Wound colonization

Wound colonization the presence of bacteria within the wound which do multiply or initiate a host reaction. 

Cause Colonization of immature intestinal tract Wound colonization resulting from contact with contaminated material Intestinal colonization secondary to disruption of normal intestinal flora Ingestion of preformed toxin in contaminated food products Respiratory exposure to toxin aerosols or droplets Systemic toxin uptake after therapeutic toxin administration... 

Botulism is a disease caused by ingestion of foods contaminated with Clostridium botulinum (food-borne botulism) or, very rarely, by wound infection (wound botulism) or colonization of the intestinal tract with Clostridium botulinum (infant botulism). The toxins block the release of acetylcholine. Botulism is characterized by generalized muscular weakness, which first affects eye and throat muscles and later extends to all skeletal muscles. Flaccid paralysis can lead to respiratory failure. 

Bacterial colonization of pressure sores is common. Because infection impairs wound healing and may require systemic antimicrobial therapy, the clinician must be able to distinguish it from colonization. Table 70-8 describes the clinical presentation of infected pressure sores. 

Bartlett JG, Condon RE, Gorbach SL, Clarke JS, Nichols RL, Ochi S Veterans Administration Cooperative Study on Bowel Preparation for Elective Colorectal Operations Impact of oral antibiotic regimen on colonic flora, wound irrigation cultures and bacteriology of septic complications. Ann Surg 1978,188 249-254. 

Some surgeons advocate direct application to the wound of or irrigation of the wound with either antibiotics or povidone-iodine during colon resection. Solutions containing povidone-iodine should almost never be placed in the peritoneal cavity, because they are likely to be absorbed and subsequently to cause toxic effects. 

Diphtheria causes a demyelinative neuropathy. Coryne-bacterium diphtheriae colonizes the pharynx or open wounds, and secretes a protein exotoxin. The B subunit of this exotoxin binds to plasma membranes and facilitates entry into cytosol of the A subunit, which catalyzes ADP-ribosylation, and inactivation of an elongation factor required for protein synthesis. Cardiac muscle and Schwann cells are particularly susceptible to this toxin, and hence patients with diphtheria develop cardiomyopathy and demyelinative polyneuropathy [20]. While diphtheria is now uncommon because of childhood immunization against C. diphtheriae, the disruption in preventative medicine programs caused by disintegration of the Soviet Union was followed by a substantial incidence of diphtheritic polyneuropathy in Russia. 

Rat colon Bile adds Cholestyramine High fat diets Wounding... 

In modern European medicine, St. John s wort extracts are included in many over-the-counter and prescription drugs for management of mild depression, and have clinical implications for bed-wetting and nightmares in children. The extracts are included in diuretic preparations and the oil is taken orally using a teaspoon to help heal gastritis, gastric ulcers, and inflammatory conditions of the colon. The oil is also used extensively externally in burn and wound remedies. 

Alee Vera (Aloe barbadensis) Uses Topically for bums, skin irritation, sunburn, wounds internally used for constipation, amenorrhea, asthma, colds Actions Multiple chemical components aloinosides inhibit H20 electrolyte reabsorption irritates colon which T peristalsis propulsion wound healing d/t i production of thromboxane A2, inhibiting bradykinin, histamine Available forms Apply gel topically 3-5/d PRN caps 100-200 mg PO hs Contra Do not use if PRG, lactating, or children <12 y Notes/SE Abd cramping, D, edema, hematuria, hypokalemia, muscle weakness, dermatitis Interactions w/ internal use T K+ loss W/ BB, corticosteroids, diuretics, licorice T effects OF antiarrhythmics, corticosteroids, digoxin, diuretics, hyperglycemias, jimsonweed EMS Assess for dehydration, electrolyte imbalance (hypokalemia), abd distress w/ internal use stimulates uterine contractions may cause spontaneous abortion... 

Sodium sulfacetamide ophthalmic solution or ointment is effective treatment for bacterial conjunctivitis and as adjunctive therapy for trachoma. Mafenide acetate is used topically to prevent bacterial colonization and infection of burn wounds. Mafenide is absorbed from burn sites, and systemic levels are produced. The drug and its primary metabolite also inhibit carbonic anhydrase and can cause metabolic acidosis, a side effect that limits its usefulness. Silver sulfadiazine is a much less toxic topical sulfonamide and is preferred to mafenide for prevention of infection of burn wounds. 

---