Chronic Wound Healing and Woundbed-Biofilm Interactions in Silico

Abstract

Chronic wound healing is very seriously hampered by a profound lack of basic understanding of the influence of bacteria and bacterial biofilms on the process. Treatment could greatly benefit from a longitudinal 3D assessment of spatial and biochemical properties of woundbed and fluid using molecular techniques. Inexpensive biosensor monitoring of a range of wound parameters and tissue cellular interactions would be beneficial, specially the profiling and early detection of multi-drug resistant organisms (MDROs).Point-Of-Care (POC) wound assessment to monitor the healing process will benefit from digitization and automation of wound shape, size and volume determinations, wound color imaging including a simultaneously imaged calibration color card for digital processing, as well as imaging of pH, tissue oxygenation, vascularization and temperature distributions.After initial haemostatis, a chronic wound develops when (a)biotic influences extend the inflammation period and hamper wound repair proliferation and remodeling. For healing to proceed the influence of the species and total number of bacteria present, the fraction of persister bacteria with reduced metabolic rates, the quantity of multiple drug resistance present in a (chronic) wound, disruption by wound dressings and the biochemistry of the woundbed - bacteria interaction eg. Extra Cellular Matrix (ECM) remodeling and bacterial motility has to be understood. To gain an understanding in chronic wound characteristics for theranostic purposes we present experiments in silico using Matlab and complement results with available open-source to simulate biofilms consisting of single and multiple species with species-specific properties under several of above described conditions. This may help to better understand the outcome of clinical trials and assist in the design of POC biosensors for monitoring and aiding chronic wound healing.