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Lv Y, Chen Z, Yang Z, Yang W, Chu W, Tu Y, Xie J, Cao D. Evaluation of the red & blue LED effects on cutaneous refractory wound healing in male Sprague-Dawley rat using 3 different multi-drug resistant bacteria. Lasers Surg Med 2022; 54:725-736. [PMID: 34989417 DOI: 10.1002/lsm.23515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/24/2021] [Accepted: 12/21/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVES Photobiomodulation (PBM) is widely used in clinical therapy, and is an effective approach to resist the bacterial infection of the cutaneous wound and modulate the wound healing process. Due to the several detriments of lasers, Red & Blue LED light (RBLL) may be a more viable light source. This study is aimed to evaluate and compare the therapeutic effect of RBLL light on different multi-drug resistant (MDR) bacteria in vitro and male Sprague-Dawley (SD) rat refractory MDR infection wound model in vivo. MATERIALS AND METHODS Methicillin-resistant Staphylococcus aureus (MRSA), Extended-spectrum β-lactamases -producing Escherichia coli (ESBLs-Eco), and the MDR Pseudomonas aeruginosa (MDR-Pae) were employed to evaluate the antibacterial effects of the Blue LED light in vitro. Effects of RBLL on in vivo wound healing were evaluated by analyzing time to closure, wound score, semi-quantitative test for bacterial culture, histopathological examination and Masson staining of skin tissue, immunohistochemical (IHC) staining, and western blot analysis (WB) of wound tissue. RESULTS Blue LED light inhibited MRSA, ESBLs-Eco, and MDR-Pae in vitro study. In vivo, RBLL accelerated wound healing, reduced levels of pathogenic bacteria on the wound surface while increasing the blood supply to the wound surface and inhibiting the excessive inflammatory response. CONCLUSION RBLL showed a great potential gain for the treatment of MDR bacterial infected wounds, suggesting PBM therapy is an inexpensive, convenient, pain-free, and safe therapeutic intervention for refractory MDR infection wounds.
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Affiliation(s)
- Yang Lv
- Department of Plastic and Reconstructive Surgery, The Second Hospital of Anhui Medical University, Anhui Province, P.R. China
| | - ZengHong Chen
- Department of Plastic and Reconstructive Surgery, The Second Hospital of Anhui Medical University, Anhui Province, P.R. China
| | - ZhiGuo Yang
- Department of Plastic and Reconstructive Surgery, The Second Hospital of Anhui Medical University, Anhui Province, P.R. China
| | - WenYu Yang
- Department of Oral and Maxillofacial Surgery, The Second Hospital of Anhui Medical University, Anhui Province, P.R. China
| | - WenWen Chu
- Department of Clinical Laboratory, The Second Hospital of Anhui Medical University, Anhui Province, P.R. China
| | - YiQian Tu
- Department of Plastic and Reconstructive Surgery, The Second Hospital of Anhui Medical University, Anhui Province, P.R. China
| | - Juan Xie
- Department of Plastic and Reconstructive Surgery, The Second Hospital of Anhui Medical University, Anhui Province, P.R. China
| | - DongSheng Cao
- Department of Plastic and Reconstructive Surgery, The Second Hospital of Anhui Medical University, Anhui Province, P.R. China
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Guan H, Zhang D, Ma X, Lu Y, Dong J, Niu Y, Liu Y, Lu S, Xu J, Tang J. Efficacy and safety of CO 2 laser in the treatment of chronic wounds: A Retrospective Matched Cohort Trial. Lasers Surg Med 2021; 54:490-501. [PMID: 34778981 DOI: 10.1002/lsm.23490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/27/2021] [Accepted: 11/01/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Treating chronic cutaneous wounds is challenging, and debridement is a central concept in treating them. Studies have shown that CO2 laser debridement can control local infection and promote the wound healing process. The present study aimed to investigate the efficacy and safety of fully ablative CO2 laser debridement compared to routine surgical debridement in the treatment of chronic wounds. METHODS The retrospective cohort study was conducted on patients with chronic (>1 month) cutaneous wounds (≥1 cm2 ) between December 1, 2017, and December 1, 2020, in the Wound Healing Center at Shanghai Ruijin Hospital, China. Patients treated with CO2 laser debridement with a DEKA SmartXide2 C80 (DEKA) (the CO2 laser group) were compared with matched control patients with similar baseline characteristics who had undergone routine surgical debridement (the routine group). The primary outcome was time-to-heal (days) for chronic wounds in two groups, and secondary outcomes included the wound area and BWAT (Bates-Jensen wound assessment tool) score before treatment, and at 1, 2, 3, and 4 weeks after treatment. RESULTS The study included 164 patients (82 in the CO2 laser group and 82 matched in the routine group). The time-to-heal for patients in the CO2 laser group (41.30 ± 17.11) was significantly shorter than that of the patients in the routine group (48.51 ± 24.32) (p = 0.015). At 3 and 4 weeks after treatment, the absolute wound area of the CO2 laser group was significantly smaller than that of the routine group. Also, the CO2 laser group exhibited a significantly lower relative area at 2, 3, and 4 weeks after treatment. The CO2 laser group yielded significantly lower BWAT scores at 2, 3, and 4 weeks after treatment. Additionally, the relative BWAT score was significantly lower in the CO2 laser group than the relative scores in the routine group at 2, 3, and 4 weeks after treatment. No adverse events related to the treatments were observed in either group during the study period. CONCLUSIONS The present study has shown that fully ablative CO2 laser debridement has several advantages over routine sharp surgical debridement. It is superior at ameliorating wound status and reducing wound area, and it also significantly reduces the time-to-heal for chronic wounds, without causing any adverse events.
