Healer granules in nonhealing infected wounds

Santosh Ashok Nandimath, Rajkumar Garudanahally Chickklingaiah, Viresh Ashok Nandimath, Adwait Madhav Godse, Bappaditya Mishra, S Priya

Annals of Maxillofacial Surgery 2018 8(2):224-229

Background: Head-and-neck infection is one of the most frequently encountered issues in the field of oral and maxillofacial surgery. Most of the cases with head-and-neck infections are managed by empirical antibiotic therapy and extraction of offending infected tooth/teeth. However, long-term systemic antibiotic therapy can have profound compromising effects on host immune defense and thereby hamper healing, which, in turn, may lead to life-threatening complications such as localized septic foci or widespread septicemia at times leading to death of an individual. In this study, we are reviewing management of 15 cases with space infection in the maxillofacial region by local drug delivery with the help of collagen particles combined with mupirocin 2% w/w and metronidazole 1% w/w (BioFil-AB). We intend to study its efficacy in managing the space infections associated with extraoral infected wound as well as in preventing hazards of long-term systemic antibiotic therapy. Aims: The aim of this study is to assess the efficacy of the topical use of BioFil-AB in infected maxillofacial wounds. Materials and Methods: A total of 15 patients with infected maxillofacial wounds reporting to the department of oral and maxillofacial surgery were categorized into three groups depending on the severity of infections. Of these 15 cases, 8 patients were suffering from infected extraoral wounds, 3 had traumatic infection, and remaining 4 had extraoral consolidated abscesses due to odontogenic infection. All patients had a history of prior antibiotic therapy. Incision and drainage of the septic focus/foci were performed in most of the cases, and healing of the site was assessed after application of topical BioFil-AB (mupirocin + metronidazole + collagen granules) dressing. Results and Conclusion: Dressing with BioFil-AB granules proved to be efficient in control of infection as well as in promoting uneventful wound healing, especially with good follow-up. Further studies with a large sample size may be necessary to corroborate the findings and provide substantial evidence. This novel local drug delivery therapy will definitely help in maintenance of good host immune response as well as in preventing or minimizing occurrence of antibiotic resistance.

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