Wolcott R D, Rumbaugh K P, James G, Schultz G, Phillips P, Yang Q, Watters C, Stewart P S, Dowd S E
Southwest Regional Wound Care Center, Lubbock, TX, USA.
J Wound Care. 2010 Aug;19(8):320-8. doi: 10.12968/jowc.2010.19.8.77709.
To investigate the hypothesis that newly formed wound biofilms (or bioburdens) are more susceptible to antimicrobial treatment.
Four separate and distinct models were performed by four separate biofilm research laboratories to evaluate the resistance of biofilms to antimicrobial treatments over time. These included a drip-flow biofilm model along with a hydrodebridement study, a porcine skin punch biopsy ex vivo model, a mouse chronic wound model and clinical longitudinal debridement study.
All four models showed that, within the first 24 hours, the biofilm community was more susceptible to the selected antibiotics, and after maturing for up to 48 hours became increasingly tolerant. In each model, there was at least a 24-hour period in which the biofilms were more resistant to antibiotics. Each of the models utilised showed a significant decrease in the resistance of the biofilm/ burden to gentamicin for up to 24 hours with a confidence interval of at least 95%. The resistance increased in each of the models by 48 hours and reached original resistance levels by 72 hours.
These data suggest the principles of biofilm-based wound care, along with the use of serial debridement to continually remove mature biofilm, followed by biofilm wound management strategies, including topical antibiotics while the bioburden is still immature and more susceptible, are valid.
研究新形成的伤口生物膜（或生物负荷）对抗菌治疗更敏感这一假设。
四个独立的生物膜研究实验室进行了四个不同的模型，以评估生物膜随时间对抗菌治疗的抗性。这些模型包括滴流生物膜模型以及清创术研究、猪皮打孔活检离体模型、小鼠慢性伤口模型和临床纵向清创术研究。
所有四个模型均显示，在最初的24小时内，生物膜群落对所选抗生素更敏感，在成熟长达48小时后耐受性逐渐增加。在每个模型中，至少有24小时生物膜对抗生素更具抗性。所使用的每个模型中，生物膜/负荷对庆大霉素的抗性在长达24小时内显著降低，置信区间至少为95%。每个模型中的抗性在48小时时增加，并在72小时时达到原始抗性水平。
这些数据表明，基于生物膜的伤口护理原则，以及使用连续清创术持续清除成熟生物膜，随后采用生物膜伤口管理策略，包括在生物负荷仍不成熟且更敏感时使用局部抗生素，是有效的。
