Infection following soft tissue injury: its role in wound healing

Ryan, Terence J.

doi:10.1097/qco.0b013e32801a3e7c

Cited by 29 publications

(17 citation statements)

References 23 publications

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“…Healing is impaired when the bacterial bioburden within a wound is greater than 10 5 bacterial cells per gram of tissue [51]. For each pathogen studied, the NO-releasing silica nanoparticles reduced the number of viable biofilm cells by at least approximately 2 orders of magnitude (i.e., 99% killing), a desirable characteristic that may lower the bioburden to levels below the 10 5 threshold, allowing normal healing to progress.…”

Section: Resultsmentioning

confidence: 99%

Anti-biofilm efficacy of nitric oxide-releasing silica nanoparticles

et al. 2009

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The ability of nitric oxide (NO)-releasing silica nanoparticles to kill biofilm-based microbial cells is reported. Biofilms of Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, and Candida albicans were formed in vitro and exposed to NOreleasing silica nanoparticles. Replicative viability experiments revealed that ≥ 99% of cells from each type of biofilm were killed via NO release, with the greatest efficacy (≥ 99.999% killing) against gram-negative P. aeruginosa and E. coli biofilms. Cytotoxicity testing demonstrated that the highest dose of NO-releasing silica nanoparticles inhibited fibroblast proliferation to a lesser extent than clinical concentrations of currently-administered antiseptics (e.g., chlorhexidine) with proven wound-healing benefits. This study demonstrates the promise of employing nanoparticles for delivering an antimicrobial agent to microbial biofilms.

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Section: Resultsmentioning

confidence: 99%

Anti-biofilm efficacy of nitric oxide-releasing silica nanoparticles

et al. 2009

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“…Aside from the underlying causative factors that result in the formation of ulcers, another important aspect in their chronicity is concurrent bacterial colonization or infection of the ulcerated area 15 . Wounds are usually colonized by the commensal skin flora but pathogenic bacterial species are also commonly implicated 16,17 .…”

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confidence: 99%

Novel noninvasive identification of biomarkers by analytical profiling of chronic wounds using volatile organic compounds

Thomas¹,

Riazanskaia²,

Cheung³

et al. 2010

Wound Repair Regeneration

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A complex profile of volatile organic compounds ("VOC"s) emanates from human skin, which is altered by changes in the body's metabolic or hormonal state, the external environment, and the bacterial species colonizing the skin surface. The aim of this study was to compare VOC profiles sampled from chronic leg wounds with those from asymptomatic skin. Five participants with chronic arterial leg ulcers were selected. VOC samples were obtained using polydimethylsilicone membranes ("skin-patch method") and analyzed by gas chromatography-ion trap mass spectrometry. Resultant data were analyzed using multivariate analysis and mass spectral matches were compared against the National Institute of Standards and Technology database. Principal component analysis showed differences in profiles obtained from healthy skin and boundary areas and between profiles from healthy skin and lesion samples (p<0.05). Partial least squares for discriminant analysis gave an average prediction accuracy of 73.3% (p<0.05). Mass spectral matching (verified against microbial swab results) identified unique VOCs associated with each sample area, wound bacterial colonization, and ingested medications. This study showcases a reproducible, robust, noninvasive methodology that is applicable in a clinical setting and may offer a new, hitherto unexplored, class of biochemical markers underpinning the metabolism of chronic wounds.

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“…The physical and emotional consequences are more difficult to measure; however, infections also often result in revision surgeries, prolonged antibiotic therapy, impaired functional outcome, and lengthy hospital stays 6. The overall outcome is increased patient morbidity and in some cases mortality 22…”

Section: Discussionmentioning

confidence: 99%

Development of a fracture osteomyelitis model in the rat femur

Robinson

Bechtold

Carlson

et al. 2010

Journal Orthopaedic Research

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ABSTRACT:Osteomyelitis contributes significantly to fracture morbidity. Our objective was to develop a model of induced implantassociated osteomyelitis following fracture repair by modifying an existing rat femur fracture model. Thirty male Sprague-Dawley rats were divided into three groups (Control, Staphylococcus aureus, S. aureus + ceftriaxone). The closed femur fracture model (right femur), stabilized with an intramedullary pin, was combined with inoculation of 10 4 colony-forming units (CFU) of S. aureus. Radiographs were obtained immediately after surgery and at weeks 1, 2, and 3 and were evaluated by individuals blinded to treatment group. At necropsy the CFU of S. aureus per femur and pin were determined and synovial tissue and blood were cultured. The fractured femur from two rats in each group was evaluated histologically. A statistically significant difference in the CFU/femur and CFU/pin was found across treatment groups, with the highest CFU in the S. aureus group and the lowest in the Control group. Cultures of synovial tissue were positive in 11/19 of inoculated limbs. Osteomyelitis was present both radiographically and histopathologically in both S. aureus groups but not in the controls. No rats were systemically ill or had positive blood cultures at the study endpoint. This model will be useful for the evaluation of treatments or prophylactics designed for use in implant-associated osteomyelitis. In recent years the increasing use of implantable medical devices, both temporary and permanent, combined with the growing number of immunocompromised individuals being treated, has lead to a greater number of nosocomial infections. 1,2 Several reports discuss device-associated infections in terms of economic and clinical consequences, 3-5 and some studies suggest that Staphylococcus spp. can be isolated from deep wound infections in 70-90% of elective orthopaedic surgery patients. 6 This issue increases in importance as the recent rise in infections associated with methacillin/oxacillin-resistant organisms that respond poorly to traditional therapies is considered. Although advances in surgical technique, implant sterilization, and infection control have helped decrease the likelihood of implant-associated osteomyelitis, most would argue that bacterial contamination and infection still occur at an unacceptable level.Bacterial biofilms have been ascribed a central role in implant-associated osteomyelitis due, in large part, to their resistance to antimicrobial therapy and clearance by the host immune system. 3,7-9 The development of a biofilm is dependent on several bacterial, substrate, and host factors and is a process that is initiated by adherence of planktonic organisms. 4,10 Regardless of their source or location, bacterial biofilms contribute significantly to increased morbidity and mortality, represent a therapeutic challenge, and are an area of tremendous interest in the research community. An important need in this area of research is an animal model that effectively mimics the clinical situat...

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Infection following soft tissue injury: its role in wound healing

Abstract: Antisepsis and antibiotics continue to provide a wealth of studies and some new technology. The evidence base, as examined by Cochrane systematic reviews, suggests that our strategy for preventing and dealing with infection of wounds needs further refinement.

Cited by 29 publications

References 23 publications

Anti-biofilm efficacy of nitric oxide-releasing silica nanoparticles

Anti-biofilm efficacy of nitric oxide-releasing silica nanoparticles

Novel noninvasive identification of biomarkers by analytical profiling of chronic wounds using volatile organic compounds

Development of a fracture osteomyelitis model in the rat femur

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