Browsing by Subject "infection"
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(2019)Despite the long history of skin grafting, there is no standardized treatment for split-thickness skin graft donor sites. These sites cause a notable amount of pain and discomfort to the patients and open wounds also introduce a risk for infection. There is an extensive need for treatment options promoting the fastest and least painful healing possible while also being infection-free. The treatment of split-thickness skin graft donor sites is constantly studied and there is plenty of scientific literature available about this topic. In the theory section of this Master’s thesis, the structure of skin, the process of wound healing, skin grafting surgery and wound care products for split-thickness skin graft donor sites are briefly introduced. Additionally, the method of systematic review is described. In the empirical section, a systematic review is performed to compare animal- and non-animal-based wound care products in the treatment of split skin graft donor sites. The methodological quality of the included studies is reviewed. In the literature search, 3552 references were found. In this systematic review a total of 23 articles were included comprising of 21 comparative clinical studies and two previous literature reviews. Of the original studies, 20 reviewed healing, 14 infection and 17 pain of the split-thickness skin graft donor sites. Based on the results of the systematic review, animal-based wound care products might promote healing and reduce pain experienced by patients in the treatment of split-thickness skin graft donor sites when compared with non-animal-based wound care products. The results concerning infection were inconsistent. Generally, the reporting of the clinical original studies was not comprehensive enough for proper evaluation of methodological quality. Some defects, mostly in the blinding of the patients, study personnel and the assessors of outcomes, were also found. Moreover, the studies were heterogeneous in their definitions and measuring of the reported outcomes. Therefore, there is substantial uncertainty in the results of this systematic review. The systematic and transparent way of conducting the literature search, the review of the methodological quality and the reporting of the outcomes can be considered as a strength of this thesis. The main weakness is, that only one person performed the critical steps of this study, which might increase the risk of bias and reduce the repeatability of the study.
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Staphylococcus aureus taudinaiheuttajana ja yhteisviljelmämenetelmän käyttö antimikrobiseulonnassa (2010)Staphylococcus aureus is a common commensal and significant opportunistic pathogen. It causes a wide range of infections from superficial skin infections to serious invasive infections. Its pathogenicity is affected by many factors, such as different surface proteins as well as the excretion of toxins and extracellular enzymes. It has many ways to defend a host defense system, such as the formation of capsule and small-colony variants as well as intracellular hiding. Treatment of infections is hindered due to its ability to form resistance to almost every antimicrobial agent used. So far the development of a working and effective vaccine has not been successful. The discovery of new antibacterial agents seems to be still the only efficient way to fight against resistant bacterial strains. However, the development of new antibacterial agents has proved to be difficult. Developing new screening methods is important in order for new drugs to reach the market more effectively and to ensure that new derivatives are more effective and safer. The experimental part of this study aimed at establishing a co-culture of host cells and a pathogen, and to investigate active compounds from primary screen with the established method (Kleymann and Werling 2004). Host cells in the co-culture was HL (Human Lung) cell line and the pathogen was S. aureus (ATCC 25923). Experimental work began by determining bacterial colony-forming units (CFU) and its correlation with absorbance. Based on CFU-determinations the bacterial concentration in the culture media was calculated. Next, the method was optimized and validated. In optimization, statistical parameters S/B-, S/N-values, and Z'-factor were used. Method was optimized regarding cell and bacterial concentrations and incubation time. The method was validated using known antimicrobials. Screening of compounds to be studied was carried out in two stages. All the compounds were first screened in a primary screen. The primary screening method was a standard antibacterial measurement based on turbidometry. Those compounds that were active in the primary screen were investigated in a secondary screen with a co-culture method, but none of the studied compounds showed antimicrobial activity against S. aureus. Therefore we studied the impact of medium that was used in the co-culture method to the activity of the compounds. It was found that the medium had a significant effect on the antibacterial activity of the compounds, the activity was weakened in the presence of the medium. In conclusion, w the established co-culture method is a powerful way to obtain simultaneously information on antibacterial activity as well as cytotoxicity, and it is well suited for further testing of promising compounds.
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