The impact of Manuka honey dressings on the surface pH of chronic wounds

Gethin, Georgina; Cowman, Seamus; Conroy, Ronán

doi:10.1111/j.1742-481x.2007.00424.x

Cited by 166 publications

(134 citation statements)

References 37 publications

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“…Acidic pH favors wound healing by enhancing fibroblast replication, early angiogenesis, and release of oxygen that is bound to hemoglobin (Bohr effect). This is in contrast with chronic wounds, where pH remains alkaline most of the time except during the epithelialization stage (11,12,20). S. aureus lives in acidic pH on skin surface (58,59), but our model indicates that once established in wounds, S. aureus biofilms increase pH, and this is likely to be an impediment to wound healing.…”

Section: Discussioncontrasting

confidence: 41%

“…In chronic wounds, for example, pH increases from 7.5 to 8.9, and this enhances the activity of proteolytic enzymes. As healing ensues, wound pH declines to around 6, where the activity of enzyme inhibitors is optimal (11,19,20). Nothing is known about the specific contribution to the pH of chronic wounds by various types of bacterial biofilms in general and S. aureus biofilms in particular, despite S. aureus being an important wound pathogen.…”

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confidence: 99%

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Staphylococcus aureus Induces Hypoxia and Cellular Damage in Porcine Dermal Explants

et al. 2015

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fWe developed a porcine dermal explant model to determine the extent to which Staphylococcus aureus biofilm communities deplete oxygen, change pH, and produce damage in underlying tissue. Microelectrode measurements demonstrated that dissolved oxygen (DO) in biofilm-free dermal tissue was 4.45 ؎ 1.17 mg/liter, while DO levels for biofilm-infected tissue declined sharply from the surface, with no measurable oxygen detectable in the underlying dermal tissue. Magnetic resonance imaging demonstrated that biofilm-free dermal tissue had a significantly lower relative effective diffusion coefficient (0.26 ؎ 0.09 to 0.30 ؎ 0.12) than biofilm-infected dermal tissue (0.40 ؎ 0.12 to 0.48 ؎ 0.12; P < 0.0001). Thus, the difference in DO level was attributable to biofilm-induced oxygen demand rather than changes in oxygen diffusivity. Microelectrode measures showed that pH within biofilm-infected explants was more alkaline than in biofilm-free explants (8.0 ؎ 0.17 versus 7.5 ؎ 0.15, respectively; P < 0.002). Cellular and nuclear details were lost in the infected explants, consistent with cell death. Quantitative label-free shotgun proteomics demonstrated that both proapoptotic programmed cell death protein 5 and antiapoptotic macrophage migration inhibitory factor accumulated in the infected-explant spent medium, compared with uninfected-explant spent media (1,351-fold and 58-fold, respectively), consistent with the cooccurrence of apoptosis and necrosis in the explants. Biofilm-origin proteins reflected an extracellular matrix-adapted lifestyle of S. aureus. S. aureus biofilms deplete oxygen, increase pH, and induce cell death, all factors that contribute to impede wound healing.

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Section: Discussioncontrasting

confidence: 41%

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confidence: 99%

Staphylococcus aureus Induces Hypoxia and Cellular Damage in Porcine Dermal Explants

et al. 2015

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“…29 Such a hypothesis seems feasible to suggest, particularly as this theory has been conceptually demonstrated for other wound dressings. 30 Based on the findings of this study, and in conjunction with other research findings, 11,30 it can be hypothesized that at an acidic pH, there is a significant reduction in MMP activity, a reduction in metal ion precipitation, and therefore an increase in the availability of ionic silver, leading to an enhanced antimicrobial barrier activity of silver. Consequently, within a more acidic wound environment, the increased availability of ionic silver will lead to a reduction of the wound microbial bioburden, a reduction in enzymatic activity, an increase in wound healing, and a reduction in the need for prolonged and unnecessary antimicrobial use.…”

Section: S T a P H Y Lo C O C C U S A U R E U S S T A P H Y Lo C O C mentioning

confidence: 78%

The Effect of pH on the Antimicrobial Efficiency of Silver Alginate on Chronic Wound Isolates

Slone

Linton

Okel

et al. 2010

The Journal of the American College of Certified Wound Speciali

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BACKGROUND: Nonhealing and stalled chronic wounds are often reported to reside within an alkaline environment. Consequently, a number of researchers have proposed that lowering the pH of a chronic wound environment will enable healing to progress. However, it is not known whether the efficacies of silver-impregnated wound dressings are affected by pH.OBJECTIVE: To investigate whether pH has an effect on the antimicrobial barrier efficacy of a silver alginate wound dressing on wound isolates.METHODS: Twenty-five bacteria and yeasts that had been routinely isolated from chronic wounds were separately exposed to a silver alginate wound dressing with the use of a standardized corrected zone of inhibition (CZOI) assay. RESULTS:The silver alginate dressing demonstrated a broad spectrum of antimicrobial barrier activity within the dressing against all wound isolates. However, at a pH of 5.5, compared with a pH of 7, the antimicrobial barrier activity of the silver alginate dressing significantly increased. For all yeasts the CZOI ranged from 6.25 to 11 mm at a pH of 7. At a pH of 5.5, the CZOI range increased from 8.5 to 12.25 mm. For the Gram-negative isolates, the CZOI ranged from 0.75 to 6.5 mm at a pH 7, compared with a CZOI range of 2.75 to 8 mm at pH 5.5. The CZOI for the Gram-positive isolates, including meticillin-resistant Staphylococcus aureus, ranged from 3 to 7.75 mm at pH 7 and from 4.5 to 11.75 mm at pH 5.5.CONCLUSION: For all isolates tested, excluding one strain of Candida albicans and one vancomycinresistant Enterococcus strain, lowering pH to 5.5 resulted in an improvement in the antimicrobial barrier activity within the silver alginate dressing. Based on these initial in vitro findings, it is possible to suggest that there may be benefits to maintaining an infected or recalcitrant wound in a slightly acid (pH 5.5) environment. In particular, doing so may lead to an enhanced antimicrobial barrier effect of silver, a quicker reduction in the wound microbial bioburden, and therefore a reduction in the need for prolonged antimicrobial use. However, more in vitro and in vivo studies would be warranted to further substantiate these claims.

