Bacterial bioburden of wounds: Influence of debridement and negative-pressure wound therapy (NPWT)

Philipp Moog, Maryna Jensch, Julia Betzl, Anna Theresa Bauer, Michael K. Cerny, Daniel Schmauss, Haydar Kükrek, Holger Erne, Hans Günther MacHens, Kai Megerle

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Objective: To clarify the role of microbiological swabs in surgical decision-making, we investigated the effect of negative-pressure wound therapy (NPWT) and serial surgical debridement on bacterial bioburden in hard-to-heal wounds and ultimately correlated them with the success of surgical closure. Method: All patients were treated with surgical debridement, jet lavage and NPWT before their wounds were finally closed. The treatment effect was assessed by correlating microbiological swabs obtained immediately after intervention with those obtained after removal of the dressings during the following surgical procedures. The result of the last microbiological swab taken before definitive surgical closure was correlated with the requirement for revision surgery. Results: We included the results of 704 microbiological swabs from 97 patients in 110 wound localisations in this monocentric, retrospective study. NPWT did not improve bacterial bioburden in 77% of cases and the duration of NPWT did not affect the result. Furthermore, no significant effect of NPWT could be found for either anaerobic (p=0.96) or aerobic bacteria (p=0.43). In contrast, surgical debridement increased bacterial load in approximately 60% of cases. If sterile wound swabs could be obtained at all, it was during the first four surgical debridements in 60% of patients; after that only 10% became sterile. Conclusions: Sterile microbiological wound swabs before surgical closure were associated with lower rates of revision surgery, while low or medium bacterial loads did not increase revision rates. Declaration of interest: This study received no specific financial support from a public, commercial or non-profit financing agency. The authors have no conflicts of interest to declare.

Original languageEnglish
Pages (from-to)604-611
Number of pages8
JournalJournal of Wound Care
Issue number8
StatePublished - 2 Aug 2021
Externally publishedYes


  • Bacterial bioburden
  • Bacterial levels
  • Dressing
  • Infection
  • Microbiology of wounds
  • Negative-pressure wound therapy
  • Npwt
  • Ulcer
  • V.a.c. therapy bioburden
  • Vac
  • Vac therapy
  • Wound
  • Wound treatment


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