Wu Yu-Feng, Lin Yu-Chen, Yang Hung-Wei, Cheng Nai-Chen, Cheng Chao-Min
Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu 300, Taiwan.
Institute of Biomedical Engineering, National Tsing Hua University, Hsinchu 300, Taiwan.
Biomedicines. 2022 May 22;10(5):1200. doi: 10.3390/biomedicines10051200.
Biofilm infection has been identified as a crucial factor of the pathogenesis of chronic wound, but wound biofilm diagnosis remains as an unmet clinical need. We previously proposed a modified wound blotting technique using Alcian blue staining for biofilm detection that was characterized as being non-invasive, time-saving, non-expansive, and informative for biofilm distribution. In this study, we adapted a novel Alcian blue grading method as the severity of biofilm infection for the wound blotting technique and compared its biofilm detection efficacy with MolecuLight i:X- a point-of-care florescence imaging device to detect bacteria and biofilm in wounds. Moreover, their predictive value of complete wound healing at 90 days was analyzed. When validated with wound culture results in the 53 enrolled subjects with chronic wounds, the modified wound blotting method showed a strong association with wound culture, while MolecuLight i:X only exhibited a weak association. In predicting 90-day wound outcomes, the modified wound blotting method showed a strong association (Kendall’s tau value = 0.563, p < 0.001), and the wound culture showed a moderate association (Spearman’s rho = 0.535, p < 0.001), but MolecuLight i:X exhibited no significant association (p = 0.184). In this study, modified wound blotting with the Alcian blue grading method showed superior value to MolecuLight i:X both in biofilm detection and predictive validity in 90-day wound-healing outcomes.
生物膜感染已被确认为慢性伤口发病机制的关键因素，但伤口生物膜诊断仍是一项未得到满足的临床需求。我们之前提出了一种改良的伤口印迹技术，使用阿尔辛蓝染色来检测生物膜，其特点是无创、省时、成本低，且能提供生物膜分布信息。在本研究中，我们采用了一种新颖的阿尔辛蓝分级方法来评估伤口印迹技术中生物膜感染的严重程度，并将其生物膜检测效果与MolecuLight i:X（一种用于检测伤口中细菌和生物膜的即时荧光成像设备）进行比较。此外，还分析了它们对伤口90天完全愈合的预测价值。在对53名纳入研究的慢性伤口患者的伤口培养结果进行验证时，改良的伤口印迹方法与伤口培养结果显示出很强的相关性，而MolecuLight i:X仅显示出较弱的相关性。在预测90天伤口愈合结果时，改良的伤口印迹方法显示出很强的相关性（肯德尔tau值 = 0.563，p < 0.001），伤口培养显示出中等相关性（斯皮尔曼rho值 = 0.535，p < 0.001），但MolecuLight i:X未显示出显著相关性（p = 0.184）。在本研究中，采用阿尔辛蓝分级方法的改良伤口印迹在生物膜检测和90天伤口愈合结果的预测有效性方面均显示出优于MolecuLight i:X的价值。
