Wound Healing Society

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Reduction Of Infection And Tissue Loss In A Porcine Model Of Prolonged Field Care
Kristo Nuutila1, Lu Yang1, Josh Grolman2, Michael Broomhead1, Andrew Onderdonk3, David Mooney2, Elof Eriksson1.
1Applied Tissue Technologies, Hingham, MA, USA, 2Harvard University, Boston, MA, USA, 3Brigham and Women's Hospital, Boston, MA, USA.

Background. In the battlefield, management of high-energy blast injuries and burns is complicated by high rates of soft tissue contamination and prolonged delays to definitive stateside care. Serious burns often result in invasive infection that can progress to septic shock and death. A critical factor in burn recovery is the time from injury to delivery of antimicrobial therapy and surgical treatment of the burn wounds. The purpose of this project was to validate the use of a hydrogel formulated with very high concentrations of antibiotics for the immediate topical care of burn wounds and determine if this treatment prevents or reduces experimentally induced infections if standard treatment is delayed for up to 7 days. Methods. Porcine partial-thickness burn wounds were created and infected with either A. baumannii, C. albicans, P. aeruginosa or S. aureus. Subsequently the burn wounds were treated topically for 7 days with a high concentration of antibiotics (1000x MIC: Minocycline, Gentamicin, Vancomycin and 10xMIC Diflucan) formulated in an alginate hydrogel. The antibiotic hydrogel treatment was compared to non-treated (blank hydrogel), silver sulfadiazine cream treated burns and to IV antibiotic treatment. On day 7 the burn wounds were harvested for quantitative bacteriology and histology. Results. The quantitative bacteriology analyses demonstrated that our antibiotic hydrogel with all the used antibiotics (n=6 wounds/group) decreased the number of bacteria in the tissue in comparison to controls. E.g 1000xMIC minocycline gel treated burns contained 1.3 log10 CFU/g and IV minocycline treated burns 6.2 log10 CFU/g bacteria (p<0.001). Histology showed that the hydrogel treatment reduced depth of tissue necrosis and wound area in comparison to controls. E.g depth of necrosis in 1000xMIC minocycline treated burns was 0.3 mm whereas the depth in the IV treated burns was 0.7 mm (p<0.01). Conclusion. It is concluded that antibiotic hydrogel stopped injury progression, minimized tissue loss and eradicated infection.


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