=24) healed in 60 days (31.76 ± 13.02), and 78% (n=31) healed in 90 days (40.81 ± 22.23). After 90 days, the remaining 23% (n=9) of participants were no longer followed.
  
  
  CONCLUSIONS
  This clinical evaluation demonstrated the overall effectiveness of this treatment protocol by attaining nearly 80% wound closure within 90 days. This protocol is intended to provide a roadmap for clinicians to follow and adapt to their wound care practice should a high prevalence of MRSA-infected wounds be present.
  
  
  BACKGROUND
  The author has disclosed that he has worked doing clinical case studies for Amerx Health Care Corp. and is on their speaker bureau. The author has also disclosed that he has no financial relationship or vested interest with Amerx Health Care Corp. No funding was provided by the NIH, Wellcome Trust, HHMI, or others.
authors.forename: G S
authors.initials: GS
authors.lastname: Graham
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D002985:Clinical Protocols; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000628:therapy*; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D010936:Plant Extracts / Q000627:therapeutic use*; D029963:Quercus; D013203:Staphylococcal Infections / Q000188:drug therapy*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects*
chemical_list: C588008:Oakin; D010936:Plant Extracts