Subeschar culture using a punch instrument in unstageable wounds

Author:

Jung Han ByulORCID,Lee Yong JigORCID

Abstract

Background A patient’s overall condition sometimes does not allow for the complete removal of a dead eschar or injured slough in cases involving a pressure-injury skin lesion. This frequently occurs in clinical practice, particularly in bedridden and older patients receiving home care or intensive care. Even after debridement, it is also difficult to manage open exudative wounds in these patients. Nevertheless, when a mature or immature eschar is treated without proper debridement, liquefaction necrosis underneath the eschar or slough tends to reveal a large, open wound with infectious exudates. We hypothesized that if the presence of any bacteria under the eschar can be evaluated and the progression of the presumed infection of the subeschar can be halted or delayed without creating an open wound, the final wound can be small, shallow, and uninfected.Methods Using a punch instrument, we performed 34 viable subeschar tissue cultures with a secure junction between the eschar and the normal skin.Results The bacterial study had 29 positive results. Based on these results and the patient’s status, appropriate antibiotics could be selected and administered. The use of suitable antibiotics led to relatively shallow and small exposed wounds.Conclusions This procedure could be used to detect potentially pathogenic bacteria hidden under black or yellow eschars. Since subeschar infections are often accompanied by multidrug-resistant bacteria, the early detection of hidden infections and the use of appropriate antibiotics are expected to be helpful to patients.

Publisher

Korean Society of Plastic and Reconstructive Surgeons

Subject

Surgery

Cited by 3 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Surgical treatment of pressure ulcer: various flaps and other surgical methods;Journal of the Korean Medical Association;2021-01-10

2. Socioeconomic effects of pressure ulcer;Journal of the Korean Medical Association;2021-01-10

3. Stage‐related implications of community‐acquired pressure injuries for the acute medical inpatients;Journal of Clinical Nursing;2020-12-28

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