Wound Assessment Tools

Approximately 10% of all burn wounds become infected and the incidence of hospital acquired infections such as antibiotic resistant MRSA is increasing

Approximately 10% of all burn wounds become infected and the incidence of hospital acquired infections such as antibiotic resistant MRSA is increasing. Diagnosis of wound infection is currently achieved by removal of the dressings and direct wound assessment and culture from swabs which takes 24 – 48 hours.

Most burn dressings are designed not to be removed and their removal for diagnostic reasons further increases the chance of wound infection occurring.

A real need therefore exists to develop novel ways to detect and treat burn wound infections, and we are working with collaborators at the University of Bath and South West Children's Burns Centre, Frenchay Hospital, Bristol to develop innovative ways of monitoring infection.

A better knowledge of variables such as pH which we have recently shown to be closely linked to wound healing is also vital. The effect that pH has on the incidence of wound infection is poorly understood and the development of techniques to control wound pH may bring additional benefits in reducing infection.

This project seeks to measure a variety of variables on the wound bed of burns patients and investigate whether correlations exist between chemical and biochemical variations and clinical outcome.

By improving our understanding of how fundamental physiological variables, including pH and Ca2+ concentration, affect clinical outcome we aim to optimise wound bed conditions to maximise healing rate and minimise scarring and develop potential prognostic measures of burn wound healing.

The pH of intact skin is acidic with values between 4 and 6, while plasma pH is approximately 7.4. Wounds often demonstrate a higher pH than 7.4, and as they heal this decreases. Pathogenic bacteria often require higher pH levels to proliferate and some evidence exists that colonised/infected wounds maintain a high pH.

Data on burn wounds specifically is lacking and there is little on skin graft take and pH values. Although progression of wound pH correlates with healing, little data exists on its potential as a predictor for treatment.

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