title: Pulsed electric fields for burn wound disinfection in a murine model.
abstract: Emerging bacterial resistance renders many antibiotics ineffective, making alternative strategies of wound disinfection important. Here the authors report on a new, physical burn wound disinfection method: pulsed electric fields (PEFs). High voltage, short PEFs create nonthermal, permanent damage to cell membranes, possibly by irreversible electroporation. In medicine, PEF technology has recently been used for nonthermal ablation of solid tumors. The authors have expanded the spectrum of PEF applications in medicine to burn wound disinfection. A third-degree burn was induced on the dorsal skin of C57BL/6 mice. Immediately after the injury, the burn wound was infected with Acinetobacter baumannii expressing the luxCDABE operon. Thirty minutes after infection, the infected areas were treated with 80 pulses delivered at 500 V/mm, 70 μs, 1 Hz. The authors used bioluminescence to quantify bacteria on skin. Three animals were used for each experimental condition. PEFs were effective in the disinfection of infected burned murine skin. The bacterial load reduction correlated with the number of delivered pulses. Forty pulses of 500 V/mm led to a 2.04 ± 0.29 Log10 reduction in bacterial load; 80 pulses led to the immediate 5.53 ± 0.30 Log10 reduction. Three hours after PEF, the bacterial reduction of the skin treated with 500 V/mm, 80 pulses was 4.91 ± 0.71 Log10. The authors introduce a new method of wound disinfection using high voltage, short PEFs. They believe that PEF technology may represent an important alternative to antibiotics in addressing bacterial contamination of wounds, particularly those contaminated with multidrug-resistant bacteria.
authors.affiliation: From the *Center for Engineering in Medicine, Department of Surgery, Massachusetts General Hospital, Harvard Medical School and the Shriners Burns Hospital, Boston; †Division of Plastic and Reconstruction Surgery, Massachusetts General Hospital, Harvard Medical School, Boston; ‡Wellman Center for Photomedicine, Massachusetts General Hospital, Boston; §Department of Dermatology, Harvard Medical School, Boston, Massachusetts; ‖Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts; ¶Department of Surgery, Massachusetts General Hospital and Shriners Hospital for Children, Boston, Massachusetts; and #Department of Biomedical Engineering, Rutgers University, Piscataway, New Jersey.
authors.forename: Alexander
authors.initials: A
authors.lastname: Golberg
authors.forename: G Felix
authors.initials: GF
authors.lastname: Broelsch
authors.forename: Daniela
authors.initials: D
authors.lastname: Vecchio
authors.forename: Saiqa
authors.initials: S
authors.lastname: Khan
authors.forename: Michael R
authors.initials: MR
authors.lastname: Hamblin
authors.forename: William G
authors.initials: WG
authors.lastname: Austen
authors.forename: Robert L
authors.initials: RL
authors.lastname: Sheridan
authors.forename: Martin L
authors.initials: ML
authors.lastname: Yarmush
mesh_terms: D000151:Acinetobacter Infections / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D040981:Acinetobacter baumannii; D000818:Animals; D058491:Bacterial Load; D002056:Burns / Q000382:microbiology / Q000628:therapy*; D004195:Disease Models, Animal; D004203:Disinfection / Q000379:methods*; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D051379:Mice; D008810:Mice, Inbred C57BL; D014946:Wound Infection / Q000382:microbiology / Q000628:therapy*