Hajská Marianna, Kurin Elena, Bittner Fialová Silvia, Vidiščák Marian, Panyko Arpád
4th Department of Surgery, Faculty of Medicine and University Hospital Bratislava, Comenius University Bratislava, Ružinovská 6, 82606 Bratislava, Slovakia.
Department of Pharmacognosy and Botany, Faculty of Pharmacy, Comenius University Bratislava, Odbojárov 10, 83232 Bratislava, Slovakia.
Antibiotics (Basel). 2025 Jul 14;14(7):707. doi: 10.3390/antibiotics14070707.
Burn wound infections remain a major clinical challenge due to delayed healing, scarring, and the risk of sepsis, especially when complicated by multidrug-resistant (MDR) Gram-negative pathogens and biofilm formation. Acellular dermal matrices (ADMs) are widely used in reconstructive and burn surgery, yet they lack intrinsic antimicrobial activity, necessitating their combination with topical agents. : This study investigates the antimicrobial and cytocompatibility profiles of ADMs impregnated with various antimicrobial agents, using in vitro planktonic and biofilm burn wound models. While the incorporation of antimicrobials into scaffolds has been previously explored, this study is, to our knowledge, the first to directly compare seven clinically relevant antimicrobial agents after they were impregnated into an ADM in a standardized in vitro model. Seven topical antimicrobials were tested against MDR and from burn patients. : The ADM with 1% acetic acid (AA) showed superior antimicrobial activity, achieving > 7 log reductions in planktonic assays and complete inhibition of biofilms. In NIH 3T3 fibroblast cytotoxicity assays, the 1% AA ADM maintained cell viability at control levels, indicating excellent biocompatibility. Compared with agents such as Betadine, Octenilin, and colistin, which showed cytotoxicity, and Prontosan, which showed low efficacy, 1% AA uniquely combined potent antibacterial effects with minimal toxicity. : Among the seven antimicrobial agents impregnated into ADMs, 1% AA demonstrated a unique efficacy and safety profile, supporting its potential for clinical application in integrated wound dressings and implantable biomaterials for infection control in burn care.
烧伤创面感染仍然是一个重大的临床挑战，因为其会导致愈合延迟、瘢痕形成以及败血症风险，尤其是当合并耐多药（MDR）革兰氏阴性病原体和生物膜形成时。脱细胞真皮基质（ADM）广泛应用于重建和烧伤手术，但它们缺乏内在的抗菌活性，因此需要与局部用药联合使用。本研究使用体外浮游菌和生物膜烧伤创面模型，研究了浸渍各种抗菌剂的ADM的抗菌和细胞相容性特征。虽然之前已经探索过将抗菌剂掺入支架中，但据我们所知，本研究是首次在标准化体外模型中将七种临床相关抗菌剂浸渍到ADM中后直接进行比较。对七种局部抗菌剂进行了针对烧伤患者的耐多药菌和 的测试。含1%醋酸（AA）的ADM显示出卓越的抗菌活性，在浮游菌检测中实现了>7个对数级的减少，并完全抑制了生物膜。在NIH 3T3成纤维细胞细胞毒性检测中，1% AA的ADM将细胞活力维持在对照水平，表明其具有优异的生物相容性。与显示出细胞毒性的聚维酮碘、奥替尼啶和黏菌素，以及显示出低疗效的普朗托散相比，1% AA独特地将强效抗菌作用与最小毒性结合在一起。在浸渍到ADM中的七种抗菌剂中，1% AA表现出独特的疗效和安全性，支持其在烧伤护理中用于感染控制的集成伤口敷料和可植入生物材料的临床应用潜力。
