078 An ORC/Collagen Matrix ConTaining Silver and Microbial Imbalances in the Chronic Wound

Abstract

Delayed healing can result for a number of reasons; however, one important factor in the wound healing process is the role of bacteria. An imbalance in the wound bioburden may lead to infection, and thereby severely delay healing. Thus to ensure healing progresses in a timely manner, it is necessary to maintain a healthy microbial balance and prevent any impending infection. Dermal cells such as fibroblasts and keratinocytes generate numerous chemokines and growth factors that regulate the immune response and the phases of healing. While topical antiseptics and antimicrobials can kill bacteria and are therefore used to help manage infection in wounds, they may also be cytotoxic to these important cell types. Cytotoxicity is acceptable when overt clinical infection is present, due to a greater need for bacterial balance. However, clinical signs of infection in chronic wounds may not be present, making it difficult to correctly determine diagnosis and appropriate use of these antimicrobial products. In these cases, a product which addresses both the antibacterial action of topical antiseptics/antimicrobials and their impact on key healing factors, (i.e., cytotoxicity to host cells), could help reduce the incidence of wound infection without impacting the rate of healing. In this study we investigated the effect of silver-ORC and an ORC/collagen matrix containing silver-ORC on human dermal fibroblast proliferation. The antimicrobial properties of the dressing was also investigated, in in vitro studies using common bacterial wound pathogens. While other silver-releasing dressings address the bioburden of nonhealing wounds, their in vitro cytotoxicity suggests that the rate of healing may not be optimal if the presence of infection is questionable. In contrast this in vitro work suggests the ORC/collagen matrix containing silver-ORC is not cytotoxic, but is still capable of controlling wound pathogens, suggesting it may be used on a broad spectrum of wounds independent of their bacterial bioburden.