Watson Fergus, Swann Marcus J, Bezard Jeanne Saint, Chen Rui, Oropallo Alisha, Percival Steven L
5D Health Protection Group Limited, Liverpool, UK.
Comprehensive Wound Healing Center and Hyperbarics, Northwell Health, New York, New York, USA.
Wound Repair Regen. 2025 Jul-Aug;33(4):e70063. doi: 10.1111/wrr.70063.
Chronic wounds are a significant burden on patients and hospitals globally, with all exhibiting high microbial loading and biofilm. Wound cleansing is critical for removing foreign contaminants, damaged tissue and opportunistic pathogens, allowing for improved healing. This study addresses the need for a standardised in vitro preclinical model for comparing the efficacy of antimicrobial wound cleansing solutions with mechanical disruption on biofilms. A novel model was developed to emulate cleaning practises whilst standardising pressure applied and scrubbing forces applied to the wound bed. Using wounded porcine explants, microbial biofilms were formed on the surface before exposure to varying physical parameters and cleaning solutions. The results showed that both increased pressure and scrubbing duration had a positive impact on biofilm removal, demonstrating > 1 log reduction in microbial levels. The model was able to show the significant difference in cleaning solutions between saline and an antimicrobial-based solution (HClO), > 4.5 log reduction, whilst under identical conditions. Confocal laser microscopy, using fluorescent viability stains, provided supporting evidence of biofilm disruption using gauze. The model's adaptability and versatility help to provide clinically relevant in vitro evidence and effective comparisons of wound cleansing agents on biofilms through the standardisation of different cleaning techniques.
慢性伤口给全球患者和医院带来了沉重负担，所有慢性伤口都表现出高微生物负荷和生物膜。伤口清洁对于清除外来污染物、受损组织和机会性病原体至关重要，有助于促进愈合。本研究满足了对一种标准化体外临床前模型的需求，该模型用于比较抗菌伤口清洁溶液与机械破坏对生物膜的疗效。开发了一种新型模型来模拟清洁操作，同时对施加在伤口床上的压力和擦洗力进行标准化。使用受伤的猪外植体，在暴露于不同物理参数和清洁溶液之前，在其表面形成微生物生物膜。结果表明，压力增加和擦洗持续时间延长均对生物膜清除有积极影响，微生物水平降低超过1个对数。该模型能够显示在相同条件下，生理盐水和基于抗菌剂的溶液（HClO）之间清洁溶液的显著差异，微生物水平降低超过4.5个对数。使用荧光活性染料的共聚焦激光显微镜提供了使用纱布破坏生物膜的支持证据。该模型的适应性和多功能性有助于通过不同清洁技术的标准化，提供临床相关的体外证据，并对伤口清洁剂对生物膜的效果进行有效比较。
