Biofilm detection by wound blotting can predict slough development in pressure ulcers: A prospective observational study

Gojiro Nakagami, Gregory Schultz, Daniel J. Gibson, Priscilla Phillips, Aya Kitamura, Takeo Minematsu, Tomomitsu Miyagaki, Akitatsu Hayashi, Sanae Sasaki, Junko Sugama, Hiromi Sanada

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)

Abstract

Bacteria have been found to form multicellular aggregates which have collectively been termed “biofilms.” It is hypothesized that biofilm formation is a means to protect bacterial cells including protection form the immune response of humans. This protective mechanism is believed to explain persistent chronic wound infections. At times, the biofilms are abundant enough to see, and remove by simple wiping. However, recent evidence has shown that the removal of these visible portions are not sufficient, and that biofilms can continue to form even with daily wiping. In this work, we tested an approach to detect the biofilms which are present after clinically wiping or sharp wound debridement. Our method is based on a variation of impression cytology in which a nitrocellulose membrane was used to collect surface biofilm components, which were then differentially stained. In this prospective study, members of an interdisciplinary pressure ulcer team at a university hospital tested our method's ability to predict the generation of wound slough in the week that followed each blotting. A total of 70 blots collected from 23 pressure ulcers produced 27 wounds negative for staining and 43 positive. In the negative blots 55.6% were found to have decreased wound slough, while 81.4% with positive staining had either increase or unchanged wound slough generation. These results lead to an odds ratio of positive blotting cases of 9.37 (95% confidence intervals: 2.47–35.5, p = 0.001) for slough formation; suggesting that the changes in wound slough formation can be predicted clinically using a non-invasive wound blotting method.

Original languageEnglish
Pages (from-to)131-138
Number of pages8
JournalWound Repair and Regeneration
Volume25
Issue number1
DOIs
Publication statusPublished - 01-01-2017
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Dermatology

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