Diagnosis and treatment of chronic wounds: current standards of Germany's Initiative for Chronic Wounds e. V.

Dissemond, Joachim; Bültemann, Anke; Gerber, Veronika; Jäger, Bürkard; Kröger, Knut; Münter, Christian

doi:10.12968/jowc.2017.26.12.727

Cited by 36 publications

(22 citation statements)

References 5 publications

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“…In the inflammatory phase of wound healing, vascular permeability increases, leading to plasma exudation and migration of immunocompetent cells into the injured tissue, to restore the microenvironment in terms of pH-regulation cleansing of the tissue and pathogen elimination by the host immune system 31,32 . During biofilm development, bacteria attach to the wound, proliferate and reorganize their surrounding environment to produce the EPS.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of antiseptics in a novel 3-dimensional human plasma biofilm model (hpBIOM)

Besser

Dietrich

Weber

et al. 2020

Sci Rep

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The increasing incidence of non-healing wounds constitutes a pivotal socio-economic burden. 60-80% of chronic wounds are colonized by pathogenic microorganisms within a protective extracellular polymeric substance, bearing a great challenge in wound management. Human plasma was used to prepare the biofilm model (hpBIOM), adding pathogens to the plasma and forming Coagulalike discs with integrated pathogens were produced. The antiseptics Octenisept and Lavasorb were tested regarding their antibacterial properties on clinically relevant biofilm-growing bacteria (MRSA, P. aeruginosa) in the hpBIOM. Biofilm-typical glycocalyx-formation was confirmed using immunohistochemical staining. Treatment of a 12 h-maturated biofilm with Octenisept resulted in complete eradication of P. aeruginosa and MRSA after 48 h. Lavasorb proved less effective than Octenisept in this setting. In more mature biofilms (24 h), both antiseptics showed a delayed, partially decreased efficacy. Summarized, the hpBIOM provides essential factors for a translational research approach to be used for detailed human biofilm analyses and evaluation of antimicrobial/-biofilm properties of established and novel therapeutic strategies and products. Octenisept and Lavasorb showed an attenuated efficacy in the hpBIOM compared to planktonic conditions and previously published biofilm-studies, prompting the question for the necessity of introducing new international standards and pre-admission requirements on a translational base.

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Section: Resultsmentioning

confidence: 99%

Efficacy of antiseptics in a novel 3-dimensional human plasma biofilm model (hpBIOM)

Besser

Dietrich

Weber

et al. 2020

Sci Rep

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“…diabetes, immobility or peripheral vascular insufficiencies. These wounds are from the beginning considered to become a chronic state [1].…”

Section: Introductionmentioning

confidence: 99%

Impact of probiotics on pathogen survival in an innovative human plasma biofilm model (hpBIOM)

et al. 2019

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Background Despite of medical advances, the number of patients suffering on non-healing chronic wounds is still increasing. This fact is attended by physical and emotional distress and an economic load. The majority of chronic wounds are infected of harmful microbials in a protecting extracellular matrix. These biofilms inhibit wound healing. Biofilm-growing bacteria developed unique survival properties, which still challenge the appropriate wound therapy. The present in-vitro biofilm models are not suitable for translational research. By means of a novel in-vivo like human plasma biofilm model (hpBIOM), this study systematically analysed the influence of 3 probiotics on the survival of five clinically relevant pathogenic microorganisms. Methods Human plasma was used to produce the innovate biofilm. Pathogenic microorganisms were administered to the plasma. By stimulating the production of a fibrin scaffold, stable coagula-like discs with integrated pathogens were produced. The five clinically relevant pathogens P. aeruginosa , S. aureus , S. epidermidis , E. faecium and C. albicans were challenged to the probiotics L. plantarum , B. lactis and S. cerevisiae . The probiotics were administered on top of the biofilm and the survival was quantified after 4 h and 24 h of incubation. For statistics, two-way ANOVA with post-hoc Tukey’s HSD test was applied. P-value > 0.05 was considered to be significant. Results SEM micrographs depicted the pathogens on the surface of the fibrin scaffold, arranged in close proximity and produced the glycocalyx. The application of probiotics induced different growth-reducing capacities towards the pathogens. B. lactis and S. cerevisiae showed slight bacteria-reducing properties. The survival of C. albicans was not affected at all. The most antimicrobial activity was detected after the treatment with L. plantarum . Conclusions This study successfully reproduced a novel human biofilm model, which provides a human wound milieu and individual immune competence. The success of bacteriotherapy is dependent on the strain combination, the number of probiotics and the activity of the immune cells. The eradicating effect of L. plantarum on P. aeruginosa should be emphasized.

