Brave new world.
For those who follow my blog, you know about biofilm. Biofilm is a thin, invisible layer on wounds which keep them from healing. They are resistant to treatment; they communicate together so resistance to antibiotics is common; they cause delay or nonhealing of wounds; and they increase inflammation and scarring. For more information on biofilm, please see my blogs here.
So how are we treating these wounds? Currently we treat with IV antibiotics, topical antibiotics, sharp debridement (we surgically take off dead or infected tissue), and dressing changes. But many bacteria are becoming drug resistant. Many biofilms have poor blood supply, so antibiotics don’t get to the bacteria. The bacteria can morph rapidly, so they outwit our treatments.
Our recent Plastic and Reconstructive Surgery Febrary 2013 Journal had an article “Bacteriophage Therapy for Staph Aureus Biofilm Infected Wounds: A new Approach to Chronic Wound Care.”
Phew! What a title, eh? And why should you care? Patients at risk for biofilm:
- Anyone who is diabetic, a smoker, has high cholesterol, high blood pressure or another reason for decreased bloody supply to heal wounds
- Anyone who receives a foreign object into their body: a hip prosthesis, breast implant, a surgical plate or screw. When your hip prosthetic loosens up or you get a capsular contracture around your breast implant these are signs of biofilm.
Study
- They used topical bacteriophages
- BACTERIOPHAGE: are viruses of bacteria which infect and kill bacteria. They are harmless to human cells
- They looked at a rabbit ear model where it was infected with Staph Aureus (a common skin bacteria and issue with healing). They compared those treated with nothing, sharp debridement, bacteriophage, or both debridement and bacteriophage.
- Findings?
- Combination of both treatments significantly reduced bacterial counts and improved all measured wound healing parameters. It decreased bacterial count by 99%. There was better new epitheilial cells and granulation tissue.
- The bacteriophage was effective when biofilm is disrupted (by sharp debridement or mutation of the film)
Love the new work. We continue to learn more to make us effective at treating these issues. I know many of you don’t think this is relevant to you. But anyone with a sore which won’t heal or has any kind of implant or prosthetic in their body should care about biofilm. There are other studies looking at soaking implants in bacteriophage solutions prior to implanting them. I will keep you updated as the studies continue….