Graphene Oxide affects Staphylococcus aureus and Pseudomonas aeruginosa dual species biofilm in Lubbock Chronic Wound Biofilm model

Abstract Chronic wound management becomes a complex procedure because of the persistence of forming biofilm pathogens that do not respond to antimicrobial treatment. The aim of this paper is to detect the Graphene Oxide-GO effect on Staphylococcus aureus and Pseudomonas aeruginosa dual species wound biofilm in Lubbock Chronic Wound Biofilm-LCWB model. LCWB is a recognized model that mimics the spatial microbial colonization into chronic wounds and reproduces the wound and its clot. Staphylococcus aureus PECHA 10 and P. aeruginosa PECHA 4, are the pathogens used in the study. The GO effect on both in forming and mature biofilms, is detected by the evaluation of the CFU/mg reduction, the cell viability and ultrastructural analysis of the treated LCWBs. Graphene Oxide, at 50 mg/l, shows a significant antibiofilm effect in forming and mature LCWBs. In particular, during the biofilm formation, GO reduces the S. aureus and P. aeruginosa growth of 55.05% ± 4.73 and 44.18% ± 3.91 compared to the control. In mature biofilm, GO affects S. aureus and P. aeruginosa by reducing their growth of 70.24% ± 4.47 and 63.68% ± 17.56, respectively. Images taken by SEM show that GO display a disaggregated microbial effect also disrupting the fibrin network of the wound-like biofilm framework. In conclusion, GO used against microorganisms grown in LCWB, displays a significant inhibitory action resulting in a promising tool for potential application in wound management.

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Antimicrobial Peptide L18R Displays a Modulating Action against Inter-Kingdom Biofilms in the Lubbock Chronic Wound Biofilm Model

Microorganisms ◽

10.3390/microorganisms9081779 ◽

2021 ◽

Vol 9 (8) ◽

pp. 1779

Author(s):

Paola Di Di Fermo ◽

Tecla Ciociola ◽

Silvia Di Di Lodovico ◽

Simonetta D'Ercole ◽

Morena Petrini ◽

...

Keyword(s):

Antimicrobial Activity ◽

Chronic Wound ◽

Early Stage ◽

Antimicrobial Treatment ◽

Microbial Colonization ◽

Wound Management ◽

Lower Percentage ◽

Mature Stage ◽

Variable Effect ◽

Conventional Antibiotics

Chronic wound infections represent an important health problem due to the reduced response to antimicrobial treatment of the pathogens organized in structured biofilms. This study investigated the effects of the previously described antifungal peptide L18R against three representative wound pathogens: Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. The antimicrobial activity of L18R was evaluated (i) against single planktonic microbial populations; (ii) on single, dual, and triadic species of biofilms in both the early stage and mature stage; and (iii) in a the polymicrobial Lubbock chronic wound biofilm (LCWB) model, mimicking spatial microbial colonization. This study used the evaluation of CFUs, biofilm biomass detection, and confocal and scanning electron microscopy analysis. L18R showed a significant antimicrobial activity against planktonic microorganisms and was able to differentially reduce the biomass of monomicrobial biofilms. No reduction of biomass was observed against the polymicrobial biofilm. In mature LCWB, L18R caused a moderate reduction in total CFU number, with a variable effect on the different microorganisms. Microscopy images confirmed a predominant presence of P. aeruginosa and a lower percentage of C. albicans cells. These findings suggest a modulating action of L18R and recommend further studies on its potential role in chronic wound management in association with conventional antibiotics or alternative treatments.

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Experience of using atraumatic ointment bandages based on peruvian balsam in the complex treatment of patients with chronic wound defects of the lower limbs

Hirurg (Surgeon) ◽

10.33920/med-15-2002-05 ◽

2020 ◽

pp. 43-57

Author(s):

Anna Tabuika

Keyword(s):

Diabetes Mellitus ◽

Staphylococcus Aureus ◽

Chronic Wounds ◽

Chronic Wound ◽

Local Treatment ◽

Lower Limbs ◽

Complex Treatment ◽

Average Area ◽

Arterial Insufficiency ◽

Significant Activation

The article reflects the results of a retrospective non-comparative study, the objects of which were 34 outpatient comorbid patients (15 of which are over 60 years old) with chronic wounds of the lower limbs developed against the background of varicosity, post-thrombotic disease, chronic arterial insufficiency of the lower limbs, diabetes mellitus or their combination. Their local treatment was carried out using atraumatic ointment dressing «Branolind N» containing Peruvian balsam. There were 23 women (67.6 %) and 11 men (32.4 %). In microbiological study prior to the beginning of treatment in 31 patients the growth of a pathogen of wound infection was revealed; in 19 patients — Staphylococcus aureus in monoculture and in various associations, in 6 patients — Pseudomonas aeruginosa in monoculture, in other cases — other pathogens. In 3 patients the pathogen was not detected. The average wound size was 34 cm2 . The phase of the wound process was additionally confirmed by cytological studies. After treatment the average area of the wound defect decreased by 10 cm2 and made 24 cm2 on average. Full healing of the wound defect occurred in 11 patients, the others had granulation and active marginal epithelization. There was also a decrease in bacterial semination of wounds, a change in composition of infection agents to less aggressive monoflora, and cytologically — a decrease in signs of inflammation against the background of significant activation of reparative processes.

