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Measuring the microbiome of chronic wounds with use of a topical antimicrobial dressing - A feasibility study.

ABSTRACT: BACKGROUND:Polymicrobial communities colonize all wounds, and biofilms are hypothesized to be a key link to the chronic state and stalled healing. Molecular methods offer greater insight when studying microbial ecology in chronic wounds, as only a small fraction of wound bacteria are cultured by currently available methods and studies have shown little agreement between culture and molecular based approaches. Some interventions, like dressings with oxidized silver, are reported to help the stalled wounds move to a normal healing trajectory but the underlying mechanisms are difficult to measure. One hypothesis is that the use of topical antimicrobial dressings targets the wound microbiome and reduces bioburden. OBJECTIVES:Our objective was to determine if culture-independent molecular methods could be used to identify the microbial composition in chronic wounds, and measure the microbiome over time when a topical antimicrobial dressing is used to reduce bioburden. METHODS:Patients with chronic wounds defined as >6 weeks in duration and not taking systemic antibiotics were recruited to participate. A wound contact layer containing silver oxynitrate was applied immediately after routine sharp debridement material was collected and swabs of the wound bed taken. Next-generation sequencing of the bacterial 16S rRNA gene in each specimen was used to measure the microbiome. RESULTS:Distinct bacterial communities were observed between swab and debridement samples, highlighting spatial differences and the importance of sampling consistency. The microbial communities appeared to be similar between different diabetes statuses, but different among the three wound categories included. CONCLUSIONS:Culture-independent methods can be applied to measure the microbiome of chronic wounds even when a topical antimicrobial dressing is applied to the wound.

SUBMITTER: Kalan L

PROVIDER: S-EPMC5695787 | biostudies-literature | 2017

REPOSITORIES: biostudies-literature

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Measuring the microbiome of chronic wounds with use of a topical antimicrobial dressing - A feasibility study.

Kalan Lindsay L Zhou Mi M Labbie Michele M Willing Benjamin B

PloS one 20171120 11

<h4>Background</h4>Polymicrobial communities colonize all wounds, and biofilms are hypothesized to be a key link to the chronic state and stalled healing. Molecular methods offer greater insight when studying microbial ecology in chronic wounds, as only a small fraction of wound bacteria are cultured by currently available methods and studies have shown little agreement between culture and molecular based approaches. Some interventions, like dressings with oxidized silver, are reported to help t ...[more]

PMID: 29155834

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Project description:Introduction Necrotizing soft tissue infection is potentially life-threatening and involves subcutaneous fascial planes, later involving overlying skin and, eventually, underlying muscles. Early diagnosis and prompt treatment are necessary for this disease's management to avoid significant morbidity and fatality. After resuscitation and optimization, early surgical debridement is followed by serials of dressing. Various materials like Edinburgh University's solution of lime (EUSOL), normal saline, povidone-iodine, and honey have been used as dressing solutions for necrotizing fasciitis. This study is based on comparing the effects of honey and EUSOL as dressing solutions in necrotizing fasciitis wounds. Methods A randomized clinical trial was conducted at the Civil Hospital Karachi, from March 2020 to July 2021. This study has been approved by the ethical review committee of the institution and registered at clinicaltrial.gov. Based on the dressing solution for necrotizing fasciitis, patients were divided into two groups, The honey group (intervention group) contains 90 patients, and the EUSOL group (control group) has 85 patients. Results A total of 175 patients' data were analyzed, 90 in the honey group and 85 in the EUSOL group. Patients presented to the hospital with symptoms of 6.20 ± 2.72 days in the honey group and 6.67 ± 4.08 days in the EUSOL group. The days required for clearance of slough in the honey group were 2.83 ± 0.79, while 2.48 ± 0.82 days in the EUSOL group with a p-value of 0.005. The duration of hospital stay was 4.96 ± 1.31 days in the intervention group and 9.33 ± 1.45 days in the control group, with a p-value of 0.007. Wound healing days were 20.23 ± 4.45 in the intervention group while 28.38 ± 7.06 days in the control group, with a significant p-value of 0.000. Conclusion While managing necrotizing soft tissue infection wounds with honey. Honey promotes faster wound healing and shorter hospital stays compared to EUSOL.

