Biofilm maturity studies indicate sharp debridement opens a time-dependent therapeutic window
Biofilm maturity studies indicate sharp debridement opens a time-dependent therapeutic window
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生物膜成熟度研究表明，锐性清创打开了一个随时间变化的治疗窗口
DOI：
10.12968/jowc.2010.19.8.77709
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发表时间：
2010-08-01
影响因子：
1.9
通讯作者：
Dowd, S. E.
中科院分区：
文献类型：
--
作者：
Wolcott, R. D.;Rumbaugh, K. P.;Dowd, S. E.
目的：要调查的假设，新形成的伤口生物膜（或bidens）更容易抗菌treatment.Method：四个独立的和不同的模型进行了四个独立的生物膜研究实验室，以评估随着时间的推移，抗菌治疗的生物膜的阻力。这些包括一个滴流生物膜模型沿着沿水清创研究，猪皮肤打孔活检离体模型，小鼠慢性伤口模型和临床纵向清创study.Results：所有四个模型表明，在第一个24小时内，生物膜社区更容易受到选定的抗生素，并成熟后长达48小时变得越来越宽容。在每个模型中，至少有24小时的时间段，其中生物膜对抗生素更具耐药性。所用的每个模型显示生物膜/负荷对庆大霉素的抗性显著降低长达24小时，置信区间至少为95%。在每个模型的电阻增加了48小时，并达到了原始的电阻水平由72 hours.Conclusion：这些数据表明，原则的生物膜为基础的伤口护理，沿着使用连续清创术不断地去除成熟的生物膜，其次是生物膜伤口管理策略，包括局部抗生素，而生物负载仍然是不成熟的，更容易受到影响，是有效的。
Objective: To investigate the hypothesis that newly formed wound biofilms (or bioburdens) are more susceptible to antimicrobial treatment.Method: Four separate and distinct models were performed by four separate biofilm research laboratories to evaluate the resistance of biofilms to antimicrobial treatments over time. These included a drip-flow biofilm model along with a hydrodebridement study, a porcine skin punch biopsy ex vivo model, a mouse chronic wound model and clinical longitudinal debridement study.Results: All four models showed that, within the first 24 hours, the biofilm community was more susceptible to the selected antibiotics, and after maturing for up to 48 hours became increasingly tolerant. In each model, there was at least a 24-hour period in which the biofilms were more resistant to antibiotics. Each of the models utilised showed a significant decrease in the resistance of the biofilm/burden to gentamicin for up to 24 hours with a confidence interval of at least 95%. The resistance increased in each of the models by 48 hours and reached original resistance levels by 72 hours.Conclusion: These data suggest the principles of biofilm-based wound care, along with the use of serial debridement to continually remove mature biofilm, followed by biofilm wound management strategies, including topical antibiotics while the bioburden is still immature and more susceptible, are valid.