title: Measurement of vancomycin hydrochloride concentration in the exudate from wounds receiving negative pressure wound therapy: a pilot study.
abstract: It has been reported that negative pressure wound therapy (NPWT) is effective in the treatment of contaminated wounds. We hypothesised that systemically administered antibiotics migrate to wound site effectively by NPWT, which provides the antibacterial effect. We measured and compared the concentrations of vancomycin in the exudate and blood serum. Eight patients with skin ulcers or skin defect wounds who were treated with NPWT and were administered an intravenous drip of vancomycin were enrolled in this study. The wound surfaces were muscle, muscle fascia or adipose tissue. We administered vancomycin intravenously to NPWT patients (1-3 g/day). The exudate was obtained using 500 ml V.A.C. ATS canisters without gel. Three days later, the concentrations of vancomycin were measured. The mean concentration of vancomycin in the exudate from NPWT was 67% of the serum vancomycin concentration. We found that concentrations of vancomycin in NPWT exudates are higher than the previously reported concentrations in soft tissue without NPWT. The proactive use of NPWT might be considered in cases of suspected wound contamination when a systemic antibiotic is administered.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Ida
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Matsumura
authors.affiliation: Division of Pharmacy, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Onishi
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo, Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Ono
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo, Japan.
authors.forename: Ryutaro
authors.initials: R
authors.lastname: Imai
authors.affiliation: Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo, Japan.
authors.forename: Katsueki
authors.initials: K
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000032:analysis / Q000493:pharmacokinetics; D005122:Exudates and Transudates / Q000737:chemistry*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D010865:Pilot Projects; D014640:Vancomycin / Q000032:analysis* / Q000493:pharmacokinetics; D014946:Wound Infection / Q000378:metabolism / Q000628:therapy*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin
keywords: Exudate; Infection; Negative pressure wound therapy; Vancomycin