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“…Allerdings gibt es auch Wunden, die unabhängig von dieser zeitlich orientierten Definition von Beginn an als chronisch anzusehen sind, da ihre Behandlung eine Therapie der weiterhin bestehenden Ursache erfordert. Hierzu gehören beispielsweise Wunden bei Dekubitus, diabetischem Fußsyndrom, peripherer arterieller Verschlusskrankheit (PAVK) oder chronischer venöser Insuffizienz (CVI) . Es existieren sehr viele verschiedene Ursachen, die für ein Ulcus cruris verantwortlich sein können (Tabelle ).…”

Section: Introductionunclassified

Systemische Therapien des Ulcus cruris

Dissemond

Erfurt‐Berge

Goerge

et al. 2018

J Deutsche Derma Gesell

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ZusammenfassungFür eine erfolgreiche Behandlung von Patienten mit Ulcus cruris ist es essentiell, die zugrundeliegende Ätiologie zu klären und, wenn möglich, eine kausale Therapie einzuleiten. Begleitend ist die an den Phasen der Wundheilung orientierte Wundbehandlung, meist in Verbindung mit einer Kompressionstherapie, die Therapie der Wahl. Der Stellenwert der systemischen Therapien wird in Abhängigkeit der zugrundeliegenden Genese sehr unterschiedlich und oft kontrovers beurteilt. In diesem Übersichtsartikel werden die aktuellen Aspekte der systemischen medikamentösen Therapien für Patienten mit Ulcus cruris bei den häufigen Genesen chronische venö-se Insuffizienz, periphere arterielle Verschlusskrankheit, Livedovaskulopathie, Vaskulitis, Necrobiosis lipoidica, Calciphylaxie und Pyoderma gangraenosum differenziert vorgestellt und kritisch diskutiert.Zusammenfassend kann festgestellt werden, dass es sich bei vielen der hier vorgestellten Therapien um einen Off-Label-Use handelt. Bei den häufiger vorkommenden Wundarten wie beispielsweise Ulcus cruris venosum, mixtum und arteriosum sind Medikamente für die Therapie zwar hoffnungsvolle Optionen, bisher aber in der Regel kein Behandlungsstandard. Im Gegensatz hierzu haben systemische Therapien bei den anderen hier vorgestellten Krankheitsbildern eine meist zentral wichtige Bedeutung. Es sind in erster Linie immunmodulierende und rheologisch wirksame Medikamente, die eingesetzt werden, um die Wundheilung zu beschleunigen. SummarySuccessful management of patients with leg ulcers requires identification of the underlying etiology, with subsequent initiation of causal treatment, if feasible. Supplementary measures of first choice include stage-adjusted wound treatment, usually combined with compression therapy. The significance of systemic drugs has been the subject of controversial debate, depending on the underlying cause of the condition. The present review article is therefore meant to highlight current aspects of systemic drug therapies for the treatment of leg ulcers associated with chronic venous insufficiency, peripheral arterial disease, livedoid vasculopathy, vasculitis, necrobiosis lipoidica, calciphylaxis and pyoderma gangrenosum.In summary, the majority of therapeutic options presented herein are used off-label. While systemic drugs are promising options for the more common types of wounds such as venous, mixed or arterial leg ulcers, they do not represent the

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Diagnosis and treatment of chronic wounds: current standards of Germany's Initiative for Chronic Wounds e. V.

Cited by 36 publications

References 5 publications

Efficacy of antiseptics in a novel 3-dimensional human plasma biofilm model (hpBIOM)

Efficacy of antiseptics in a novel 3-dimensional human plasma biofilm model (hpBIOM)

Impact of probiotics on pathogen survival in an innovative human plasma biofilm model (hpBIOM)

Systemische Therapien des Ulcus cruris

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