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An Examination of the Antimicrobial Effects of a 15% Sodium Chloride Impregnated Dressing on Wounds

Catherine T. Milne, APRN, MSN, BC, CWOCN, Bristol Hospital Wound, Ostomy, Lymphedema Center, Advanced Practice Nurse, 842 Clark Avenue, Bristol, CT 06010, JoAnn Hagan, LPN, Bristol Hospital Wound, Ostomy, Lymphedema Center, Staff Nurse, 842 Clark Avenue, Bristol, CT 06010, Armann O. Ciccarelli, MD, Federal Hill Plastic Surgery, Chief of Surgery, Bristol Hospital; Medical Director Bristol Hospital Wound, Ostomy, Lymphedema Center, 291 Queen St., Bristol, CT 06010, and Christian Ertl, MD, FACS, Bristol Hospital, Associate Professor of Surgery UCONN School of Medicine, Department of Surgery, Brewster Rd., Bristol, CT 06010.

Clinical Problem: Wounds with critical colonization have shown delayed or absent healing trajectories1-2. A number of antimicrobial topical dressings have been developed to treat critical colonization3 using silver, iodine, and methylene blue/gentian violet. Older, traditional methods, such as honey, acetic acid and Dakin's Solution have also shown to reduce bacterial loads in chronic wounds3. It is unknown if a 15% sodium chloride impregnated dressing, commonly used for autolytic debridement of non-viable tissue, could also function as an antimicrobial agent in critically colonized wounds.

Clinical Approach: Semi-quantitative cultures using the Levine technique were taken from a convenience sample of ten hypertonic saline naïve patients with clinical signs of critical colonization and repeated twenty-four hours later after the application of a 15% Sodium Chloride Impregnated Dressing*.

Outcomes: Preliminary data show a reduction or absence of bacteria in the majority of patients twenty four hours after application of a 15% sodium chloride impregnated dressing.

Conclusions: The use of a 15% sodium chloride impregnated dressing in critically colonized wounds is a viable antimicrobial treatment option for critically colonized wounds. Further study is warranted.

* Mesalt Dressing, Molnlycke Health Care, Sweden

1Thomson PD. Immunology, microbiology, and the recalcitrant wound. Ostomy/Wound Management. 2000;46(1A Suppl):77S-82S.

2 Schultz GS, Sibbald RG, Falanga V, Ayello EA, Dowsett C, Harding K, Romanelli M, Stacey MC, Teot L, Vanscheidt W. Wound bed preparation: a systematic approach to wound management. Wound Repair Regen. 2003;11(Suppl 1):S1-S28.

3 Bowler PG, Duerden BI, Armstrong DG. Wound Microbiology and Associated Approaches to Wound Management. Clinical Microbiology Rev 2001;14(2):244-269.


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