ABSTRACT
ABSTRACT: Wound infection is a major challenge for clinicians globally, with accurate and timely identification of wound infection being critical to achieving clinical and cost-effective management, and promotion of healing. This paper presents an overview of the development of the International Wound Infection Institute (IWII)'s 2022 Wound Infection in Clinical Practice consensus document. The updated document summarises current evidence and provides multidisciplinary healthcare providers with effective guidance and support on terminology, paradigms related to biofilm, identification of wound infection, wound cleansing, debridement and antimicrobial stewardship. Integral to the update is revision of wound infection management strategies which are incorporated within the IWII's Wound Infection Continuum (IWII-WIC) and management plan. The aim of the 2022 IWII consensus document update was to provide an accessible and useful clinical resource in at least six languages, incorporating the latest evidence and current best practice for wound infection and prevention. Dissemination techniques for the consensus are discussed and highlighted.
Subject(s)
Wound Infection , Humans , Wound Infection/therapyABSTRACT
OBJECTIVES: The aim of this study was to establish an international, interorganisational consensus on wound infection terminology. METHODS: This project consisted of definition scoping and a Delphi process to produce a consensus glossary for 18 wound infection terms. Recent guidelines/consensus documents were reviewed to identify 2-4 definitions for each term. An online consensus process was undertaken using the RAND Appropriateness Method, a consensus method for panels to reach agreement. International wound organisations nominated experts to participate, from whom 21 participants were selected to represent different organisations, geographic regions and disciplines. In the first consensus round, each term was presented alongside 2-3 definitions and participants nominated their preferred definition, with the majority vote used to select a baseline definition. The consensus process then proceeded, with participants using a 9-point Likert scale to score their level of agreement or disagreement with the definition for each term. Participants also provided a justification outlining the reason behind their rating. At the end of each round, an index was calculated to provide a quantitative evaluation indicating whether agreement or disagreement had been reached. RESULTS: Reasoning statements were summarised and the definitions were adjusted to incorporate concepts identified by participants. The adjusted definition was presented in the next consensus round, together with the reasoning statements. Terms for which a final definition was not achieved in three consensus rounds were finalised with preferential voting using 2-3 definitions that had reached consensus. PROJECT PROGRESS AND SIGNIFICANCE: The project generated a glossary of wound infection terms, endorsed through participation of 15 international organisations, for dissemination of guidelines and clinical decision-making/teaching tools.
Subject(s)
Wound Infection , Humans , Wound Infection/diagnosisABSTRACT
Chlorantraniliprole susceptibility was determined in diet-incorporation bioassays for six fall armyworm, Spodoptera frugiperda (J. E. Smith), populations feeding on sweet corn, Zea mays L., in southern Florida between 2017 and 2019. The LC50 and LC90 values of these populations estimated using probit analyses ranged from 0.022 to 0.084 ppm and 0.112 to 0.471 ppm, respectively. Thus, susceptibility levels among the six field populations varied, but to a relatively small extent, with approximately fourfold differences in LC50 and LC90 values between the most and least susceptible populations. These field populations were all less susceptible than a reference population maintained in the laboratory without prior exposure to chlorantraniliprole, with RR50 values between 5.3 and 20.1 and RR90 values between 14.3 and 60.3. These results suggest reduced chlorantraniliprole susceptibility in S. frugiperda populations collected in Florida sweet corn relative to a reference laboratory population. However, field experiments in 2017 and 2019 showed that foliar applications of chlorantraniliprole reduced S. frugiperda injury and infestations to levels comparable to or lower than applications of indoxacarb, novaluron, or spinetoram. This study does not provide evidence of practical resistance to chlorantraniliprole in S. frugiperda infesting Florida sweet corn fields.
