Successful Management Of Mrsa Cervical Surgical Site Infection Using Closed Pulse Irrigation* Wound Therapy At Home
Patrick V. Marasco, MD,FACS1, Rafael Mungai, RN2, Lisa Arello, RN, NP3.
1Plastic Surgery Center, North Andover, MA, USA, 2ACE Home Care, Worcester, MA, USA, 3Univeristy of Massachusetts Memorial Medical Center, Worcester, MA, USA.
Background: Surgical site infection (SSI) is a complication of surgery which delays healing, lowers quality of life and increases healthcare costs. SSI's pose significant challenges to wound healing at home. Pressurized irrigation is standard operating room practice for contaminated, infected or traumatic surgical wounds to remove bacteria, necrosis and debris. This new “biophysical” approach offers bacterial biofilm management in a containment system allowing bedside hydromechanical removal of biofilm bacteria without operating room costs. Purpose: We describe a 70 yo female who developed a posterior neck SSI and surgical wound after lipoma excision. Daily Closed Pulse Irrigation* (CPI*) was used to successfully manage a non-healing posterior midline Methicillin-Resistant Staphylococcus Aureus (MRSA) wound in the home setting. Methods: 10 daily closed pressurized irrigation treatments with hydrogel dressings were performed at home to achieve complete healing. CPI* uses a mechanical irrigator (8-15 psi) without suction to deliver 3 L NS at 90⁰ F, in a safe, portable, bedside containment system. Results: Clinical results show that daily closed pressurized irrigation was perfomed to successfully treat a non-healing MRSA cervical SSI wound by providing more frequent and reliable non-invasive reduction of bacterial bioburden. This case demonstrates that daily closed pressurized irrigation can promote rapid healing by secondary intention at home and reduce cost. Conclusions: CPI* is a low-cost solution that improved outcomes and quality of life for patients at home. A self-contained delivery system allowed frequent safe, hydromechanical debridement with rapid granulation/epithelialization and should be further investigated.
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