May 2013
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Review of Small Intestine Submucosa Extracellular Matrix Technology in Multiple Difficult-To-Treat Wound Types
Index: WOUNDS. 2013;25(5):113–120.
Abstract: The extracellular matrix (ECM) of the dermis is a critical structural component required for normal wound healing. The ECM, along with its key signaling components, provides the support structure necessary for fibroblasts, immune cells, and keratinocytes. When ECM activity is dysfunctional, the normal wound healing process is compromised, leading to slow, irregular repair, which may result in the development of chronic wounds. To replace dysfunctional ECM, several strategies have been developed to promote the development of a proper ECM or to replace the ECM entirely. One such method is the use of small intestine submucosa (SIS) to replace the nonfunctional ECM. Small intestine submucosa closely mimics the normal ECM of the human dermis despite being of porcine derivation. Small intestine submucosa wound matrix is an example of an available ECM-based biomaterial that has demonstrated improvements in wound management in the clinical setting.
Key words: extracellular matrix, wound healing, small intestine submucosa
Original Research »
A Prospective Randomized Trial Comparing Subatmospheric Wound Therapy With a Sealed Gauze Dressing and the Standard Vacuum-Assisted Closure Device: A Supplementary Subgroup Analysis of Infected Wounds
Index: WOUNDS. 2013;25(5):121–130.
Abstract: Introduction. Subatmospheric pressure wound therapy (SAWT) is commonly used to manage infected wounds. However, this practice remains controversial because the safety and efficacy of the technique has not been carefully documented. Methods. The authors assessed the safety and efficacy of a sealed gauze dressing with wall suction applied (GSUC) compared to vacuum assisted-closure (VAC), both soaked with topical antimicrobials. Subjects included 31 hospitalized patients with acutely infected wounds compared with 56 patients with noninfected wounds. Results. There were significant reductions in wound surface area and volume in both infected and noninfected groups; there was no significant difference in the rate of change observed in the GSUC vs the VAC arms of the study. In the infected group, the reduction in wound surface area was 4.4% per day for GSUC and 4.8% per day for VAC. Wound volume was 7.8% per day for GSUC, and 9.7% per day for VAC (P < 0.001 for all). Evidence of wound infection in all patients, regardless of treatment group, resolved by 96 hours of onset of treatment, and there were no complications specifically related to the use of a sealed dressing over infected wounds. Conclusion. Gauze dressing with wall suction and VAC therapy can be used in selected acute, infected wounds and both methods of treatment appear to be similarly effective for reducing wound surface area and volume.
Key words: subatmospheric pressure wound therapy, vacuum-assisted closure, gauze dressing with suction, infection
Original Research »
Inactivation of Mycobacterium smegmatis Following Exposure to 405-Nanometer Light from a Supraluminous Diode Array
Index: WOUNDS. 2013;25(5):131–135.
Abstract: Objective. To determine the potential for blue light (405 nm) to produce a bactericidal effect on Mycobacterium smegmatis. Additionally, the study sought to evaluate a series of doses in terms of their respective bactericidal capabilities. Background Data. The effect of blue light on Staphylococcus aureus has been studied and it was found that a bactericidal outcome can be obtained with low doses of blue light.1 Methods. M. smegmatis was tested because of the recent appearance of the Mycobacterium family of organisms as a public health threat among persons receiving tattoos. The organism was treated in vitro with 405 nm light emitted from a supraluminous diode (SLD) array. Doses of 60 Jcm-2, 90 Jcm-2, 120 Jcm-2, 150 Jcm-2, 180 Jcm-2, 215 Jcm-2, and 250 Jcm-2 were used. Colony counts were performed and compared to untreated controls using Student t tests and one-way ANOVA with Tukey post hoc analysis. Results. The results revealed statistically significant bactericidal effects of the blue light on M. smegmatis (F6, 28 = 50.518, P = 0.000). The treatment reduced the number of bacterial colonies at all doses, but 60 Jcm-2 did not produce a statistically significant kill rate. All other doses produced a significant kill rate with 120 Jcm-2, 150 Jcm-2, and 215 Jcm-2, demonstrating the most effective kill rates of 98.3%, 96.7%, and 100%, respectively. Conclusions. Appropriate doses of 405 nm light from an SLD array can kill M. smegmatis in vitro. A dose of at least 100 Jcm-2 dose is needed for the most effective inactivation of the organism. The dose response for this organism to blue light is not linear. Some degree of effectiveness is lost at 180 Jcm-2 and 250 Jcm-2.
Key words: blue light, Mycobacterium, bactericidal effect
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