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Fluorescent Imaging and Precise Suppression of Bacterial Infection in Chronic Wounds by Porphyrin-Based Metal-Organic Framework Nanorod

Journal of Materials Chemistry B ◽

10.1039/d1tb01649k ◽

2021 ◽

Author(s):

zhen zou ◽

Lihua Zhang ◽

Minzhi Ouyang ◽

Yufei Zhang ◽

Huanxiang Wang ◽

...

Keyword(s):

Bacterial Infection ◽

Antibacterial Agents ◽

Chronic Wounds ◽

Chronic Wound ◽

Metal Organic Framework ◽

Critical Role ◽

Fluorescent Imaging ◽

Wound Management ◽

Metal Organic ◽

Chronic Wound Management

Nano-antibacterial agents play a critical role in chronic wound management. However, an intelligent nanosystem that can provide both visual warning of infection and precise sterilization remains a hurdle. Herein, a...

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A Retrospective Analysis of Clinical Use and Outcomes Using Viable Placental Membrane Allografts in Chronic Wounds

WOUNDS A Compendium of Clinical Research and Practice ◽

10.25270/wnds/2021.329333 ◽

2021 ◽

Vol 33 (12) ◽

pp. 329-333

Author(s):

Laura Swoboda

Keyword(s):

Retrospective Analysis ◽

Real World ◽

Chronic Wounds ◽

Chronic Wound ◽

Arterial Disease ◽

Wound Management ◽

Foot Ulcers ◽

Controlled Trials ◽

Clinical Use ◽

Exposed Bone

Introduction. Viable placental membrane (vPM) has been shown to decrease time to healing, adverse wound events, and wound-related infections. Wound research exclusion criteria commonly exclude wound types other than diabetic foot ulcers and venous leg ulcers (VLUs), comorbidities including peripheral arterial disease (PAD) and uncontrolled diabetes mellitus (DM), and wounds with exposed bone or tendon. Objective. This retrospective research study evaluated the clinical use and outcomes of the vPM with living mesenchymal stem cells used in chronic wound management in the community hospital outpatient department setting with the goal of comparing real-world use and outcomes of the product with use and outcomes described in the chronic wound literature. Materials and Methods. A retrospective analysis on vPM treatments at a Wisconsin academic health system’s community hospitals. Participants included all patients who received vPM therapy between July 1, 2016, and August 21, 2019. Results. A total of 89 patients received vPM treatment during the study period (mean age, 70 years; 69% male [n = 61], 31% female [n = 28]). Wound types were 54% diabetic or neuropathic foot ulcers (n = 48), 17% VLUs (n = 15), 7% pressure injuries (n = 6), and 22% atypical wounds (n = 20). The average wound duration prior to vPM initiation was 104 days. Average wound size at presentation was 6.9 cm2. Of study participants 54% had PAD (n = 48), 63% had DM (n = 56), 33.7% had DM and PAD (n = 30), and 17% had exposed bone or tendon (n = 15). Average adjusted time to healing after initiation of vPM was 81.2 days. The percentage of wounds healed 12 weeks after initiation of vPM treatment was 57%. Conclusions. Effectiveness of vPM observed in controlled trials also was observed in this real-world study on vPM for multiple wound types, patients with comorbidities including PAD and uncontrolled DM, and wounds with exposed bone or tendon. Results of this study were not statistically different from those reported in the literature. More randomized controlled trials are needed to explore the efficacy of vPM on patient presentations common to wound healing centers.

