wound botulism

Examples of wound botulism in the following topics:

• Botulism

  • The toxin enters the human body in one of three ways: by colonization of the digestive tract by the bacterium in children (infant botulism) or adults (adult intestinal toxemia), by ingestion of toxin from foods (foodborne botulism), or by contamination of a wound by the bacterium (wound botulism).
  • Wound botulism results from the contamination of a wound with the bacteria, which then secrete the toxin into the bloodstream.
  • There are two primary Botulinum Antitoxins available for treatment of wound and foodborne botulism.
  • A 14-year-old with botulism.
  • Compare and contrast the three major modes of entry for Botulinium toxin (infant botulism or adult intestinal toxemia, foodborne botulism, and wound botulism) and describe its mechanism of action

• Paralysis-Causing Bacterial Neurotoxins

  • Botulinum toxin can cause botulism, a serious and life-threatening illness in humans and animals.
  • Foodborne botulism can be transmitted through food that has not been heated correctly prior to being canned, or food from a can that has not been cooked correctly.
  • Most infant botulism cases cannot be prevented because the bacteria that cause this disease are in soil and dust.
  • Honey can contain the bacteria that cause infant botulism, so children less than 12 months old should not be fed honey.
  • By inhibiting acetylcholine release, the toxin interferes with nerve impulses and causes flaccid (sagging) paralysis of muscles in botulism, as opposed to the spastic paralysis seen in tetanus.

• Deep Wound Healing

  • A deep wound involves the inner, deeper layers of the skin (dermis).
  • Deep wounds that damage the dermis, or even the underlying muscle and fat, are more difficult to heal than shallow, epidermal-only wounds.
  • The wound healing process for deep wounds is similar to that of shallow wounds.
  • The ECM formed during wound healing may also be weaker in deep wounds, making the site susceptible to additional later wounding.
  • This image illustrates the phases of wound healing.

• Epidermal Wound Healing

  • Epidermal wound healing describes the mechanism by which the skin repairs itself after injury.
  • Epidermal wound healing refers to the repair of the epidermis in response to wounding.
  • Epidermal only wounds are typically less severe than those affecting the dermis and so stages of the wound healing response may be missed.
  • Immune cells may still be recruited to the wound site because the removal of the epidermal barrier makes the wound susceptible to infection.
  • Keratinocytes—epidermal epithelial cells—around the wound site migrate across the wound and close it.

• Steps of Tissue Repair

  • Upon wounding, the first phase of the wound response is concerned with maintaining homoeostasis within the body.
  • Most wounds, even superficial shallow wounds, result in damage to the circulatory system.
  • Additionally, vasoconstriction initially occurs around the wound site as a means of isolating the wound site.
  • It is thought that surviving epithelial cells around the wound edge become more motile and stretch to cover the wound site.
  • Following closure of the wound, remodeling can occur.

• Paralysis

  • Other major causes are stroke, trauma with nerve injury, poliomyelitis, amyotrophic lateral sclerosis (ALS), botulism, spina bifida, multiple sclerosis, and Guillain-Barré syndrome.
  • Ascending paralysis contrasts with descending paralysis, which occurs in conditions such as botulism.

• Platelets

  • Platelets, also called thrombocytes, are membrane-bound cell fragments that are essential for clot formation during wound healing.
  • Platelets are important for the blood clotting process, making them essential for wound healing.
  • The complex process of wound repair can only begin once the clot has stopped bleeding.
  • Platelets secrete many factors involved in coagulation and wound healing.
  • If the number of platelets is too low, excessive bleeding can occur and wound healing will be impaired.

• Bacterial Foodborne Diseases

  • In the past, sporadic cases of botulism, the potentially fatal disease produced by a toxin from the anaerobic bacterium Clostridium botulinum, were relatively common.

• Skin Grafts

  • They are useful in reducing the bacterial concentration of an open wound, as well as reducing fluid loss.
  • An increasingly common aid to both pre-operative wound maintenance and post-operative graft healing is the use of negative pressure wound therapy (NPWT).
  • This system works by placing a section of foam cut to size over the wound, then laying a perforated tube onto the foam.
  • A vacuum unit then creates negative pressure, sealing the edges of the wound to the foam, and drawing out excess blood and fluids.
  • NPWT can also be used between debridement and graft operations to assist an infected wound in remaining clean for a period of time before new skin is applied.

• Clot Retraction and Repair

  • While the clot retracts, the wound begins to heal.
  • The first step of wound healing is epithelial cell migration, which forms a scab before the clot retracts.
  • The wound itself contracts, reducing in size.
  • After these steps occur, new epithelial cells grow to cover the wound.
  • If the wound was severe or unevenly shaped, or if healing takes too long, scarring may occur from collagen deposition.