Dialkyl Carbamoyl Chloride–Coated Dressing Prevents Macrophage and Fibroblast Stimulation via Control of Bacterial Growth: An In Vitro Assay

Abstract

In this work, we evaluated the direct effect of a dialkyl carbamoyl chloride (DACC)-coated dressing on Staphylococcus aureus adhesion and growth in vitro, as well as the indirect effect of the dressing on fibroblast and macrophage activity. S. aureus cultures were treated with the dressing or gauze in Müller-Hinton medium or serum-supplemented Dulbecco’s modified Eagle medium. Bacterial growth and attachment were assessed through colony-forming units (CFU) and residual biomass analyses. Fibroblast and macrophage co-cultures were stimulated with filtered supernatants from the bacterial cultures treated with the DACC-coated dressing, following which tumor necrosis factor (TNF)-α/transforming growth factor (TGF)-β1 expression and gelatinolytic activity were assessed by enzyme-linked immunosorbent assays (ELISA) and zymography, respectively. The DACC-coated dressing bound 1.8–6.1% of all of the bacteria in the culture. Dressing-treated cultures presented biofilm formation in the dressing (enabling mechanical removal), with limited formation outside of it (p < 0.001). Filtered supernatants of bacterial cultures treated with the DACC-coated dressing did not over-stimulate TNF-α or TGF-β1 expression (p < 0.001) or increase gelatinolytic activity in eukaryotic cells, suggesting that bacterial cell integrity was maintained. Based on the above data, wound caregivers should consider the use of hydrophobic dressings as a first option for the management of acute or chronic wounds.

Experimental and clinical evidence for DACC-coated dressings: an update

“…they proposed that no chemically or pharmacologically ac ve substances are released from the DACCcoated dressing, 32 and providing addi onal evidence previously proposed as the mode of ac on for DACC-coated dressings. 1,2 The findings of Ortega-Peña et al 33 that S. aureus binds directly to DACCcoated dressing supports the previously proposed physical removal mode of ac on, 1,2 and the authors proposed that the hydrophobic nature of the DACC-coated dressing enabled bacterial binding and physical removal of bacteria, and that this removal maintained bacterial structural integrity. The physical removal of intact bacteria reduces the poten al for the release of molecules toxic for cells (e.g., bacterial endotoxins) involved in the wound healing response.…”

“…31 Overall, 2/5 (40%) clinical studies featured outcomes related to an microbial effec veness (including treatment or preven on), 27,30 2/5 (40%) studies featured outcomes related to wound progression or healing, 28,30 and 2/5 (40%) study included outcomes related to cost-effec veness. 28,29 Of the laboratory studies, 2/4 (50%) studies demonstrated the effects of DACC-coated dressing bacteria, 32,33 2/4 (50%) studies detailed the effect of the dressing on cells important on the wound healing response (kera nocytes, fibroblasts, and macrophages), 33,34 and 1/4 (25%) study describes the interac on between DACC-coated dressing and bacterially produced and clinically important endotoxin. 35 The in vitro and clinical evidence iden fied for this review update are summarised in Tables 1 and 2, respec vely.…”

“…As stated previously, bacterially derived endotoxins that are released as a result of bacterial killing causes inflamma on and can impair wound healing, [40][41][42] Ortega-Peña et al 33 reported results of an in vitro study examining DACC-coated dressing. The authors demonstrated that filtered supernatants of bacterial cultures treated with DACC-coated dressing did not over-s mulate the produc on of several growth factors (tumor necrosis factor (TNF)-alpha, transforming growth factor (TGF)-beta1) or increase gela noly c ac vity in fibroblast and macrophage co-cultures, and the authors speculated that the physical removal of bacteria by DACC-coated dressings without killing minimised the risk of the release of molecules pro-inflammatory or toxic for cells important for healing.…”

“…The authors also demonstrated that varying pH did not influence an bacterial performance. Ortega-Peña et al 33 reported the direct effect of a DACC-coated dressing on S. aureus adhesion and growth in a laboratory-based study. A piece of DACC-coated dressing or co on gauze was placed in each well of a 24-well culture plate and incubated for 3 hours in S. aureus cultures.…”

Disinfection, Sterilization, and Decontamination of Pathogens in Medicine

“…The article by Silvestre Ortega-Peña et al, titled "Dialkyl Carbamoyl Chloride-Coated Dressing Prevents Macrophage and Fibroblast Stimulation via Control of Bacterial Growth: An In Vitro Assay" [25] reported that a dialkyl carbamoyl chloride (DACC)-coated dressing attaches to Staphylococcus aureus and induces growth. Intriguingly, the supernatants of S. aureus cultures incubated with the DACC-coated dressing were found to downregulate inflammation associated with the cytokine overexpression of TNF-α and TGF-β1 as well as diminishing gelatinase activity in macrophage cultures and fibroblast/macrophage co-cultures.…”