Topical antimicrobial protection of postoperative surgical sites at risk of infection with Propionibacterium acnes: an in-vitro study.

BACKGROUND: Propionibacterium acnes is an increasingly recognized pathogen in surgical site infections, particularly in relation to joint replacements and spinal procedures. Due to its low virulence and slow-growing nature, clinical signs of infection may be prolonged, and diagnosis is often challenging. As a consequence, appropriate presurgical skin preparation and postsurgical protection of the wound using antimicrobial dressings are important considerations in the prevention of surgical site infections caused by P. acnes. AIM: To investigate the antimicrobial efficacy of a silver-containing gelling fibre wound dressing against P. acnes using stringent in-vitro models that simulated a variety of wound conditions. METHODS: A simulated wound fluid model was used to quantify the killing capacity of the silver-containing dressing over time under conditions that mimicked a heavily exuding wound. A simulated colonized shallow wound model was used to investigate the impact of dressing conformability on antimicrobial activity, and a third model was designed to measure the efficacy of the dressing on bacteria embedded within a simulated colonized wound surface. FINDINGS: The in-vitro data demonstrated that the silver-containing wound dressing was bactericidal against P. acnes, it maintained its killing effect over a prolonged period (seven days) under conditions simulating excessive exudate, and the gelled dressing matrix (following hydration) enabled the dressing to conform to a simulated wound topography, thus optimizing antimicrobial activity in a shallow wound model. CONCLUSION: Based on the in-vitro data generated, use of the silver-containing dressing as part of a postoperative care protocol may help to minimize the risk of prolonged and debilitating surgical site infections caused by P. acnes.

A rapid appraisal of the nutritional status of Irian Jaya refugees and Papua New Guineans undergoing severe food shortage in the North Fly region.

A survey of nutritional status of recent border crossers from Irian Jaya undergoing severe food shortages was carried out. The two camps visited were those considered to have the most serious problems at the height of the crisis. Komopkin Camp had the highest levels of malnutrition in all age groups and in all categories, including 52% of children aged 1 to 5 years with signs of kwashiorkor. No kwashiorkor, however, was found in the other camp. Papua New Guinea villagers living alongside the refugees in Komopkin were also suffering from malnutrition, though of lesser severity and shorter duration.