Our objective was to determine the length of time that wound care supplies can be stored in the home setting before they become contaminated. With the rise in the numbers of antibiotic-resistant organisms, we wanted to try to determine if we were using safe practices when storing supplies in the home.
This was a prospective, exploratory study.
Setting and Subjects
The setting was homes of persons who required wound care by a home health care agency in the Midwest. The types of wounds included postoperative wound complications, diabetic foot ulcer, pressure ulcer, venous stasis ulcer, chemotherapy extravasation, and radiation burn.
Methods and Instruments
Cultures were collected from wound care supplies when the package was opened and on day 7 and day 14 with use of standard laboratory techniques. Two data collection tools were developed: a flow sheet used to record the length of time the package was opened and a tool that reported the laboratory's bacteriologic results to the investigator.
Cultures were obtained from 3 sterile items, including one package of 4 × 4 gauze, one disposable suture set, and one bottle of ¼-inch packing gauze, before they were placed in the patient's home. These 3 baseline cultures were the control samples; they showed no growth. Cultures of the open packages of reusable supplies in the home began to show growth of different organisms by day 7. Cultures of the open packages left in the home for longer periods of time almost always showed a larger growth and variety of organisms that potentially could become problematic for a patient.
This study identified the number and types of organisms found on wound care supplies used in the home setting on day 7 and day 14. Some colonies of organisms were large enough to be pathogenic to certain patients. This information was used to develop protocols for orientation of new staff, to perform skills testing of current staff, and to reinforce storage practices of wound care supplies left in the home.