Treatment of MRSI in granulation bed

Re: Treatment of MRSI in granulation bed

Tim Charlesworth — Fri, 20 Feb 2015 21:30:17 GMT

Use Honey and Silver dressings (e.g. Acticoat) for these. Both seem to work well Vs MRSA. Acticoat is sig more expensive. If you're just leaving the wound to granulate then this will prob do (and obvious risk of reinfection anyway) but if you were going to close the wound/graft etc then we usually use Clindamycin (Antirobe) which usually clears the infection within a few dd (would reswab preop whatever you do),

Tim

Re: Treatment of MRSI in granulation bed

a.bardell — Fri, 20 Feb 2015 19:48:59 GMT

Used to use those silver impregnated dressings quite a lot in a previous life- seemed to help this sort of wound if I remember rightly. Less messy than honey and not sure re cost comparison

Anyone else use these?

Re: Treatment of MRSI in granulation bed

Hannah Wynne Richards — Fri, 20 Feb 2015 10:11:03 GMT

Again I send a lot of bacteriology swabs to an external lab. The last one that had MRSA was owned by an elderly lady who was regularly attending outpatients for a non-healing leg ulcer! Co-incidence? The owners' ulcer was long-standing. The dog came in for a lunp removal, and the wound broke down.

Wynne

Re: Treatment of MRSI in granulation bed

Glenn Hodgson — Fri, 20 Feb 2015 09:59:26 GMT

[quote user="Martin Atkinson"]

It amuses me, if that is the right word, how many cultures come back as MRSA and the alarm bells ring that this is almost a death sentence because that is what has been indoctrinated into us by the scare mongers. In fact all it says is what's on the tin: it's methicillin resistant staph. aureus but it is still sensitive to a number of antibiotics that we commonly use (OK not in this case and some are truly resistant to all antibiotics known to mankind).

[/quote]

I agree! Its a granulation bed and should be fine. The media has a big impact on responses to it. I wander how much of what we do is influenced by Holby city....

On the bright side this is the first MResistant bug we have found at the practice. And we do look a fair bit.

Re: Treatment of MRSI in granulation bed

Bob Russell — Fri, 20 Feb 2015 09:21:54 GMT

Manuka honey dressings can be great for these if you feel the bacterial culture is relevant. A good healthy granulation bed is pretty resilient to infection so does it need antibiotics as opposed to good wound management? Quite uncomfortable for the first seconds after applying.

Re: Treatment of MRSI in granulation bed

Martin Atkinson — Fri, 20 Feb 2015 08:54:41 GMT

I would follow my golden rule that given the choice between antibiotics or drainage and good wound management but not both, then drainage and wound management wins every time. And Manuka sounds good.