Update on the Role of Infection and Biofilms in Wound Healing: Pathophysiology and Treatment

Gompelman, Michelle; Asten, Suzanne Van; Peters, Edgar J.G.

doi:10.1097/prs.0000000000002679

Cited by 41 publications

(29 citation statements)

References 86 publications

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“…Many factors contribute to delayed wound healing, including diabetes mellitus, vascular insufficiency, local pressure, protease deregulation, reduced growth factor activity, inflammation, and concurrent infection . Infections with bacteria have a particularly deleterious effect on wound healing, especially when the wound already exhibits delayed wound healing . The four most common bacteria in wounds are Enterobacteriaceae family members, Enterococcus species, P. aeruginosa , and Staphylococcus species .…”

Section: Discussionmentioning

confidence: 99%

“…44 Infections with bacteria have a particularly deleterious effect on wound healing, especially when the wound already exhibits delayed wound healing. 45 The four most common bacteria in wounds are Enterobacteriaceae family members, Enterococcus species, P. aeruginosa, and Staphylococcus species. 46 Mixed infections with these bacteria are often observed.…”

Section: Discussionmentioning

confidence: 99%

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Antimicrobial photodynamic therapy in skin wound healing: A systematic review of animal studies

Sun

Ogawa

Xiao

et al. 2019

International Wound Journal

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Bacterial infection is a common wound complication that can significantly delay healing. Classical local therapies for infected wounds are expensive and are frequently ineffective. One alternative therapy is photodynamic therapy (PDT). We conducted a systematic review to clarify whether PDT is useful for bacteria‐infected wounds in animal models. PubMed and Medline were searched for articles on PDT in infected skin wounds in animals. The language was limited to English. Nineteen articles met the inclusion criteria. The overall study methodological quality was moderate, with a low‐moderate risk of bias. The animal models were mice and rats. The wounds were excisional, burn, and abrasion wounds. Wound size ranged from 6 mm in diameter to 1.5 × 1.5 cm2. Most studies inoculated the wounds with Pseudomonas aeruginosa or methicillin‐resistant Staphylococcus aureus. Eleven and 17 studies showed that the PDT of infected wounds significantly decreased wound size and bacterial counts, respectively. Six, four, and two studies examined the effect of PDT on infected wound‐cytokine levels, wound‐healing time, and body weight, respectively. Most indicated that PDT had beneficial effects on these variables. PDT accelerated bacteria‐infected wound healing in animals by promoting wound closure and killing bacteria.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Antimicrobial photodynamic therapy in skin wound healing: A systematic review of animal studies

Sun

Ogawa

Xiao

et al. 2019

International Wound Journal

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“…2 Several studies, including those from our own laboratories, have indicated that biofilm infections impair wound healing. 2,[6][7][8]10,11,13,14 Therefore, novel strategies of dismantling biofilms are a primary and immediate need in wound care.…”

Section: Discussionmentioning

confidence: 99%

“…2 In addition to impaired cellular wound healing processes, the presence of biofilm infection derails natural wound healing. [3][4][5][6][7][8][9][10][11][12][13][14] Innovative strategies to combat wound biofilm infection, while promoting healing of hardto-heal wounds, are urgently needed.…”

Section: Introductionmentioning

confidence: 99%

Disposable Patterned Electroceutical Dressing (PED-10) Is Safe for Treatment of Open Clinical Chronic Wounds

Prakash

Mathew-Steiner

et al. 2019

Advances in Wound Care

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Objective: To evaluate if patterned electroceutical dressing (PED) is safe for human chronic wounds treatment as reported by wound care providers. Approach: This work reports a pilot feasibility study with the primary objective to determine physically observable effects of PED application on host tissue response from a safety evaluation point of view. For this pilot study, patients receiving a lower extremity amputation with at least one open wound on the part to be amputated were enrolled. Patients were identified through the Ohio State University Wexner Medical Center (OSUWMC) based on inclusion and exclusion criteria through prescreening through the Comprehensive Wound Center's (CWC) Limb Preservation Program and wound physicians and/or providers at OSUWMC. Wounds were treated with the PED before amputation surgery. Results: The intent of the study was to identify if PED was safe for clinical application based on visual observations of adverse or lack of adverse events on skin and wound tissue. The pilot testing performed on a small cohort (N = 8) of patients showed that with engineered voltage regulation of current flow to the open wound, the PED can be used with little to no visually observable adverse effects on chronic human skin wounds. Innovation: The PED was developed as a second-generation tunable electroceutical wound care dressing, which could potentially be used to treat wounds with deeper infections compared with current state of the art that treats wounds with treatment zone limited to the surface near topical application. Conclusion: Technology advances in design and fabrication of electroceutical dressings were leveraged to develop a tunable laboratory prototype that could be used as a disposable low-cost electroceutical wound care dressing on chronic wounds. Design revisions of PED-1 (1 kO ballast resistor) circumvented previously observed adverse effects on the skin in the vicinity of an open wound. PED-10 (including a 10 kO ballast resistor) was well tolerated in the small cohort of patients (N = 8) on whom it was tested, and the observations reported here warrant a larger study to determine the clinical impact on human wound healing and infection control.

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“…All wounds are colonized to a certain degree, and a major role of the inflammatory phase of wound healing is to bring microbes down to steady-state and innocuous levels [11,36] [37]. Biofilm has the capability to seize nutrients in the ECM, such as carbon, nitrogen and phosphate, to supplement their own growth [38]. Once a full-fledged biofilm is formed, a layer of extracellular polymeric substances (EPS) surrounds and protects them against a vast of "predators" such as macrophages, antimicrobial peptides and antibiotics [39].…”

Section: Wound Infections and Healingmentioning

confidence: 99%

Antibacterial hydrogels for managing wound infections

Yeo¹

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List of Schemes Scheme 2.1. Chemical structures of (a) PEI-PEGMA and (b) PEGDMA. (Page 33) Scheme 2.2. Antibacterial killing mechanisms of hydrogel. Biofilm bacteria are killed and removed by absorption into the hydrogel followed by contact-killing (mode 1) and infection-triggered release of bactericidal star cationic PEI (mode 2). Scale bar on the right is 20 µm. (Page 35) Scheme 2.3. The synthesis strategy for PEI-PEGMA. (Page 36) Scheme 2.4. The synthesis strategy for PEI-PEGACA. (Page 54) Scheme 3.1. Synthesis of polyimidazolium polymers. (a) Synthesis of amine-terminated polyimidazolium (PIM). (b) Synthesis of maleimide-terminated polyimidazolium (PIMmal).

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Update on the Role of Infection and Biofilms in Wound Healing: Pathophysiology and Treatment

Abstract: Biofilm formation has a substantial role in chronic wounds. Several diagnostic and therapeutic methods against biofilm are currently being developed.

Cited by 41 publications

References 86 publications

Antimicrobial photodynamic therapy in skin wound healing: A systematic review of animal studies

Antimicrobial photodynamic therapy in skin wound healing: A systematic review of animal studies

Disposable Patterned Electroceutical Dressing (PED-10) Is Safe for Treatment of Open Clinical Chronic Wounds

Antibacterial hydrogels for managing wound infections

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