Glow in The Dark Gels May Aid Wound Treatment

By kdodia on Sep 19, 2011 Staffnurse.com UK

Ultra violet light could soon be used to detect and assess infected wounds following the development of polymers that shine when there are bacteria present. Researchers at the University of Sheffield, England, found that when a gel containing the polymers was applied to a wound, the level of fluorescence indicated the severity of infection. Professor Sheila MacNeil, an expert in tissue engineering and wound healing, explained: The polymers incorporate a fluorescent dye and are engineered to recognise and attach to bacteria, collapsing around them as they do so. This change in polymer shape generates a fluorescent signal that weve been able to detect using a hand-held UV lamp.

The polymers are attached to fragments of antibiotics, which bind to either gram negative or gram positive bacteria both of which cause very serious infections. This then enables clinicians to decide which, if any, antibiotic should be used. The availability of these gels would help clinicians and wound care nurses to make rapid, informed decisions about wound management, and help reduce the overuse of antibiotics, added project lead Dr Steve Rimmer. Existing methods of detecting bacterial infection involve swabbing the wound and culturing the swabs in a specialist bacteriology laboratory, which can take several days. But the Sheffield team believes its technology could reduce the detection of bacterial infection to within a few hours.

The study has already demonstrated that when the polymer (PNIPAM) is modified with the antibiotic vancomycin and ethidium bromide, a fluorescent dye, is added, there is a fluorescent signal when it encounters gram negative bacteria. Other polymers have responded to S. aureus, a gram positive bacterium. Dr Rimmer said these advances mean that a hand-held sensor device can be developed to be used in a clinical setting.

Submitted by: Kevin Jeff Alivio BSN-IV

Submitted to: Mr.Mart Villavicencio, RN

Noisy Operations Link to Increased Infections After Surgery

By Spoon Full of Sugar on Jun 6, 2011

June 4 Patients who undergo surgery in noisy operating theatres face increased risk of contracting infections, Swiss research has claimed. Chatting about non-patients topics, which leads to a lack of concentration by the surgical team, may be one factor, a small study of 35 patients found. The patients all underwent planned, major abdominal surgery at Berne University Hospital, Switzerland and six (17 per cent) developed SSIs. The only variable was the noise level in the operating theatre, which was considerably higher in the infected patients. Dr Guido Beldi, staff surgeon and research group leader from the Department of Visceral Surgery and Medicine, said patients with SSIs spent up to 13 days longer in hospital, making their stay cost up to three times as costly as other patients. Having found a significant association between SSIs within 30 days of surgery and increased sound levels in the operating theatre, we can only conclude that noise is associated with a stressful environment or lack of concentration and this impacts on the surgical outcome, he added. Key findings of the research, which is published in the July issue of BJS, the British Journal of Surgery included:
y y

Median sound levels during surgery were significantly higher for the patients who developed SSIs (43.5dB) than for those who did not (25dB); Peak levels of at least 4dB above the median were found in 23 per cent of the SSI patient operations, twice as many as the 11 per cent observed in the other operations.

The researchers found that sound levels appeared to increase in both groups 60 minutes after the first incision. While it could be related to increased difficulty with the operation, talking about non-patient topics was also associated with a significantly higher noise level, which may suggest a lack of concentration by the entire surgical team. Dr Beldi said the interpretation was speculative because the timing of the non-patient-related conversations was not recorded. The results of our study suggest that increased sound levels in the operating theatre may point to issues such as surgical difficulty, a stressful environment, impaired discipline or concentration concludes Dr Beldi. Each of these factors may increase the risk of SSIs and other complications and further studies looking at the source of operating theatre noise and its specific influence on the behaviour and performance of surgeons is warranted. In an editorial, Professor Ara Darzi from the Division of Surgery at Imperial College London, said the study should encourage surgeons to find solutions to the everyday problems they encounter in the operating theatre. The authors are to be commended on seeking clinically important parameters concerning the quality and safety against which to measure outcome he says. Not all great research need necessarily be on a large scale; surgeons should be encouraged to examine the day-to-day problems they encounter and seek innovative ways to investigate them. Adverse effect of noise in the operating theatre on surgical-site infection. Kurmann et al. British Journal of Surgery. 98, pp1021-1025. (2011). DOI: 10.1002/bjs.7496

SUBMITTED TO: Mr. Mart Villavicencio, RN SUBMITTED BY: Franky Rigor O. Libardo