Dr. Philip Frost Department of Dermatology & Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
Int Wound J. 2024 Oct;21(10):e70059. doi: 10.1111/iwj.70059.
Chronic non-healing wounds pose significant challenges due to an elevated inflammatory response caused in part by bacterial contamination (Physiol Rev. 2019;99:665). These wounds lead to billions being spent in the health care system worldwide (N Engl J Med. 2017;376:2367, Int J Pharm. 2014;463:119). We studied the in-vitro and in-vivo antimicrobial effects of a multimodal wound matrix (MWM) against two common wound pathogens, Methicillin-Resistant Staphylococcus aureus (MRSA USA300) and Pseudomonas aeruginosa ATCC 27312 (PA27312) (Int Wound J. 2019;16:634). The in-vitro study conducted was a zone of inhibition test with the two microbes at 104 Log CFU/mL inoculated on Tryptic soy agar with 5% sheep blood (TSAII) plates. Treatments used were MWM, Mupirocin (Positive control for MRSA), Silver Sulfadiazine (Positive Control for PA), Petrolatum and Sterile Saline (both serving as Negative Controls). Treatments were allowed to diffuse into the agar for 3 h and then were incubated for 24 h at 37°C. The in-vivo study utilized a deep dermal porcine wound model (22 × 22 × 3 mm) created on six animals. Three animals were inoculated with MRSA USA300 and the other three with PA27312 with each allowing a 72-h biofilm formation. After 72 h, baseline wounds were assessed for bacterial concentration and all remaining wounds were treated with either MWM alone, Silver Treatment or Untreated Control. Wounds were assessed on days 4, 8 and 12 after treatment application for microbiological analysis. In-vitro, MWM exhibited significant inhibition of MRSA USA300 and PA27312 growth when compared to negative controls (p ≤ 0.05). Likewise, in-vivo, the MWM-treated wounds exhibited a significant (p ≤ 0.05) bacterial reduction compared to all other treatment groups, especially on days 8 and 12 for both pathogens. MWM demonstrated promise in addressing colonized wounds with biofilms. Additional studies on MWM's benefits and comparisons with existing treatments are warranted to optimize wound care strategies (Adv Wound Care. 2021;10:281).
慢性难愈性创面由于部分由细菌污染引起的炎症反应升高而带来重大挑战(生理学评论。2019 年;99:665)。这些创面导致全球医疗保健系统花费数十亿美元(N Engl J Med. 2017;376:2367,Int J Pharm. 2014;463:119)。我们研究了一种多模式创面基质(MWM)对两种常见创面病原体耐甲氧西林金黄色葡萄球菌(MRSA USA300)和铜绿假单胞菌 ATCC 27312(PA27312)的体外和体内抗菌效果(Int Wound J. 2019;16:634)。在 104 Log CFU/mL 的两种微生物接种在含 5%绵羊血的胰蛋白酶大豆琼脂(TSAII)平板上进行的体外研究是抑菌试验。使用的处理方法是 MWM、莫匹罗星(MRSA 的阳性对照)、磺胺嘧啶银(PA 的阳性对照)、凡士林和无菌生理盐水(均作为阴性对照)。处理方法允许在琼脂中扩散 3 小时,然后在 37°C 下孵育 24 小时。体内研究利用了在六只动物身上创建的深真皮猪创面模型(22×22×3mm)。三只动物接种了 MRSA USA300,另外三只接种了 PA27312,每只动物允许形成 72 小时生物膜。72 小时后,对基线创面进行细菌浓度评估,并用 MWM 单独、银处理或未处理对照处理所有剩余创面。处理后第 4、8 和 12 天评估创面进行微生物分析。体外,MWM 显示对 MRSA USA300 和 PA27312 生长的显著抑制,与阴性对照相比(p≤0.05)。同样,体内,MWM 处理的创面与所有其他治疗组相比,细菌减少具有显著意义(p≤0.05),尤其是在两种病原体的第 8 天和第 12 天。MWM 显示出在处理有生物膜的定植创面方面有希望。需要进一步研究 MWM 的益处,并与现有治疗方法进行比较,以优化创面护理策略(Adv Wound Care. 2021;10:281)。