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JSF-12, 13+14 MARTS, 2008 B I O F I L M

JSF-12, 13+14 MARTS, 2008 B I O F I L M. DET INFICEREDE SÅR INFLAMMATION ?? INFEKTION ??. DET INFICEREDE SÅR OVERVEJELSER: ■ KONTAMINERING ? ■ KOLONISERING ? ■ KRITISK KOLONISERING ? ■ KLINISK INFEKTION ?. DET INFICEREDE SÅR BIOFILM Quorum sensing: (QS)

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JSF-12, 13+14 MARTS, 2008 B I O F I L M

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  1. JSF-12, 13+14 MARTS, 2008 B I O F I L M

  2. DET INFICEREDE SÅR INFLAMMATION ?? INFEKTION ??

  3. DET INFICEREDE SÅR OVERVEJELSER: ■ KONTAMINERING ? ■ KOLONISERING ? ■ KRITISK KOLONISERING ? ■ KLINISK INFEKTION ?

  4. DET INFICEREDE SÅR BIOFILM Quorum sensing: (QS) Bakteriernes kommunikation Virulensfaktorer (Bakterierne bliver først virulente patogener, når de når et antal, hvor QS-systemet aktiverer virulensfaktorerne. Indtil da er de mere uskadelige kolonisatorer)

  5. DET INFICEREDE SÅR BIOFILM Antibiotika Quorum sensing-inhibitorer

  6. Biofilms in chronic wounds. James GA, Swogger E, Wolcott R, Pulcini ED, Secor P, Sestrich J, Costerton JW, Wound Repair Regen. 2008 Jan-Feb;16(1):37-44. • Stewart PS. • Chronic wounds including diabetic foot ulcers, pressure ulcers, and venous leg ulcers are a worldwide health problem. It has been speculated that bacteria colonizing chronic wounds exist as highly persistent biofilm communities. This research examined chronic and acute wounds for biofilms and characterized microorganisms inhabiting these wounds. Chronic wound specimens were obtained from 77 subjects and acute wound specimens were obtained from 16 subjects. Culture data were collected using standard clinical techniques. Light and scanning electron microscopy techniques were used to analyze 50 of the chronic wound specimens and the 16 acute wound specimens. Molecular analyses were performed on the remaining 27 chronic wound specimens using denaturing gradient gel electrophoresis and sequence analysis. Of the 50 chronic wound specimens evaluated by microscopy, 30 were characterized as containing biofilm (60%), whereas only one of the 16 acute wound specimens was characterized as containing biofilm (6%). This was a statistically significant difference (p<0.001). Molecular analyses of chronic wound specimens revealed diverse polymicrobial communities and the presence of bacteria, including strictly anaerobic bacteria, not revealed by culture. Bacterial biofilm prevalence in specimens from chronic wounds relative to acute wounds observed in this study provides evidence that biofilms may be abundant in chronic wounds.

  7. Horrocks A: Prontosan wound irrigation and gel: management of chronic wounds. Br J Nurs: 2006. Chronic wounds present a challenge that is costly in terms of quality of life to the patient and in financial terms for the NHS. Several factors contribute to the development of a chronic wound, in particular the influence of bacteria as a biofilm within the wound environment. Irrigating a wound with normal saline has long been advocated as the most appropriate method of wound irrigation but biofilms are now known to be resistant to this method of cleansing. A small (10 patient) evaluation of the use of Prontosan in patients whose duration of chronic wounds exceeded 1 year has demonstrated that Prontosan wound irrigation and Prontosan gel are an appropriate alternative for cleaning, moistening and decontaminating encrusted, contaminated and chronic skin wounds, and can have a dramatic influence of the quality of life for such patients. This article discusses the cause of chronicity within a wound and discusses in depth three of the ten patients in the evaluation.

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