0930_Lavery.pdf

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1、Lawrence A.Lavery,DPM,MPHProfessor and Vice Chair of ResearchDepartment of Orthopedic SurgeryUniversity of Texas Health Science CenterSan Antonio,TexasLaveryuthscsa.eduInari Medial,consultantClyra Medical,consultantTissue Health Plus,consultantGlobal Clinical Research Institute,consultantAltrazeal I

2、nc,consultantMimiX Biotherapeutics,consultantProMedTek,consultant3Is there a critical level of“bioburden?”Does biofilm impedes healing?Is enzymatic debridement effective?A.Yes B.No Infections Develop in Skin BreaksLikelihood of Infection=#Microorganisms x VirulenceHost ResistanceCompromised HostImpa

3、ired immune responseLeukocyte dysfunctionNeuropathy blocks pain Micro and macro vascular diseaseOncul O,Effect of the function of polymorphonuclear leukocytes and interleukin-1 beta on wound healing in patients with diabetic foot infections.J Infect.2007 Mar;54(3):250-6Stegenga ME,Effect of acute hy

4、perglycaemia and/or hyperinsulinaemia on proinflammatory gene expression,cytokine production and neutrophil function in humans.Diabet Med.2008 Feb;25(2):157-64Karima M1,Enhanced superoxide release and elevated protein kinase C activity in neutrophils from diabetic patients:associationwith periodonti

5、tis.J Leukoc Biol.2005 Oct;78(4):862-70.Attempted to infect 26 health volunteers26 coagulate negative staphylococci strains 22 sensitive to penacillin 4 sensitive to erythromyacinElek SD and Conen Br J Exp Pathol.1957 Dec;38(6):573586.Intradermal injection Superficial scratches Incision 10mm x 4mmMP

6、D-Minimum Pus-forming Dose 2.0-8.5 x 106staphylococciElek SD and Conen Br J Exp Pathol.1957 Dec;38(6):573586.MPD-minimum Pus-forming Dose was 2.0-8.5 x 106staphylococciSilk suture soaked in broth overnight1.3 x 103staphylococciElek SD and Conen Br J Exp Pathol.1957 Dec;38(6):573586.“In spite of peni