Novel Diagnostic Technologies and Therapeutic Approaches Targeting Chronic Wound Biofilms and Microbiota.
Novel Diagnostic Technologies and Therapeutic Approaches Targeting Chronic Wound Biofilms and Microbiota.
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DOI：
10.1007/s13671-022-00354-9
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发表时间：
2022-06
影响因子：
1.6
通讯作者：
Pastar, Irena
中科院分区：
文献类型：
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作者：
Chen, Vivien;Burgess, Jamie L;Verpile, Rebecca;Tomic-Canic, Marjana;Pastar, Irena
提供慢性伤口生物膜和致病微生物群的最新诊断方法和治疗方法的最新发展概述。生物膜感染是慢性伤口愈合受损的主要原因之一，包括糖尿病足溃疡、腿部静脉溃疡、压疮和无法愈合的外科伤口。作为一个有组织的微环境，通常包括多种微生物物种，生物膜通过允许逃避宿主免疫反应和抗菌治疗的方法发展和持续存在。抑制和减少生物膜感染已被证明可以改善伤口愈合的结果。然而，慢性伤口生物膜的治疗是一个挑战，因为准确、容易获得的临床鉴定方法有限，而且生物膜对治疗剂有保护作用。在这里，我们回顾了最近在临床环境中用于微创、增强生物膜检测的视觉标记的方法。我们概述了伤口护理治疗的进展，包括抗生素膜作用的研究，如水手术和超声清创，负压伤口滴注治疗，抗菌肽，纳米颗粒和纳米载体，电敷料和噬菌体治疗。目前生物膜靶向治疗的证据主要是在临床前研究中进行的，许多治疗方法的临床研究有限。改善生物膜的识别、监测和治疗需要扩展护理点可视化方法，并在可靠的临床试验中增加对抗生素膜疗法的评估。
To provide an up-to-date overview of recent developments in diagnostic methods and therapeutic approaches for chronic wound biofilms and pathogenic microbiota. Biofilm infections are one of the major contributors to impaired wound healing in chronic wounds, including diabetic foot ulcers, venous leg ulcers, pressure ulcers, and nonhealing surgical wounds. As an organized microenvironment commonly including multiple microbial species, biofilms develop and persist through methods that allow evasion from host immune response and antimicrobial treatments. Suppression and reduction of biofilm infection have been demonstrated to improve wound healing outcomes. However, chronic wound biofilms are a challenge to treat due to limited methods for accurate, accessible clinical identification and the biofilm’s protective properties against therapeutic agents. Here we review recent approaches towards visual markers for less invasive, enhanced biofilm detection in the clinical setting. We outline progress in wound care treatments including investigation of their antibiofilm effects, such as with hydrosurgical and ultrasound debridement, negative pressure wound therapy with instillation, antimicrobial peptides, nanoparticles and nanocarriers, electroceutical dressings, and phage therapy. Current evidence for biofilm-targeted treatments has been primarily conducted in preclinical studies, with limited clinical investigation for many therapies. Improved identification, monitoring, and treatment of biofilms require expansion of point-of-care visualization methods and increased evaluation of antibiofilm therapies in robust clinical trials.