title: Maintenance of wound bacterial balance.
abstract: BACKGROUND
  There is a critical number of bacteria above which tissue responds with infection. This balance of 10(5) or fewer bacteria/g tissue is also required for wound healing to proceed normally. This study evaluated whether a chronic wound once in bacterial balance can maintain that balance over time.
  
  
  METHODS
  Serial biopsies for bacterial analyses were obtained weekly during a blinded, placebo-controlled cytokine clinical trial of pressure ulcers. To enter the trial ulcers had to be debrided and have a bacterial count of 10(5) or fewer bacteria/g tissue with no beta-hemolytic streptococci.
  
  
  RESULTS
  In all, 96% of cultures (350/363) remained at <10(2) bacteria/g tissue over the 5-week trial; 3% had 10(2) to 10(5), and only 1% had >10(5) bacteria/g tissue.
  
  
  CONCLUSIONS
  Chronic pressure ulcers, once debrided and brought into bacterial balance, will remain in bacterial balance if cared for and kept free of necrotic tissue.
authors.affiliation: Department of Surgery, University of South Florida, Tampa, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Robson
authors.forename: R J
authors.initials: RJ
authors.lastname: Mannari
authors.forename: P D
authors.initials: PD
authors.lastname: Smith
authors.forename: W G
authors.initials: WG
authors.lastname: Payne
mesh_terms: D001706:Biopsy; D002908:Chronic Disease; D003646:Debridement; D006801:Humans; D011157:Population Dynamics; D003668:Pressure Ulcer / Q000382:microbiology* / Q000473:pathology; D013290:Streptococcal Infections / Q000382:microbiology*; D014945:Wound Healing