In vitro bactericidal activity of a carbohydrate polymer with zinc oxide for the treatment of chronic wounds

Abstract

<jats:p> <jats:bold>Introduction.</jats:bold> Biological adhesives and effective topical therapeutic agents that improve wound healing are urgently required for the treatment of chronic ulcers. A biodegradable adhesive based on a carbohydrate polymer with zinc oxide (CPZO) was shown to possess anti-inflammatory activity and enhance wound healing, but its bactericidal activity was unknown.</jats:p> <jats:p> <jats:bold>Aim.</jats:bold> To investigate the bactericidal activity of CPZO against bacteria commonly present as infectious agents in chronic wounds.</jats:p> <jats:p> <jats:bold>Methodology.</jats:bold> We examined the bactericidal activity of CPZO against three biofilm-producing bacteria (<jats:italic> <jats:named-content content-type="species"> <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://doi.org/10.1601/nm.11043" xlink:type="simple">Staphylococcus aureus</jats:ext-link> </jats:named-content> </jats:italic>, <jats:italic> <jats:named-content content-type="species"> <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://doi.org/10.1601/nm.3093" xlink:type="simple">Escherichia coli</jats:ext-link> </jats:named-content> </jats:italic> and <jats:italic> <jats:named-content content-type="species"> <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://doi.org/10.1601/nm.2553" xlink:type="simple">Pseudomonas aeruginosa</jats:ext-link> </jats:named-content> </jats:italic>) through three strategies: bacterial suspension, biofilm disruption and <jats:italic>in vitro</jats:italic> wound biofilm model.</jats:p> <jats:p> <jats:bold>Results.</jats:bold> In suspension cultures, CPZO had direct, potent bactericidal action against <jats:italic> <jats:named-content content-type="species"> <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://doi.org/10.1601/nm.11043" xlink:type="simple">S. aureus</jats:ext-link> </jats:named-content> </jats:italic> within 24 h, whereas <jats:italic> <jats:named-content content-type="species"> <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://doi.org/10.1601/nm.3093" xlink:type="simple">E. coli</jats:ext-link> </jats:named-content> </jats:italic> took 7 days to be eliminated. By contrast, <jats:italic> <jats:named-content content-type="species"> <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://doi.org/10.1601/nm.2553" xlink:type="simple">P. aeruginosa</jats:ext-link> </jats:named-content> </jats:italic> survived up to 14 days with CPZO. CPZO had biofilm disruption activity against clinical isolates of <jats:italic> <jats:named-content content-type="species"> <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://doi.org/10.1601/nm.11043" xlink:type="simple">S. aureus</jats:ext-link> </jats:named-content> </jats:italic> in the anti-biofilm test. Finally, in the <jats:italic>in vitro</jats:italic> wound biofilm model, CPZO dramatically reduced the bacterial viability of <jats:italic> <jats:named-content content-type="species"> <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://doi.org/10.1601/nm.11043" xlink:type="simple">S. aureus</jats:ext-link> </jats:named-content> </jats:italic> and <jats:italic> <jats:named-content content-type="species"> <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://doi.org/10.1601/nm.2553" xlink:type="simple">P. aeruginosa</jats:ext-link> </jats:named-content> </jats:italic>.</jats:p> <jats:p> <jats:bold>Conclusions.</jats:bold> Together with its previously shown anti-inflammatory properties, the bactericidal activity of CPZO gives it the potential to be a first-line therapeutic option for chronic various ulcers and, possibly, other chronic ulcers, preventing or controlling microbial infections, and leading to the healing of such complicated chronic ulcers.</jats:p>

Successful Healing of Two Very Large Pelvic-Perineal Chronic Fistulized Ulcers in A Patient with Congenital Myelomeningocele Treated with A Carbohydrate Polymer with Zinc Oxide: Case Report

“…The groups of microorganisms that usually affect pressure ulcer wounds are Staphylococcus epidermidis, Enterococcus, Streptococcus and Corynebacterium. Being Staphylococcus aureus and Pseudomonas aeruginosas the most common bacterias in pressure ulcers [19][20][21].…”

“…The use of this medical device therefore can be applied in the treatment of diabetic ulcers, chronic varicose venous ulcers and other chronic wounds. CPZO is well tolerated, has not produced any undesirable effects, is easy to prepare and apply at home and does not require refrigeration for storage nor transportation [27][28][29][30].…”

Extensive Chronic Bilateral Limbs Erysipelas with Ulcerations in an Elderly Patient After a Myocardial Infarction, Refractory to Multiple Treatments Successfully Healed with a New Medical Device - II

“…Several groups including ours, have reported the clinical finding that when patients with chronic leg ulcers were cared for at home in the manner just described, the prognosis is much improved, better compliance with the treatment, better nutrition, and healing times are reduced as are the family expenses which is extremely important when it is known that many chronic leg ulcers, are frequently experienced by families in lower social levels [3][4][5]. Previous reports have shown that the P.P.Z.O., has potent anti-inflammatory effects and reduces infiltrate of several pro-inflammatory cells, such as mononuclear cells in experiments carried out in in vivo murine models and also, antimicrobial properties even in cases where the responsible causative agent is a multi-resistant bacterium to the most commonly prescribed antimicrobials used everywhere [6].…”