title: The effectiveness of negative pressure therapy on infected wounds: preliminary results.
abstract: Vacuum-assisted closure (VAC) therapy is a sophisticated system that maintains a closed, humid, sterile and isolated environment. Wound infection is considered a relative contraindication. The objective of this study is to extend the indications for VAC therapy to include infected wounds by demonstrating its ability to increase the antibiotic concentration in the damaged and infected tissues. Patients who presented with ulcers infected with daptomycin-sensitive bacteria were eligible to be enrolled in this prospective study. They were given antibiotic therapy with daptomycin with a specific protocol. A biopsy of the lesion was carried out to detect tissue concentration of the drug at time 0. Afterwards, the patients were subjected to VAC therapy. At the end of VAC therapy, a second lesion biopsy was performed and analysed to detect tissue concentration of the drug at time 1. A control group was enrolled in which patients followed the same protocol, but they were treated with traditional dressings. Fisher's exact test was used to compare the two groups. The results highlighted a significant increase in the concentration of antibiotics in the study group tissue; the improvement was sensibly lower in the control group. Statistical differences were not found between the two groups. The preliminary analysis of the data showed an important increase of antibiotic concentration in the tissue after VAC therapy. Despite the encouraging data, it is necessary to broaden the sample of patients and perform the same study with other antibiotics.
authors.affiliation: 'P. Valdoni' Department of Surgery, U.O. of Plastic Reconstructive Surgery, 'Sapienza' University of Rome, Rome, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Lo Torto
authors.affiliation: Policlinico Luigi Di Liegro, Via dei Badoer, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Ruggiero
authors.affiliation: 'P. Valdoni' Department of Surgery, U.O. of Plastic Reconstructive Surgery, 'Sapienza' University of Rome, Rome, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Parisi
authors.affiliation: Drexel University College of Medicine, Philadelphia, PA, USA.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Borab
authors.affiliation: Faculty of Bioscience and Technology for Food, Agriculture and Environment, University of Teramo, Teramo, Italy.
authors.forename: Manuel
authors.initials: M
authors.lastname: Sergi
authors.affiliation: 'P. Valdoni' Department of Surgery, U.O. of Plastic Reconstructive Surgery, 'Sapienza' University of Rome, Rome, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Carlesimo
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002908:Chronic Disease / Q000628:therapy*; D017576:Daptomycin / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy / Q000379:methods*; D011446:Prospective Studies; D014945:Wound Healing / Q000502:physiology*; D014946:Wound Infection / Q000628:therapy*; D014947:Wounds and Injuries / Q000628:therapy*
chemical_list: D000900:Anti-Bacterial Agents; D017576:Daptomycin
keywords: Chronic wound; Daptomicin; Negative pressure wound therapy; Vacuum Assisted Closure therapy