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“…Varios estudios han mostrado tasas significativamente reducidas de infección de heridas causadas por quemaduras, lo que indica que la miel esteriliza y promueve la granulación temprana. Aunque cada componente de la miel tiene su acción específica, la actividad antimicrobiana in vivo puede ocurrir debido a una reacción sinérgica entre ellos (Seckam & Cooper, 2013;Molan, 2009;Gethin et al, 2008).…”

Section: Introductionunclassified

Efecto Cicatrizante de la Miel de Ulmo (Eucryphia cordifolia) Suplementada con Ácido Ascórbico como Tratamiento en Quemaduras

et al. 2015

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RESUMEN: Debido al daño de la piel producto de quemaduras, los microorganismos encuentran condiciones favorables para su desarrollo, produciéndose desnaturalización, necrosis, exudado, congestión y edema. La miel posee actividad antioxidante, antiinflamatoria y antibacteriana. A su vez, el ácido ascórbico mejora la barrera epidérmica y reduce la contracción de heridas, entre otros. El objetivo de esta investigación fue evaluar morfológicamente la cicatrización de heridas con un tratamiento en base a miel de ulmo (Eucryphia cordifolia) suplementada con ácido ascórbico, comparando su efecto con miel de ulmo no suplementada, en heridas causadas por quemaduras de tipo B. La investigación fue aprobada por el Comité Ético Científico de la Universidad de La Frontera. Se trabajó con 15 cobayos (Cavia porcellus) distribuidos en tres grupos: MS (miel suplementada), M (miel), y Control+ (Hidrogel-Tull). Se provocó una quemadura en seco en el dorso del tórax de 1 cm de diámetro, que abarcó hasta el límite de la fascia profunda. Al día 10 de tratamiento, se extrajeron las biopsias y se depositaron en PBS. Posteriormente, fueron fijadas en formalina tamponada y procesadas para fines histológicos, realizándose las técnicas de VGE, VGC, PAS, y Sirius Red. El cobayo se utilizó como modelo animal por tener un metabolismo dependiente de ácido ascórbico. El grupo MS mostró un rápido debridamiento en comparación a los grupos control, con cierre epidermal en el 60% de las muestras, observándose una fase proliferativa avanzada. El grupo M no regeneró la capa epidérmica y presentó una fase proliferativa inicial. Los resultados de este estudio evidenciaron que al suplementar la miel de ulmo con ácido ascórbico se logra una cicatrización más rápida, con respecto a la miel de ulmo no suplementada, en heridas causadas por quemaduras.PALABRAS CLAVE: Cicatrización; Miel ulmo; Ácido ascórbico; Quemaduras. INTRODUCCIÓNEl tratamiento de heridas por quemadura es un problema importante de la medicina clínica, donde los microorganismos encuentran condiciones extremadamente favorables para su desarrollo. El daño a la piel, una barrera protectora natural, conduce a la desnaturalización de la proteína, necrosis y exudado, donde predomina la congestión y edema. Como consecuencia de ello, los mecanismos de defensa, tanto humoral como celular, se deterioran. Por otro lado, la agresión térmica genera daño oxidativo, con una mayor actividad de radicales libres, lo que resulta en peroxidación lipídica, donde la correcta evaluación de la profundidad de la quemadura determina la decisión sobre el tratamiento, ya sea conservadora o quirúrgica local, (Gutiérrez, 2002). Muchas son las propiedades que se encuentran en api-terapéuticos, productos recogidos ytratados por abejas. La miel, además de generar una disminución de la inflamación, y promover la granulación, genera un control de radicales libres debido a su efecto antioxidante, limitando el daño y disfunción multiorgánica posterior, (Jull et al., 2008). Varios estudios han mostrado tasas significativamente...

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The impact of Manuka honey dressings on the surface pH of chronic wounds

Cited by 166 publications

References 37 publications

Staphylococcus aureus Induces Hypoxia and Cellular Damage in Porcine Dermal Explants

Staphylococcus aureus Induces Hypoxia and Cellular Damage in Porcine Dermal Explants

The Effect of pH on the Antimicrobial Efficiency of Silver Alginate on Chronic Wound Isolates

Efecto Cicatrizante de la Miel de Ulmo (Eucryphia cordifolia) Suplementada con Ácido Ascórbico como Tratamiento en Quemaduras

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