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Chronic wounds: the challenges of appropriate management

British Journal of Community Nursing ◽

10.12968/bjcn.2019.24.sup9.s26 ◽

2019 ◽

Vol 24 (Sup9) ◽

pp. S26-S32 ◽

Cited By ~ 4

Author(s):

Leanne Atkin

Keyword(s):

Wound Healing ◽

Health Services ◽

Chronic Wounds ◽

Chronic Wound ◽

Wound Management ◽

Product Selection ◽

Wound Assessment ◽

Moisture Balance ◽

Selection For ◽

Chronic Wound Management

The immense burden imposed by chronic wounds—those persisting over 6 weeks despite active intervention—on patients and health services is well recognised. There are various reasons for why a wound fails to progress towards closure, and clinicians must investigate the underlying cause of wound chronicity, as this information guides the management of such wounds. The TIME framework (T=tissue; I=infection/inflammation; M=moisture balance; E=wound edges) is a useful tool for practitioners to systematically undertake wound assessment and product selection. This article discusses chronic wound management based on the TIME framework, examining the aspects to be considered when managing chronic wounds. It also describes the process of dressing selection for overcoming the various barriers to wound healing, specifically discussing the AQUACEL family of dressings.

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Nonrandom Distribution of Pseudomonas aeruginosa and Staphylococcus aureus in Chronic Wounds

Journal of Clinical Microbiology ◽

10.1128/jcm.01395-09 ◽

2009 ◽

Vol 47 (12) ◽

pp. 4084-4089 ◽

Cited By ~ 235

Author(s):

M. Fazli ◽

T. Bjarnsholt ◽

K. Kirketerp-Moller ◽

B. Jorgensen ◽

A. S. Andersen ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Pseudomonas Aeruginosa ◽

Chronic Wounds ◽

Nonrandom Distribution ◽

And Staphylococcus Aureus

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Telemedicine in Chronic Wound Management: Systematic Review And Meta-Analysis

JMIR mhealth and uhealth ◽

10.2196/15574 ◽

2020 ◽

Vol 8 (6) ◽

pp. e15574

Author(s):

Lihong Chen ◽

Lihui Cheng ◽

Wei Gao ◽

Dawei Chen ◽

Chun Wang ◽

...

Keyword(s):

Wound Healing ◽

Cohort Studies ◽

Mobile Phones ◽

Standard Care ◽

Chronic Wounds ◽

Chronic Wound ◽

Meta Analysis ◽

Wound Management ◽

Efficacy And Safety ◽

Chronic Wound Management

Background Chronic wounds have been a great burden to patients and the health care system. The popularity of the internet and smart devices, such as mobile phones and tablets, has made it possible to adopt telemedicine (TM) to improve the management of chronic wounds. However, studies conducted by different researchers have reported contradictory results on the effect of TM on chronic wound management. Objective The aim of this work was to evaluate the efficacy and safety of TM in chronic wound management. Methods We systematically searched multiple electronic databases (MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials [CENTRAL]) to identify eligible studies published from inception to June 12, 2019. Inclusion criteria were randomized controlled trials (RCTs) and interventional cohort studies that investigated the use of TM in chronic wound management. RCT and observational data were analyzed separately. A meta-analysis and qualitative analysis were conducted to estimate endpoints. Results A total of 6 RCTs and 6 cohort studies including 3913 patients were included. Of these, 4 studies used tablets or mobile phones programmed with apps, such as Skype and specialized interactive systems, whereas the remaining 8 studies used email, telephone, and videoconferencing to facilitate the implementation of TM using a specialized system. Efficacy outcomes in RCTs showed no significant differences in wound healing (hazard ratio [HR] 1.16, 95% CI 0.96-1.39; P=.13), and wound healing around 1 year (risk ratio [RR] 1.05, 95% CI 0.89-1.23; P=.15). Noninferiority criteria of TM were met. A decreased risk of amputation in patients receiving TM was revealed (RR 0.45, 95% CI 0.29-0.71; P=.001). The result of cohort studies showed that TM was more effective than standard care (HR 1.74, 95% CI 1.43-2.12; P<.001), whereas the outcome efficacy RR of wound healing around 1 year (RR 1.21, 95% CI 0.96-1.53; P=.56) and 3 months (RR 1.24, 95% CI 0.47-3.3; P=.67) was not significantly different between TM and standard care. Noninferiority criteria of TM were met for wound healing around 1 year in cohort studies. Conclusions Currently available evidence suggests that TM seems to have similar efficacy and safety, and met noninferiority criteria with conventional standard care of chronic wounds. Large-scale, well-designed RCTs are warranted.

