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https://www.mdpi.com/2673-1991/3/1/4/pdf
Discussion
Regardless of the advances in the medical field, wound infections still pose a significant challenge in a daily routine of a burn ward [3]. One of the most common types of infections in burn patients is through pseudomonas strains. Pseudomonas aeruginosa is a common encapsulated, Gram-negative rod bacterium. It thrives in both aerobic and low oxygen environments and can be found in soil, water, and skin flora. The ability to aggregate and produce a biofilm only increases its resistance to antimicrobial therapy. In our case, coexisting diabetes is also predisposed to a prolonged infection and poor wound healing. In spite of repeated debridements, we were faced with a persistent infection resulting in a total skin loss putting the patient at risk of a bilateral lower leg amputation. A case series of defect reconstructions using NovoSorb BTM from N. S. Solanki et al. [4]showed a high tolerance of the dermal scaffold against infection. In this case, the wound infection was diagnosed after BTM application. Normally no artificial material is recommended in the infected wound ground. To our knowledge and after a literature search using the keywords “novosorb” and “novosorb BTM” in Pubmed, our case report presents the first application of the NovoSorb BTM in the infected wound with Pseudomonas aeruginosa and proved that it could lead to successful treatment. Figure 4. (A) End result by transfer to burn-rehabilitation with almost completely consolidated wounds. (B) Result after burn-rehabilitation with patient being able to freely walk again.
It is disputable if the same effect could be achieved with more thorough and radical debridement and earlier use of Mafenid. We used primarily topical iodine (Braunol) to treat the skin graft infection according to the standard of care in our clinic.
It is to underline that we used NovoSorb BTM as a temporary measure to improve the wound ground win extra time to gain control over the infection and ultimately allow theEur. Burn J. 2022, 3 33 successful autologous skin grafting as a definitive wound coverage. We suspect that the
neovascularized dermal scaffold BTM as intermediary wound coverage allowed for successful treatment of the Pseudomonas aeruginosa infection and subsequent skin grafting [5]. Increased inflammatory response properties of BTM, in comparison to Integra® as shown
in the study from P. A. Cheshire et. al, may have helped in the successful treatment [6].
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