title: Continuous topical irrigation for severely infected wound healing.
abstract: BACKGROUND
  Management of severely infected wounds is a formidable challenge. The pilot prospective cohort study is to investigate the influence of continuous topical irrigation (CTI) on the outcomes of severely infected wounds.
  
  
  METHODS
  This pilot study was performed on 17 patients with a single severely infected wound treated with CTI, compared with a control group of 15 patients treated with standard of care from January 2011-January 2013. Bates-Jensen wound assessment tool severity scores and the clinical outcomes were recorded. Profiles of cytokines and/or proteinase in wound fluid were quantified weekly.
  
  
  RESULTS
  Comparing with the control, the CTI-treated patients required fewer days for wound infection clearance (8 ± 2 versus 19 ± 5 d, P < 0.001), had wounds closed earlier (17 ± 4 versus 36 ± 7 d, P < 0.001), and had fewer inhospital stay days (23 ± 5 versus 42 ± 8 d, P < 0.001). Bates-Jensen wound assessment tool severity scorings, proinflammatory cytokines (tumor necrosis factor-α, interleukin 1β, and interleukin 6), and matrix metalloproteinase-8 were significantly decreased in response to CTI.
  
  
  CONCLUSIONS
  This pilot study demonstrates that CTI improves severely infected wound healing through partly inhibiting proinflammatory cytokines and improving tissue regeneration.
authors.affiliation: Department of General Surgery, Affiliated Zhongda Hospital, Southeast University Medical School, Nanjing, Jiangsu, China. Electronic address: tqs@seu.edu.cn.
authors.forename: Qingsong
authors.initials: Q
authors.lastname: Tao
authors.affiliation: Department of Surgery, Research Institute of General Surgery, Jinling Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China.
authors.forename: Jianan
authors.initials: J
authors.lastname: Ren
authors.affiliation: Department of General Surgery, Affiliated Zhongda Hospital, Southeast University Medical School, Nanjing, Jiangsu, China.
authors.forename: Zhenling
authors.initials: Z
authors.lastname: Ji
authors.affiliation: Department of General Surgery, Affiliated Zhongda Hospital, Southeast University Medical School, Nanjing, Jiangsu, China.
authors.forename: Baochai
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Surgery, Haian People's Hospital, Nantong University Medical School, Nantong, Jiangsu, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zheng
authors.affiliation: Department of Surgery, Research Institute of General Surgery, Jinling Hospital, Nanjing University Medical School, Nanjing, Jiangsu, China.
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D007507:Therapeutic Irrigation / Q000379:methods*; D014945:Wound Healing; D014946:Wound Infection / Q000628:therapy*
chemical_list: D015415:Biomarkers
keywords: Cytokines; Matrix metalloproteinase; Topical irrigation; Wound infection