Efficacy of Concentrated Surfactant-Based Wound Dressings in Wound Repair and Biofilm Reduction.

Abstract

Objective: This study was set up to evaluate the efficacy of a concentrated surfactant-based wound dressing (with and without silver sulfadiazine [SSD]) on wound repair, by investigating their ability to enhance human dermal fibroblast proliferation and viability. In addition, the wound dressings were evaluated for their ability to suppress biofilms in a three-dimensional (3D) in vitro wound biofilm model and modulate the inflammatory cytokine interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNFα). Approach: Problematic biofilms are well known to affect fibroblast and keratinocyte viability. To assess wound repair and inflammatory cytokine modulation, a direct cytotoxicity assay and a 3D keratinocyte-fibroblast model were employed. Results: At 1 and 7 days posttreatment, the non-antimicrobial dressing was noncytotoxic and the antimicrobial dressing was moderately cytotoxic to adult human dermal fibroblasts cells. Within the 3D wound model, the biofilm demonstrated a decelerating effect on wound closure and a decrease in viable cells. When the non-antimicrobial- and antimicrobial-based concentrated surfactant-based wound dressing was applied to the wound model, reduced biofilm was observed. The application of wound dressings to the biofilm-infected wound also resulted in a reduction of IL-6 and TNFα. The concentrated surfactant-based wound dressing without an antimicrobial was shown to enhance cellular viability and migration. Innovation and Conclusion: We have demonstrated the ability of a surfactant-based wound dressing to minimize the deleterious effects of a wound biofilm, modulate the secretion of inflammatory cytokines, and enhance cellular proliferation in a biofilm-infected wound model. Furthermore, the non-antimicrobial-based concentrated surfactant dressings did not affect cellular viability and therefore represents a multifaceted approach to the treatment of wounds infected with biofilms.