Focused Ultrasound Treatment of Skin and Soft Tissue Abscesses

皮肤和软组织脓肿的聚焦超声治疗

基本信息

批准号：
10339133
负责人：
Thomas Matula
金额：
$ 69.9万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-06-15 至 2027-05-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10339133
关键词：
Abscess Accident and Emergency department Aftercare Animal Model Animals Antibiotic Therapy Antibiotics Antimicrobial Resistance Area Bacteria Bacteroides fragilis Biological Markers Blood Breast C-reactive protein Cellulitis Chronic Cicatrix Communities Complete Blood Count Complex Data Development Devices Drainage procedure Drug resistance Drug usage Economic Burden Effectiveness Emergency department visit Escherichia coli Etiology Evolution Expenditure Family suidae Fine needle aspiration biopsy Focused Ultrasound Focused Ultrasound Therapy Gram-Negative Bacteria Gram-Positive Bacteria Health Care Costs Healthcare Histology Homelessness Hospitalization Human In Vitro Incision and drainage Infection Injections Injury Inpatients Intramuscular Length of Stay Maintenance Measures Mechanics Methods Modeling Monitor Morbidity - disease rate Neck Needles Outpatients Pain Patients Persons Physicians Physiologic pulse Population Procedures Public Health Pus Radiation exposure Reporting Resistance Resolution Risk Risk Factors Secondary to Site Skin Tissue Soft Tissue Infections Staphylococcus aureus Streptococcus Structure Technology Time Tissues Training Treatment Failure Treatment Protocols Ultrasonography clinically relevant cost effective therapy effectiveness evaluation first-in-human hospital readmission image guided imaging biomarker improved intraperitoneal methicillin resistant Staphylococcus aureus pathogen patient population porcine model procedural pain programs psychosocial secondary infection soft tissue standard of care subcutaneous success treatment effect ultrasound wound care wound healing wound treatment

项目摘要

Skin and soft tissue infections (SSTIs) are among the most common infections encountered in ambulatory and inpatient settings with cellulitis and abscess being most common. Effective treatments are needed as SSTIs are a high-volume condition, and the overall healthcare burden remains high. SSTIs are one of the top causes for hospital readmissions. Furthermore, the standard of care, incision and drainage (I&D), is one of the most painful procedures in the emergency department. In addition to pain and the potential for unsightly scarring, other complications from I&D include damage to surrounding structures, an extension of the infection into adjacent tissues, bacteremic complications and reoccurrence. Furthermore, patient populations with psychosocial risk factors (e.g., homelessness, IV drug use) are prone to secondary infections and wound care remains problematic in these populations. Although bacteria can develop drug resistance, they remain susceptible to mechanical damage. In particular, short intense pulses of Focused Ultrasound (FUS), histotripsy, non-invasively generates localized cavitation that mechanically disrupts the bacteria and represents a new paradigm for non- invasive abscess treatment. We propose that histotripsy can non-invasively disinfect and liquefy many superficial and intramuscular abscesses allowing for complete fine needle aspiration. Our Aims are to expand our animal model to include MRSA pathogens and perform animal studies to advance this technology toward first in human studies. If successful, this approach could decrease patient morbidity, eliminate hospital stays, and lower healthcare costs.

皮肤和软组织感染（SSTI）是最常见的感染之一门诊和住院环境中最常见的是蜂窝组织炎和脓肿常见的。由于 SSTI 的发病率很高，因此需要有效的治疗总体医疗负担仍然很高。 SSTI 是住院的主要原因之一重新入院。此外，护理标准、切开引流（I&D）是其中之一急诊科最痛苦的手术。除了疼痛和可能会留下难看的疤痕，I&D 的其他并发症包括损伤周围结构，感染延伸到邻近组织，菌血症并发症和复发。此外，存在心理社会风险的患者群体因素（例如无家可归、静脉注射毒品）容易发生继发感染和伤口这些人群的护理仍然存在问题。虽然细菌可以产生药物电阻，它们仍然容易受到机械损坏。尤其是短时间、激烈的聚焦超声 (FUS) 脉冲、组织解剖、非侵入性产生局部空化以机械方式破坏细菌，代表了非细菌的新范例侵入性脓肿治疗。我们建议组织解剖学可以无创地消毒和液化许多浅表和肌内脓肿，以便进行完整的细针穿刺愿望。我们的目标是扩大我们的动物模型以包括 MRSA 病原体和进行动物研究，将这项技术推向人类研究的先河。如果如果成功，这种方法可以降低患者发病率，消除住院时间，并且降低医疗费用。