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Background: In view of the ever-increasing representation of Staphylococcus spp. strains resistant to various antibiotics, the development of in vivo models for evaluation of novel antimicrobials is of utmost importance., Methods: In this article, we describe the development of a fully immunocompetent porcine model of extensive skin and soft tissue damage suitable for testing topical antimicrobial agents that matches the real clinical situation. The model was developed in three consecutive stages with protocols for each stage amended based on the results of the previous one., Results: In the final model, 10 excisions of the skin and underlying soft tissue were created in each pig under general anesthesia, with additional incisions to the fascia performed at the base of the defects and immediately inoculated with Staphylococcus aureus suspension. One pig was not inoculated and used as the negative control. Subsequently, the bandages were changed on Days 4, 8, 11, and 15. At these time points, a filter paper imprint technique (FPIT) was made from each wound for semi-quantitative microbiological evaluation. Tissue samples from the base of the wound together with the adjacent intact tissue of three randomly selected defects of each pig were taken for microbiological, histopathological, and molecular-biological examination. The infection with the inoculated S. aureus strains was sufficient during the whole experiment as confirmed by both FPIT and from tissue samples. The dynamics of the inflammatory markers and clinical signs of infection are also described., Conclusions: A successfully developed porcine model is suitable for in vivo testing of novel short-acting topical antimicrobial agents., (© 2024 The Author(s). Animal Models and Experimental Medicine published by John Wiley & Sons Australia, Ltd on behalf of The Chinese Association for Laboratory Animal Sciences.)

Necrotizing fasciitis is a life-threatening skin and soft tissue infection associated with high morbidity and mortality in adult patients. This infection can present as either type 1 infection caused by a mixed microflora ( Streptococci , Enterobacteriacae , Bacteroides sp., and Peptostreptococcus sp.), most commonly developing in patients after surgery or in diabetic patients, or as type 2. The latter type is monomicrobial and, usually, caused by group A Streptococci . Rarely, this type can be also caused by other pathogens, such as Vibrio vulnificus . V vulnificus is a small mobile Gram-negative rod capable of causing 3 types of infections in humans-gastroenteritis, primary infection of the vascular bed, and wound infections. If infecting a wound, V vulnificus can cause a life-threatening condition-necrotizing fasciitis. We present a rare case of necrotizing fasciitis developing after an insect bite followed by exposure to the seawater. Rapid propagation of the infectious complication in the region of the right lower limb led to a serious consideration of the necessity of amputation. Due to the clearly demarcated necroses and secondary skin and soft tissue infection caused by a multiresistant strain of Acinetobacter baumannii , we, however, resorted to the use of selective chemical necrectomy using 40% benzoic acid-a unique application in this kind of condition. The chemical necrectomy was successful, relatively gentle and thanks to its selectivity, vital parts of the limb remained preserved and could have been subsequently salvaged at minimum blood loss. Moreover, the antimicrobial effect of benzoic acid led to rapid decolonization of the necrosis and wound bed preparation, which allowed us to perform defect closure using split-thickness skin grafts. The patient subsequently healed without further complications and returned to normal life.

Inhalation injury is a serious complication in patients with burns that dramatically increases their morbidity and mortality. These patients are always suspected of having inhalation injury with potential intoxication. We usually encounter carbon monoxide intoxication, but it is necessary to think about the possibility of poisoning by other combustion products. Cyanide intoxications are less common, but their diagnosis and treatment are more complicated. The diagnosis can only be based on the history, clinical findings, and indirect laboratory signs. Direct determination of plasma cyanide levels is not generally adopted in routine clinical practice. Nowadays, several specific antidotes with different mechanisms of action are available. There are no clear guidelines on the antidote of choice, as the evidence base is limited by a lack of randomised controlled trials in humans. In two mini case reports, we present our experience with the diagnosis and therapy of patients with suspected cyanide poisoning.