Project description:IntroductionAlthough pain experienced at dressing change has been reported as the worst aspect of living with chronic wounds, UK guidance for their management is primarily tailored to wound healing and only attends to pain as a secondary consideration. Consequently, there is little up-to-date guidance that specifically addresses how patients, carers and healthcare professionals should manage wound-related pain at dressing change. This mapping review will identify, describe and appraise the existing research evidence for strategies used to assess pain intensity and prevent or alleviate pain at dressing change in chronic wounds. In addition, it will highlight areas for future research and inform the development of up-to-date guidance for healthcare professionals.Methods and analysisWe will search MEDLINE and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily (via Ovid SP), Embase (via Ovid SP), Cochrane Central Register of Controlled Trials (via Wiley Cochrane Library), Cumulative Index of Nursing and Allied Health Literature (via EBSCO) and the Web of Science Citation Index Expanded and Social Sciences Citation Index (via Clarivate Analytics). Screening will be undertaken independently by two reviewers, with any disagreements resolved through discussion. Included studies will be subject to coding, using a tested data extraction tool, by two reviewers working independently. The methodological quality of the studies included will be reviewed using quality assessment instruments appropriate for each study design (Cochrane Risk of Bias tool (RoB 2); Risk of Bias in Non-randomised Studies of interventions tool; Critical Appraisal Skills Programme tool). Data will be described narratively and also presented visually in an interactive web-based evidence and gap map.Ethics and disseminationAs this mapping review does not collect original data, ethical approval is not applicable. Findings will be disseminated via a written report, an interactive online mapping tool and in peer-reviewed journals and conference presentations.Prospero registration numberCRD42021260130.

Project description:Every 1.2 s, a diabetic foot ulcer is developed, and every 20 s, one amputation is carried out in diabetic patients. Monitoring and controlling protease activity have been considered as a strategy for more efficient management of diabetic and other chronic wounds. This study aimed to develop a casein-based dressing that, by its disappearance, provides information about the activity of proteases and simultaneously harnesses proteolytic activity. Casein films were fabricated by using an aqueous solution, and heat treatment was successfully deployed as a green and clean approach to confer hydrolytic stability. Our results showed that casein-based films' mechanical characteristics, water absorption, and proteolytic stability could be controlled by the length of the heat treatment, which proved to be a useful tool. An increase in the treatment duration from 30 min to 3 h led to toleration of 2.4 times higher stress, 2 times lower water uptake, and 3.4 times higher proteolytic stability at examined conditions. Selected casein-based structures responded to Bacillus sp. bacteria's protease (BSP) and human neutrophil elastase (HNE) as representatives of bacterial and nonbacterial proteases found in the wounds at 10 and 200 ng mL-1 levels, respectively. The hydrolysis was accompanied by a 36% reduction in proteolytic activity measured by using a casein-based universal protease activity assay. The released casein fragments could scavenge 90% of the examined radicals. In-vitro cell culture studies showed that the hydrolysates were not cytotoxic, and the casein-based film had a favorable interaction with fibroblast cells, indicating its potential as a scaffold in the case that proteolytic activity would not be to the extent that causes its rapid disintegration. In general, these findings hold promise for applying the developed casein-based structure for detecting proteolytic activity without the need for any equipment, kits, or expertise and, more importantly, in a highly economical manner. In the case that the proteolytic activity would not be severe, it could also serve as a substrate for cell adhesion and growth; this would aid in the healing process.

Dataset Information

Measuring the microbiome of chronic wounds with use of a topical antimicrobial dressing - A feasibility study.

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Measuring the microbiome of chronic wounds with use of a topical antimicrobial dressing - A feasibility study.

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