In Vitro Efficacy of Bacterial Cellulose Dressings Chemisorbed with Antiseptics against Biofilm Formed by Pathogens Isolated from Chronic Wounds.

Karolina Dydak,Grzegorz Kubielas,Karol Fijalkowski,Olga Aniołek,Adam Junka,Malwina Brożyna,Justyna Paleczny,Marzenna Bartoszewicz,Agata Dydak

doi:10.3390/ijms22083996

Abstract

Local administration of antiseptics is required to prevent and fight against biofilm-based infections of chronic wounds. One of the methods used for delivering antiseptics to infected wounds is the application of dressings chemisorbed with antimicrobials. Dressings made of bacterial cellulose (BC) display several features, making them suitable for such a purpose. This work aimed to compare the activity of commonly used antiseptic molecules: octenidine, polyhexanide, povidone-iodine, chlorhexidine, ethacridine lactate, and hypochlorous solutions and to evaluate their usefulness as active substances of BC dressings against 48 bacterial strains (8 species) and 6 yeast strains (1 species). A silver dressing was applied as a control material of proven antimicrobial activity. The methodology applied included the assessment of minimal inhibitory concentrations (MIC) and minimal biofilm eradication concentration (MBEC), the modified disc-diffusion method, and the modified antibiofilm dressing activity measurement (A.D.A.M.) method. While in 96-well plate-based methods (MIC and MBEC assessment), the highest antimicrobial activity was recorded for chlorhexidine, in the modified disc-diffusion method and in the modified A.D.A.M test, povidone-iodine performed the best. In an in vitro setting simulating chronic wound conditions, BC dressings chemisorbed with polyhexanide, octenidine, or povidone-iodine displayed a similar or even higher antibiofilm activity than the control dressing containing silver molecules. If translated into clinical conditions, the obtained results suggest high applicability of BC dressings chemisorbed with antiseptics to eradicate biofilm from chronic wounds.

Highlights

IntroductionThe disease entity referred to as chronic wound is predominantly a result of patient comorbidities such as diabetes, obesity, and disorders of the immune and/or cardiovascular system
Chronic wounds, which do not follow the natural healing trajectory, are at high risk of infection caused by microbial biofilms—settled cellular communities embedded within an external matrix and highly tolerant to therapeutic counter-measures
A number of approaches designed for chronic wound care have been proposed, including TIME(RS) [15,16,174], biofilm-based wound care strategy (BBWC) [175,176], and wound at-risk score (WAR) [11]

Summary

Introduction

The disease entity referred to as chronic wound is predominantly a result of patient comorbidities such as diabetes, obesity, and disorders of the immune and/or cardiovascular system. Long-term effects of these diseases translate into disturbances of chronic wound healing. The open cavity of a chronic wound, often filled with an abundant volume of exudate (wound fluid), which is rich in nutrients, constitutes a perfect environment for microbial development [1,2,3,4]. The presence of microorganisms in open wounds is.

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