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Affiliation(s)
- Haonan Guan
- Department of Burn, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Wound Healing Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Di Zhang
- Department of Burn, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Wound Healing Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xian Ma
- Department of Burn, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Wound Healing Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yechen Lu
- Department of Burn, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Wound Healing Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jiaoyun Dong
- Department of Burn, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Wound Healing Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yiwen Niu
- Department of Burn, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Wound Healing Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yingkai Liu
- Department of Burn, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Wound Healing Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shuliang Lu
- Department of Burn, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Wound Healing Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jiping Xu
- Department of Orthopaedics, Shanghai Fengxian District Center Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jiajun Tang
- Department of Burn, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Wound Healing Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Guan H, Dong W, Lu Y, Jiang M, Zhang D, Aobuliaximu Y, Dong J, Niu Y, Liu Y, Guan B, Tang J, Lu S. Distribution and Antibiotic Resistance Patterns of Pathogenic Bacteria in Patients With Chronic Cutaneous Wounds in China. Front Med (Lausanne) 2021; 8:609584. [PMID: 33816517 PMCID: PMC8010674 DOI: 10.3389/fmed.2021.609584] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/22/2021] [Indexed: 12/17/2022] Open
Abstract
Background: To determine the distribution and antimicrobial susceptibility pattern of pathogenic bacteria in patients with chronic cutaneous wounds on a national scale. Methods: A retrospective study was conducted using the data recorded between January 1, 2018 and January1, 2020 in 195 hospitals across China. After screening the data, 815 patients with chronic wounds were finally analyzed. The data collected included information about the patients' general condition and local cutaneous wound assessments, especially microbial culture and antibiotic susceptibility tests. The analyses were performed using SPSS Version 26. Results: The study included 815 patients (290 [35.6%] females; 63 [50-74] years). The most common causes of chronic cutaneous wounds were diabetes (183, 22.5%), infection (178, 21.8%), and pressure (140, 17.2%). Among these, 521(63.9%) samples tested yielded microbial growth, including 70 (13.4%) polymicrobial infection and 451 (86.6%) monomicrobial infection. The positive rate of microbial culture was highest in wound tissue of ulcers caused by infection (87.6%), followed by pressure (77.1%), diabetes (68.3%), and venous diseases (67.7%). Bates-Jensen wound assessment tool (BWAT) scores >25 and wounds that lasted for more than 3 months had a higher positive rate of microbial culture. BWAT scores >25 and wounds in the rump, perineum, and feet were more likely to exhibit polymicrobial infection. A total of 600 strains were isolated, of which 46.2% (277 strains) were Gram-positive bacteria, 51.3% (308 strains) were Gram-negative bacteria, and 2.5% (15 strains) were fungi. The most common bacterial isolates were Staphylococcus aureus (29.2%), Escherichia coli (11.5%), Pseudomonas aeruginosa (11.0%), Proteus mirabilis (8.0%), and Klebsiella pneumoniae (5.8%). The susceptibility tests showed that 116 cultured bacteria were Multidrug resistant (MDR) strains. The resistance rates of S. aureus were 92.0% (161/175) to penicillin, 58.3% (102/175) to erythromycin, and 50.9% (89/175) to clindamycin. Vancomycin was the most effective antibiotic (0% resistance rate) against all Gram-positive bacteria. Besides, the resistance rates of E. coli were 68.1% (47/69) to ampicillin, 68.1% (47/69) to ciprofloxacin, 60.9% (42/69) to levofloxacin. However, all the isolated Gram-negative bacteria showed low resistance rates to tigecycline (3.9%) and amikacin (3.6%). Conclusions: The distribution of bacteria isolated from chronic cutaneous wounds varies with the BWAT scores, causes, duration, and the location of wounds. Multidrug resistance is a serious health issue, and therefore antibiotics used in chronic wounds must be under strict regulation. Our findings may help clinicians in making informed decisions regarding antibiotic therapy.
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Affiliation(s)
- Haonan Guan
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Wei Dong
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Yechen Lu
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Minfei Jiang
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Di Zhang
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Yakupu Aobuliaximu
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Jiaoyun Dong
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Yiwen Niu
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Yingkai Liu
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Bingjie Guan
- Department of General Surgery, School of Medicine, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Jiajun Tang
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Shuliang Lu
- Department of Burn, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.,Wound Healing Center, School of Medicine, Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China
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