Vergleich der Effizienz von Polyhexanid-Biguanid, Argon-Kaltplasma und Kochsalzlavage zur Dekontamination von Bisswunden beim Hund

Zusammenfassung

Ziel der Studie war, die Keimbelastung sowie die klinische Effizienz von Polyhexanid, Argon-Kaltplasma und Kochsalzlösung zur Reduktion der Bioburden bei Hundebissverletzungen zu überprüfen.

Material und Methoden: In die Studie eingeschlossen wurden Hunde mit Bissverletzungen, die durch ein chirurgisches Debridement mit anschließender Wundbehandlung durch Lavage mit Polyhexanid-Biguanid (A), Therapie mit kaltem Argonplasma (B) oder Lavage mit physiologischer Kochsalzlösung (C) versorgt wurden. Ein bakterieller Abstrich erfolgte bei allen Patienten nach Debridement sowie nach der Lavage bzw. Behandlung mit Argon-Kaltplasma. Zur Auswertung der Resultate diente der Chi-Quadrat-Test.

Ergebnisse: Insgesamt 40 Hunde gingen in die Studie ein (A: n = 12; B: n = 10; C: n = 18). Bei einem Großteil der Verletzungen handelte es sich um geringfügige Bisswunden. Ein Keimnachweis ergab sich bei 87,5% aller Patienten, wobei 19,8% aller Isolate als multiresistent klassifiziert wurden. Eine Reduktion der Keimlast durch Lavage wurde bei 8/12 Hunden der Gruppe A, 5/10 Hunden der Gruppe B und 14/18 Hunden der Gruppe C erreicht. Eine komplette Dekontamination durch Lavage gelang bei 5/12 Hunden der Gruppe A, 2/10 der Gruppe B und 9/18 der Gruppe C. Statistisch signifikante Unterschiede oder Effekte auf spätere Komplikationen waren nicht festzustellen.

Schlussfolgerung: Zwischen den verschiedenen Lavagekonzepten bestanden keine statistisch signifikanten Unterschiede, doch wurde in der Kaltplasma-Gruppe die geringste Dekontamination erzielt.

Klinische Relevanz: Bei Bissverletzungen ist von einer hohen Keimbelastung auszugehen. Zudem werden zunehmend multiresistente Isolate nachgewiesen. Basierend auf diesen ersten Ergebnissen ließ sich keine Überlegenheit von Polyhexanid oder Kaltplasma gegenüber physiologischer Kochsalzlösung zur Wundlavage nachweisen.

Summary

Objective: To evaluate the bacterial contamination rate and to compare the efficacy of polyhexanide, cold argon plasma and saline at reducing bacterial bio-burden in dog bite wounds.

Material and methods: Dogs with bite-wound injuries were included when surgical debridement was pursued with subsequent treatment using either polyhexanide-biguanide lavage (A), cold argon plasma treatment (B) or saline lavage (C). Culture swabs were taken after debridement as well as after lavageor argon treatment. Statistical analysis was performed using the chi-square test.

Results: A total of 40 dogs were enrolled in the study (A: n = 12; B: n = 10; C: n = 18). The majority of injuries were minor and 87.5% of patients had positive bacterial culture results pre-lavage, with 19.8% of isolates classified as multidrug resistant. A reduction in wound bioburden was achieved in 8/12 patients in group A, 5/10 patients in group B and 14/18 patients in group C. Complete decontamination was achieved in 5/12 patients in group A, 2/10 in group B and 9/18 in group C. None of these differences were statistically significant nor associated with the development of complications.

Conclusion: No statistically significant differences were detected between the treatment groups; however, the cold argon plasma treatment provided the least effective decontamination.

Clinical relevance: Bite wounds yield a high rate of bacterial contamination, with increasing multidrug-resistance rates. Based on these preliminary results, no superior effect was detected for lavage using polyhexanidebiguanide or cold argon plasma.

Schlüsselwörter

Hund - Bissverletzung - Wundantiseptika - Wundversorgung - Lavage

Keywords

Dog - bite injury - wound antiseptics - wound treatment - lavage

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