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Methods for chronic wound research — A scoping systematic review of the recommendations, guidelines and standards

Wound Practice and Research ◽

10.33235//wpr.27.2.62-73 ◽

2019 ◽

Vol 27 (2) ◽

pp. 62-73

Author(s):

CN Parker ◽

A Francis ◽

KJ Finlayson

Keyword(s):

Systematic Review ◽

Research Methods ◽

Chronic Wounds ◽

Chronic Wound ◽

Grey Literature ◽

Wound Management ◽

Core Outcome ◽

Management Research ◽

Research Gaps ◽

Guidelines And Standards

Background This scoping systematic review aimed to investigate the existing literature for recommendations, guidelines and standards for research on chronic wound diagnosis, assessment, management and prevention; to identify gaps in this literature; and produce recommendations to support future wound management research. Methods A scoping systematic literature review was undertaken in 2017–2018, which aligned with PRISMA guidelines and searched academic databases and grey literature published between 2007 and 2017. Results Eighty-nine documents included recommendations or outcomes on research methods for studies on chronic wound diagnosis, assessment, management and/or prevention; covering the areas of research design, sampling, randomisation and blinding, independent and outcome measures and interventions for research in chronic wounds. Common themes regarding research gaps and flaws were identified. Conclusion This review identified existing evidence, guidelines, recommendations and standards regarding the conduct of chronic wound research internationally. Recommendations include the need for standardised vocabulary, standardised checklists for wound research, development of core outcome datasets and an agreed and standardised set of economic parameters and methodology for cost-effectiveness. Establishment of a centralised national methodology service for wound research to assist with methodology design would be beneficial.

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New Adapted In Vitro Technology to Evaluate Biofilm Formation and Antibiotic Activity Using Live Imaging under Flow Conditions

Diagnostics ◽

10.3390/diagnostics11101746 ◽

2021 ◽

Vol 11 (10) ◽

pp. 1746

Author(s):

Cassandra Pouget ◽

Catherine Dunyach-Remy ◽

Alix Pantel ◽

Sophie Schuldiner ◽

Albert Sotto ◽

...

Keyword(s):

Biofilm Formation ◽

Cell Imaging ◽

Chronic Wounds ◽

Chronic Wound ◽

Live Imaging ◽

Bacterial Biofilm ◽

Flow Conditions ◽

Promising Tool ◽

Reference Strains

The polymicrobial nature of biofilms and bacterial interactions inside chronic wounds are keys for the understanding of bacterial cooperation. The aim of this present study was to develop a technique to study and visualize biofilm in live imaging under flow conditions (Bioflux™ 200, Fluxion Biosciences). The BiofluxTM system was adapted using an in vitro chronic wound-like medium (CWM) that mimics the environment encountered in ulcers. Two reference strains of Staphylococcus aureus (Newman) and Pseudomonas aeruginosa (PAO1) were injected in the BiofluxTM during 24 h to 72 h in mono and coculture (ratio 1:1, bacteria added simultaneously) in the CWM vs. a control medium (BHI). The quantification of biofilm formation at each time was evaluated by inverted microscopy. After 72 h, different antibiotics (ceftazidime, imipenem, linezolid, oxacillin and vancomycin) at 1x MIC, 10x MIC and 100x MIC were administrated to the system after an automatic increase of the flow that mimicked a debridement of the wound surface. Biofilm studies highlighted that the two species, alone or associated, constituted a faster and thicker biofilm in the CWM compared to the BHI medium. The effect of antibiotics on mature or “debrided” biofilm indicated that some of the most clinically used antibiotic such as vancomycin or imipenem were not able to disrupt and reduce the biofilm biomass. The use of a life cell imaging with an in vitro CWM represents a promising tool to study bacterial biofilm and investigate microbial cooperation in a chronic wound context.

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What Is New in the Understanding of Non Healing Wounds Epidemiology, Pathophysiology, and Therapies

Ulcers ◽

10.1155/2013/625934 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 16

Author(s):

H. Trøstrup ◽

T. Bjarnsholt ◽

K. Kirketerp-Møller ◽

N. Høiby ◽

C. Moser

Keyword(s):

Chronic Wounds ◽

Antimicrobial Treatment ◽

Bacterial Biofilm ◽

Wound Management ◽

Western World ◽

World Knowledge ◽

Representative Sampling ◽

Healing Wounds ◽

The Impact

Chronic wounds are a growing socioeconomic problem in the western world. Knowledge on recalcitrant wounds relies on in vitro studies or clinical observations, and there is emerging evidence on the clinical impact of bacterial biofilm on skin healing. Chronic wounds are locked in the inflammatory state of wound healing, and there are multiple explanations for this arrest with the theory of exaggerated proteolysis as the most commonly accepted. Previously, there has not been enough focus on the different etiologies of chronic wounds compared to acute, healing wounds. There is an urgent need to group chronic wounds by its cause when searching for possible diagnostic or therapeutic targets. Good wound management should therefore consist of recognition of basic wound etiology, irrigation, and debridement in order to reduce microbial and necrotic load, frequently changed dressings, and appropriate antimicrobial and antibiofilm strategies based on precise diagnosis. Representative sampling is required for diagnosis and antimicrobial treatment of wounds. The present review aims at describing the impact of biofilm infections on wounds in relation to diagnosing, treatment strategies, including experimentally adjuvant approaches and animal models.

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