Abstract
BackgroundThe colonization of burn wounds by Pseudomonas aeruginosa can lead to septic shock, organ injuries, and high mortality rates. We hypothesized that negative pressure wound therapy (NPWT) would decrease invasion and proliferation of P. aeruginosa within the burn wound and reduce mortality.MethodsThermal injuries were induced in anesthetized mice, and P. aeruginosa was applied to the wound surface for 24 h. After removing the burn eschar and debridement, the animals were subjected to either NPWT or wet-to-dry (WTD) treatment protocols. The bacterial loads on the wound surface were assessed during 7 d of treatment, as were the concentrations of inflammatory cytokines in the peripheral blood samples. Survival was monitored daily for 14 d after burn induction. Finally, samples of wounded skin, lung, liver, and kidney were collected and subjected to histopathological examination.ResultsApplying P. aeruginosa to the burn wound surface led to sepsis. During early stages of treatment, NPWT reduced the mortality of the septic animals and levels of P. aeruginosa within the burn wound compared with WTD-treated animals. Circulating levels of cytokines and cytoarchitectural abnormalities were also significantly reduced via NPWT.ConclusionsOur data indicate that NPWT inhibits the invasion and proliferation of P. aeruginosa in burn-wounded tissue and decreases early mortality in a murine model of burn-wound sepsis. These therapeutic benefits likely result from the ability of NPWT to decrease bacterial proliferation on the wound surface, reduce cytokine serum concentrations, and prevent damage to internal organs.
Highlights
For patients with burn wounds, Pseudomonas aeruginosa (P. aeruginosa) is often the etiological agent of serious infection [1]
Because each test was independently repeated three times, 6 mice were used for the detection of bioluminescent bacteria in the wound, 36 mice were used for the bacterial cultures, and 180 mice were used for the cytokine analysis
Bacterial Bioluminescence At 24 h after the wounds were infected with P. aeruginosa, baseline quantities of bacteria were determined
Summary
For patients with burn wounds, Pseudomonas aeruginosa (P. aeruginosa) is often the etiological agent of serious infection [1]. Once the wound has been colonized with P. aeruginosa, this bacterium rapidly proliferates within the damaged tissue This event has high mortality rates and often leads to a disseminated infection, which can result in bacteremia, and septic shock [2]. The treatment of these infections is confounded by the resistance (both innate and acquired) of P. aeruginosa to many antimicrobials [3]. Many studies have demonstrated that P. aeruginosa rapidly proliferates within burned tissue, eventually spreading throughout the body via the circulatory system [5,7,8,9] This process induces uncontrolled inflammation, sepsis, and multiorgan failure. We hypothesized that negative pressure wound therapy (NPWT) would decrease invasion and proliferation of P. aeruginosa within the burn wound and reduce mortality
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