Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
J Wound Care. 2021 Apr 1;30(Sup4):S4-S13. doi: 10.12968/jowc.2021.30.Sup4.S4.
Wound biofilms delay healing of hard-to-heal wounds. Convenient biofilm identification tools for clinical settings are currently not available, hindering biofilm-based wound management. Wound blotting with biofilm staining is a potential tool for biofilm detection, owing to its convenience. Although predictive validity of wound blotting has been established, it is necessary to confirm its concurrent validity. Furthermore, current staining systems employing ruthenium red have some disadvantages for clinical use. This study aimed to evaluate the usability of alcian blue as a substitute for ruthenium red.
Both in vitro and in vivo clinical samples were used to investigate validity and usability.
The in vitro study showed that proteins and extracellular DNA in biofilms did not affect staining ability of ruthenium red and alcian blue in the detection of biofilms. In the in vivo study, using a wound biofilm model with , the staining sensitivity of ruthenium red was 88.9% and 100% for alcian blue, with correlation coefficients of signal intensities with native polyacrylamide gel electrophoresis (PAGE) of r=0.67 (p=0.035) and r=0.67 (p=0.036) for ruthenium red and alcian blue, respectively. Results from clinical samples were r=0.75 (p=0.001) for ruthenium red and r=0.77 (p<0.001) for alcian blue. The sensitivities of wound blotting staining by ruthenium red and alcian blue were very high and had a good correlation with native PAGE analysis.
Because the alcian blue procedure is more convenient than the ruthenium red procedure, wound blotting with alcian blue staining would be a promising tool to guide clinicians in delivering biofilm-based wound management.
伤口生物膜会延迟难以愈合的伤口的愈合。目前临床上缺乏便捷的生物膜识别工具，这阻碍了基于生物膜的伤口管理。由于其便捷性，使用生物膜染色的伤口擦拭法是一种潜在的生物膜检测工具。尽管已经证实了伤口擦拭法的预测有效性，但仍有必要确认其同时有效性。此外，目前使用钌红的染色系统在临床应用中存在一些缺点。本研究旨在评估使用碱性蓝作为钌红替代品的可用性。
本研究使用体外和体内临床样本来研究其有效性和可用性。
体外研究表明，生物膜中的蛋白质和细胞外 DNA 不会影响钌红和碱性蓝检测生物膜的染色能力。在体内研究中，使用 诱导的伤口生物膜模型，钌红和碱性蓝的染色灵敏度分别为 88.9%和 100%，与天然聚丙烯酰胺凝胶电泳（PAGE）信号强度的相关系数分别为 r=0.67（p=0.035）和 r=0.67（p=0.036）。临床样本的结果分别为 r=0.75（p=0.001）和 r=0.77（p<0.001）。钌红和碱性蓝的伤口擦拭染色的灵敏度均很高，与天然 PAGE 分析具有良好的相关性。
由于碱性蓝的操作程序比钌红更方便，因此使用碱性蓝进行伤口擦拭染色可能是一种很有前途的工具，可以指导临床医生进行基于生物膜的伤口管理。
