title: Antimicrobial dressings: Comparison of the ability of a panel of dressings to prevent biofilm formation by key burn wound pathogens.
abstract: Antimicrobial medicated dressings (AMD) are often used to reduce bacterial infection of burns and other wounds. However, there is limited literature regarding comparative efficacies to inform effective clinical decision making.
  
  
  OBJECTIVE
  Following on from a previous study where we demonstrated good antibiofilm properties of acetic acid (AA), we assessed and compared the in vitro anti-biofilm activity of a range of AMDs and non-AMDs to AA.
  
  
  METHODS
  Laboratory experiments determined the ability of a range of eleven commercial AMD, two nAMD, and AA, to prevent the formation of biofilms of a panel of four isolates of Pseudomonas aeruginosa and Acinetobacter baumannii.
  
  
  RESULTS
  There is a large variation in ability of different dressings to inhibit biofilm formation, seen between dressings that contain the same, and those that contain other antimicrobial agents. The best performing AMD were Mepilex(®) Ag and Acticoat. AA consistently prevented biofilm formation.
  
  
  CONCLUSIONS
  Large variation exists in the ability of AMD to prevent biofilm formation and colonisation of wounds. A standardised in vitro methodology should be developed for external parties to examine and compare the efficacies of commercially available AMDs, along with robust clinical randomised controlled trials. This is essential for informed clinical decision-making and optimal patient management.
authors.affiliation: Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK; Institute of Microbiology and Infection, School of Biosciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. Electronic address: fenella.halstead@uhb.nhs.uk.
authors.forename: Fenella D
authors.initials: FD
authors.lastname: Halstead
authors.affiliation: Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK; Institute of Microbiology and Infection, School of Biosciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. Electronic address: maryamrauf1@yahoo.co.uk.
authors.forename: Maryam
authors.initials: M
authors.lastname: Rauf
authors.affiliation: Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; The Healing Foundation Burns Research Centre, Birmingham, UK. Electronic address: amy.bamford@uhb.nhs.uk.
authors.forename: Amy
authors.initials: A
authors.lastname: Bamford
authors.affiliation: Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; The Healing Foundation Burns Research Centre, Birmingham, UK. Electronic address: Christopher.wearn@uhb.nhs.uk.
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Wearn
authors.affiliation: NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK. Electronic address: j.bishop.1@bham.ac.uk.
authors.forename: Jonathan R B
authors.initials: JRB
authors.lastname: Bishop
authors.affiliation: Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK; Institute of Microbiology and Infection, School of Biosciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. Electronic address: rebecca.burt@uhb.nhs.uk.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Burt
authors.affiliation: Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK. Electronic address: adam.fraise@uhb.nhs.uk.
authors.forename: Adam P
authors.initials: AP
authors.lastname: Fraise
authors.affiliation: Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; The Healing Foundation Burns Research Centre, Birmingham, UK; Birmingham Children's Hospital, Birmingham, UK. Electronic address: naiem.moiemen@uhb.nhs.uk.
authors.forename: Naiem S
authors.initials: NS
authors.lastname: Moiemen
authors.affiliation: Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK. Electronic address: beryl.oppenheim@uhb.nhs.uk.
authors.forename: Beryl A
authors.initials: BA
authors.lastname: Oppenheim
authors.affiliation: NIHR Surgical Reconstruction and Microbiology Research Centre, Queen Elizabeth Hospital, Birmingham, UK; Institute of Microbiology and Infection, School of Biosciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. Electronic address: m.a.webber@bham.ac.uk.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Webber
mesh_terms: D019342:Acetic Acid / Q000494:pharmacology / Q000627:therapeutic use; D000151:Acinetobacter Infections / Q000517:prevention & control; D040981:Acinetobacter baumannii / Q000187:drug effects* / Q000254:growth & development; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001458:Bandages; D018441:Biofilms / Q000187:drug effects* / Q000254:growth & development; D002056:Burns / Q000382:microbiology / Q000628:therapy*; D002710:Chlorhexidine / Q000494:pharmacology / Q000627:therapeutic use; D006722:Honey; D066298:In Vitro Techniques; D007455:Iodine / Q000494:pharmacology / Q000627:therapeutic use; D008826:Microbial Sensitivity Tests; D011091:Polyesters / Q000627:therapeutic use; D011095:Polyethylenes / Q000627:therapeutic use; D011552:Pseudomonas Infections / Q000517:prevention & control; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000254:growth & development; D012834:Silver / Q000494:pharmacology / Q000627:therapeutic use; D014946:Wound Infection / Q000517:prevention & control
chemical_list: C117408:Acticoat; D000900:Anti-Bacterial Agents; D011091:Polyesters; D011095:Polyethylenes; D012834:Silver; D007455:Iodine; D019342:Acetic Acid; D002710:Chlorhexidine
keywords: Antimicrobial; Biofilms; Burns; Dressings; Wounds