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A Current Overview of Chronic Wounds Presenting to a Plastic Surgery Unit in Central India

Authors Khan MM, Cheruvu VPR, Krishna D, Minz R, Laitonjam M, Joshi R

Received 12 June 2020

Accepted for publication 11 August 2020

Published 28 September 2020 Volume 2020:7 Pages 43—51


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Marco Romanelli

Manal M Khan, Ved Prakash Rao Cheruvu, Deepak Krishna, Reena Minz, Michael Laitonjam, Rishabh Joshi

Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India

Correspondence: Ved Prakash Rao Cheruvu
Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, 1st Floor, Hospital Building, Saket Nagar, Bhopal, Madhya Pradesh 462020, India
Tel +91 8872209777

Purpose: To analyze the demographic, clinical, and microbiological profile of patients presenting to our unit with chronic wounds of various etiologies with an intent to give a current overview of chronic wounds.
Patients and Methods: We performed a prospective observational study of patients presenting with chronic wounds from October 2018 to September 2019. The study was conducted at the Department of Burns and Plastic Surgery of a tertiary care institute in a non-metropolitan city in Central India. A total of 103 patients were included in the study. Data collected from the patients included demographic details, history, clinical features, and relevant laboratory reports. Wound swabs obtained by Levine’s technique were sent for culture and sensitivity studies. Treatment was instituted according to the clinical picture and modified if necessary. Progress was monitored until the wound healed, either by conservative management or by surgical intervention. Patients were followed up for six months thereafter.
Results: Most of the patients presented with lower limb wounds (n=81, 78.64%). Swab specimens from 103 wounds were cultured. Among the isolates, gram-negative organisms were more common than gram-positive organisms. Staphylococcus aureus was the most common species isolated, followed by Pseudomonas aeruginosa. The frequency of infections caused by other gram-negative organisms like Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis was on the rise. There were significant differences in the patterns of antimicrobial resistance in our patients. Sharp debridements were required in almost all cases for wound preparation. Most of the patients (n=74, 71.84%) underwent surgical intervention for achieving wound closure. Split-thickness skin grafting (STSG) was the most common surgical intervention performed (n=45, 43.68% patients), followed by local and distant flaps.
Conclusion: Our study gives a current overview of the causes, clinical presentation, prevalent microbial flora, and their antibiotic susceptibilities prevalent in chronic wounds presenting to our unit. Treatments administered are discussed with emphasis on the different reconstructions performed.

Keywords: anti-bacterial agents, biofilms, drug resistance, multiple bacterial, Pseudomonas aeruginosa, Staphylococcus aureus, wound healing

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