Maintenance of wound bacterial balance.
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.
Robson
M C
MC
Department of Surgery, University of South Florida, Tampa, USA.
Mannari
R J
RJ
Smith
P D
PD
Payne
W G
WG
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