Marco Falcone1, Barbara De Angelis2, Federico Pea3, Alessandro Scalise4, Stefania Stefani5, Rolando Tasinato6, Orazio Zanetti7, Luca Dalla Paola8. 1. Division of Infectious Diseases, Department of Clinical and Experimental Medicine, University of Pisa, Via Paradisa 2, 56124 Pisa, Italy. Electronic address: marco.falcone@unipi.it. 2. Surgical Science Department, Plastic and Reconstructive Surgery, University of Rome 'Tor Vergata', Rome, Italy. 3. Alma Mater Studiorum, University of Bologna, University Hospital IRCCS Policlinico Sant'Orsola Malpighi, Bologna, Italy. 4. Clinic of Plastic and Reconstructive Surgery, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy. 5. Department of Biomedical and Biotechnological Sciences, Biological Tower, University of Catania, Catania, Italy. 6. Azienda Sanitaria Locale 3 Serenissima del Veneto, Department of General and Vascular Surgery, Venice, Italy. 7. Alzheimer Unit, IRCCS S. Centro Giovanni di Dio 'Fatebenefratelli', Brescia, Italy. 8. Maria Cecilia Hospital, Cotignola, Italy.
Abstract
OBJECTIVES: Chronic wound infections may delay the healing process and are responsible for a significant burden on healthcare systems. Since inappropriate management may commonly occur in the care of these patients, this review aims to provide a practical guide underlining actions to avoid in the management of chronic wound infections. METHODS: We performed a systematic review of the literature available in PubMed in the last 10 years, identifying studies regarding the management of patients with chronic wound infections. A panel of experts discussed the potential malpractices in this area. A list of 'Don'ts', including the main actions to be avoided, was drawn up using the 'Choosing Wisely' methodology. RESULTS: In this review, we proposed a list of actions to avoid for optimal management of patients with chronic wound infections. Adequate wound bed preparation and wound antisepsis should be combined, as the absence of one of them leads to delayed healing and a higher risk of wound complications. Moreover, avoiding inappropriate use of systemic antibiotics is an important point because of the risk of selection of multidrug-resistant organisms as well as antibiotic-related adverse events. CONCLUSION: A multidisciplinary team of experts in different fields (surgeon, infectious disease expert, microbiologist, pharmacologist, geriatrician) is required for the optimal management of chronic wound infections. Implementation of this approach may be useful to improve the management of patients with chronic wound infections.
OBJECTIVES: Chronic wound infections may delay the healing process and are responsible for a significant burden on healthcare systems. Since inappropriate management may commonly occur in the care of these patients, this review aims to provide a practical guide underlining actions to avoid in the management of chronic wound infections. METHODS: We performed a systematic review of the literature available in PubMed in the last 10 years, identifying studies regarding the management of patients with chronic wound infections. A panel of experts discussed the potential malpractices in this area. A list of 'Don'ts', including the main actions to be avoided, was drawn up using the 'Choosing Wisely' methodology. RESULTS: In this review, we proposed a list of actions to avoid for optimal management of patients with chronic wound infections. Adequate wound bed preparation and wound antisepsis should be combined, as the absence of one of them leads to delayed healing and a higher risk of wound complications. Moreover, avoiding inappropriate use of systemic antibiotics is an important point because of the risk of selection of multidrug-resistant organisms as well as antibiotic-related adverse events. CONCLUSION: A multidisciplinary team of experts in different fields (surgeon, infectious disease expert, microbiologist, pharmacologist, geriatrician) is required for the optimal management of chronic wound infections. Implementation of this approach may be useful to improve the management of patients with chronic wound infections.