Browsing by Author "Hochwalt, Phillip C."

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Delayed wound healing in diabetic (db/db) mice with Pseudomonas aeruginosa biofilm challenge: A model for the study of chronic wounds
(2010-08) Zhao, Ge; Hochwalt, Phillip C.; Usui, Marcia L.; Underwood, Robert A.; Singh, Pradeep K.; James, Garth A.; Stewart, Philip S.; Fleckman, Philip; Olerud, John E.
Chronic wounds are a major clinical problem that lead to considerable morbidity and mortality. We hypothesized that an important factor in the failure of chronic wounds to heal was the presence of microbial biofilm resistant to antibiotics and protected from host defenses. A major difficulty in studying chronic wounds is the absence of suitable animal models.The goal of this study was to create a reproducible chronic wound model in diabetic mice by the application of bacterial biofilm. Six-millimeter punch biopsy wounds were created on the dorsal surface of diabetic (db/db) mice, subsequently challenged with Pseudomonas aeruginosa (PAO1) biofilms 2 days postwounding, and covered with semiocclusive dressings for 2 weeks. Most of the control wounds were epithelialized by 28 days postwounding. In contrast, none of biofilm-challenged wounds were closed. Histological analysis showed extensive inflammatory cell infiltration, tissue necrosis, and epidermal hyperplasia adjacent to challenged woundsâ€”all indicators of an inflammatory nonhealing wound. Quantitative cultures and transmission electron microscopy demonstrated that the majority of bacteria were in the scab above the wound bed rather than in the wound tissue. The model was reproducible, allowed localized cutaneous wound infections without high mortality, and demonstrated delayed wound healing following a biofilm challenge. This model may provide an approach to study the role of microbial biofilms in chronic wounds as well as the effect of specific biofilm therapy on wound healing.
Development of a chronic wound in a diabetic (db/db) mouse by infection with biofilm
(2008) Zhao, Ge; Hochwalt, Phillip C.; Usui, Marcia L.; Underwood, Robert A.; Singh, Pradeep K.; James, Garth A.; Stewart, Philip S.; Fleckman, Philip; Olerud, John E.
Chronic wounds such as diabetic ulcers, pressure sores, and venous stasis ulcers are a major source of morbidity and mortality. Since chronic ulcers are not homogeneous, systematic study of ulcer therapies is difficult. Our goal is to create a standard chronic wound model. It has been shown that specialized microbial colonies known as biofilm are present in chronic human wounds. The microorganisms present in biofilm are protected from the host defenses, topical antiseptics, and systemic antibiotics. For this reason, biofilm infections persist and may contribute to poor wound healing. We hypothesize that application of biofilm to an already characterized diabetic mouse wound model may create a reproducible chronic wound. Bacterial biofilm was developed by incubating planktonic Pseudomonas aeruginosa (PAO-1) and transferring to polycarbonate membrane filters placed on LB agar plates. The biofilm (~10^8 CFU) was transferred to 6mm wounds created on the dorsal skin of diabetic mice and the wounds were covered with Tegaderm® dressing. The biofilm was transferred to the wounds at several different time points following wounding. The mice died if the biofilm was transferred soon after wounding; however, mice that were allowed to recover from the surgery before biofilm inoculation developed a purulent wound that persisted for weeks. In addition, the timing of Tegaderm® application proved to be a critical variable for purulence and quality of the wound. Ultimately, the development of a reproducible chronic wound in a diabetic mouse will allow in vivo testing of potential wound healing therapies.