Abstract

Background: Wound healing is multifactorial event with wound bed preparation (WBP) being the most important part of it. Pseudomonas aeruginosa is a significant cause of wound infections delaying the process of WBP. The growth of pseudomonas is suppressed in acidic media. Vinegar (acetic acid) has been in use to provide acidic media to suppress the growth of pseudomonas. Citrus group of fruits such as lemon, orange and grapes are rich source of Vitamin C (ascorbic acid) and citric acid. Materials and Methods: This is a comparative prospective study done in two groups having 3 patients in each group. Group A patients were investigated for the effect of local application of lemon juice for providing acidic media in wounds to suppress growth of pseudomonas to enhance wound bed preparation (WBP) for reconstruction. Group B included 3 patients treated by povidone iodine. Results: On an average the number of applications of Lemon juice therapy required was less than povidone iodine to control pseudomonas infection in wounds. Conclusion: Lemon Juice can be used as a source of providing acidic media for suppressing the growth of pseudomonas infection in wounds. It is an easily available and natural source of acidic media.

• 1.   Greenwod D, Slack RCB, Peutherer JF. Medical microbiology. 16th ed. Edinburgh: Elsevier; 2012. Pp 298-304.
• 2.   Parakar MT, Collier EH. Topley and Wilsons principles of bacteriology, virology and immunity, vol. II, 8th ed. London: Edward Arnold; 1990.Pp 708.
• 3.   Kumar S. Textbook of microbiology. New Delhi: Jaypee; 2012.Pp 405-412
• 4.   Kurihara T, Sugita M, Motai S, Kurashige S. In vitro induction of chlorhexidine and benzalkonium resistance in clinically isolated Pseudomonas aeruginosa. Kansenshogaku Zasshi 1993;67:202-6.
• 5.   Nagoba BS, Deshmukh SR, Husain RA, Gomashe AV, Wadher BJ. Bacteriological analysis of various environmental sources in a rural hospital. Indian Journal of Medical Sciences 1997;51:465-9.
• 6.   Arjunwadkar VP, Bal AM, Joshi SA, Kagal AS, Bharadwaj RS. Contaminated antiseptics — an unnecessary hospital hazard. Practitioner Section 2001;7:393-8.
• 7.   Ananthnarayan R, JayaramPanikar CK. Textbook of microbiology. 8th ed. Madras: Universities Press; 2009. p. 315-9.
• 8.   Collee JG, Fraser AG, Marmion BP, Simmons A. Mackie and Mccartney practical medical microbiology. 14th ed. New Delhi: Churchill Livingstone; 2006.
• 9.   Beheshti S, Zia M. Bacteriology of burns and antibiogram in an Iranian burn care centre. African Journal of Pharmacy and Pharmacology 2011;5:538-41.
• 10.   Tam VH, Chang KT, Abdelraouf K, Brioso CG, Ameka M, Mc Caskey LA, et al. Prevalence, resistance mechanisms, and susceptibility of multidrug-resistant blood stream isolates of Pseudomonas aeruginosa. Antimicrobial Agents and Chemotherapy 2010;45:1160-4.
• 11.   Bennet JV. Nosocomial infections due to Pseudomonas. Journal of Infectious Diseases 1974;130:S4-5.
• 12.   Smith RG. A critical discussion of the use of antiseptics in acute traumatic wounds. Journal of the American Podiatric Medical Association 2005;95:148 53.
• 13.   Khan MN, Naqui AH. Antiseptics, iodine, povidone iodine and traumatic wound cleansing. Journal of Tissue Viability 2006;16:6-10.
• 14.   Hunt TK, Hopf HW. Wound healing and wound infection — what surgeons and anaesthesiologists can do? Surgical Clinics of North America 1997;77:587 606.
• 15.   Thomas GW, Rael TL, Bar-Or R, Shimonkevitz R, Mains CW, Slone DS, et al. Mechanisms of delayed wound healing by commonly used antiseptics. Journal of Trauma 2009;66:82-91.
• 16.   Linea weaver W, Howard R, Soucy D, Mcmorris S, Freeman J, Crain C, et al. Topical Antimicrobial Toxicity. Archives Of Surgery 1985;120:267-70.
• 17.   Pathare NA. Infections and diabetes mellitus. Journal of Diabetes Association of India 1998;38:4-6.
• 18.   Mujumdar RK. Treatment of resistant Pseudomonas infection in burn patients in tropical climate using acidic medium, oxidising agent and metronidazole. Indian Journal of Surgery 1993;55:501-7.
• 19.   Nagoba BS, Gandhi RC, Wadher BJ, Gandhi SP, Deshmukh SR. Citric acid treatment of severe electric burns complicated by multiple antibiotic resistant Pseudomonas aeruginosa. Burns 1998;24:481-3.
• 20.   Nagoba BS, Wadher BJ, Deshmukh SR, Mahabaleshwar L, Gandhi RC, Kulkarni PB, et al. Treatment of superficial pseudomonal infections with citric acid - an effective and economical approach. Journal of Hospital Infection 1998;40:155-7.

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