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A proof‐of‐concept study of the removal of early and late phase biofilm from skin wound models using a liquid acoustic stream

A proof‐of‐concept study of the removal of early and late phase biofilm from skin wound models using a liquid acoustic stream
A proof‐of‐concept study of the removal of early and late phase biofilm from skin wound models using a liquid acoustic stream

Chronic wounds fail to progress through the normal stages of healing, with the largest remediable cause of chronicity being presence of a multi-species biofilm. Removal of biofilm from the wound environment is central to wound care. A device for mechanically removing biofilms from wounds has been devised. The removal is caused by small-scale liquid currents and shear, generated by acoustically activated microscopic air bubbles. These bubbles and acoustic waves are delivered onto the wound by a gentle liquid stream, allowing cleaning in situ and removal of debris in the run-off liquid. We have investigated if this liquid acoustic wound stream (LAWS) can remove bacterial biofilm from soft biological wound models and studied the effect of LAWS on the cellular tissues of the substrate. LAWS will efficiently remove early Pseudomonas aeruginosa biofilm from an artificial wound in a pig's trotter, 24 hours-mature biofilm of P. aeruginosa from a pre-wounded human full thickness skin model (EpiDerm FT), and 3-day mature biofilm of P. aeruginosa or Staphylococcus aureus from a porcine skin explant. Histological examinations of uninfected EpiDerm models that had been treated by LAWS and then stained with Haematoxylin and Eosin, demonstrated no damage to the human tissue, and wound diameter was smaller in the treated skin models compared with untreated samples. Immunofluorescence staining for cytokeratin 14 showed that keratinocytes had migrated further across the wound in the uninfected samples treated by LAWS. We discuss the implications for wound healing and propose further laboratory and clinical studies to demonstrate the removal of biofilm from patients with chronic leg ulcers and the impact on healing.

biofilm, cleaning, debridement, healing, stream, ultrasound, wound
1742-4801
2124-2135
Secker, T.J.
16b0a878-984f-4272-bfaa-667c7c63023a
Harling, Christopher, Charles
5aa04b75-8f5d-4754-a999-e11c84831f64
Hand, Chloe
a101eb46-71fa-4467-be21-fbf6a9d87a51
Voegeli, David
e6f5d112-55b0-40c1-a6ad-8929a2d84a10
Voegeli, David
9379133a-ed12-45a0-9c52-ed5a14c96dff
Keevil, Charles
cb7de0a7-ce33-4cfa-af52-07f99e5650eb
Leighton, Timothy
3e5262ce-1d7d-42eb-b013-fcc5c286bbae
Secker, T.J.
16b0a878-984f-4272-bfaa-667c7c63023a
Harling, Christopher, Charles
5aa04b75-8f5d-4754-a999-e11c84831f64
Hand, Chloe
a101eb46-71fa-4467-be21-fbf6a9d87a51
Voegeli, David
e6f5d112-55b0-40c1-a6ad-8929a2d84a10
Voegeli, David
9379133a-ed12-45a0-9c52-ed5a14c96dff
Keevil, Charles
cb7de0a7-ce33-4cfa-af52-07f99e5650eb
Leighton, Timothy
3e5262ce-1d7d-42eb-b013-fcc5c286bbae

Secker, T.J., Harling, Christopher, Charles, Hand, Chloe, Voegeli, David, Voegeli, David, Keevil, Charles and Leighton, Timothy (2022) A proof‐of‐concept study of the removal of early and late phase biofilm from skin wound models using a liquid acoustic stream. International Wound Journal, 19 (8), 2124-2135. (doi:10.1111/iwj.13818).

Record type: Article

Abstract

Chronic wounds fail to progress through the normal stages of healing, with the largest remediable cause of chronicity being presence of a multi-species biofilm. Removal of biofilm from the wound environment is central to wound care. A device for mechanically removing biofilms from wounds has been devised. The removal is caused by small-scale liquid currents and shear, generated by acoustically activated microscopic air bubbles. These bubbles and acoustic waves are delivered onto the wound by a gentle liquid stream, allowing cleaning in situ and removal of debris in the run-off liquid. We have investigated if this liquid acoustic wound stream (LAWS) can remove bacterial biofilm from soft biological wound models and studied the effect of LAWS on the cellular tissues of the substrate. LAWS will efficiently remove early Pseudomonas aeruginosa biofilm from an artificial wound in a pig's trotter, 24 hours-mature biofilm of P. aeruginosa from a pre-wounded human full thickness skin model (EpiDerm FT), and 3-day mature biofilm of P. aeruginosa or Staphylococcus aureus from a porcine skin explant. Histological examinations of uninfected EpiDerm models that had been treated by LAWS and then stained with Haematoxylin and Eosin, demonstrated no damage to the human tissue, and wound diameter was smaller in the treated skin models compared with untreated samples. Immunofluorescence staining for cytokeratin 14 showed that keratinocytes had migrated further across the wound in the uninfected samples treated by LAWS. We discuss the implications for wound healing and propose further laboratory and clinical studies to demonstrate the removal of biofilm from patients with chronic leg ulcers and the impact on healing.

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Accepted/In Press date: 6 April 2022
e-pub ahead of print date: 26 April 2022
Published date: December 2022
Additional Information: © 2022 The Authors. International Wound Journal published by Medicalhelplines.com Inc (3M) and John Wiley & Sons Ltd.
Keywords: biofilm, cleaning, debridement, healing, stream, ultrasound, wound

Identifiers

Local EPrints ID: 456766
URI: http://eprints.soton.ac.uk/id/eprint/456766
ISSN: 1742-4801
PURE UUID: e17d95ad-7959-4897-a9cd-a81884e99f2d
ORCID for T.J. Secker: ORCID iD orcid.org/0000-0001-7168-8592
ORCID for Christopher, Charles Harling: ORCID iD orcid.org/0000-0001-5122-2568
ORCID for David Voegeli: ORCID iD orcid.org/0000-0003-3457-7177
ORCID for Charles Keevil: ORCID iD orcid.org/0000-0003-1917-7706
ORCID for Timothy Leighton: ORCID iD orcid.org/0000-0002-1649-8750

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Date deposited: 10 May 2022 17:09
Last modified: 17 Mar 2024 02:54

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Contributors

Author: T.J. Secker ORCID iD
Author: Chloe Hand
Author: David Voegeli ORCID iD
Author: David Voegeli
Author: Charles Keevil ORCID iD

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