title: The use of desiccation to treat Staphylococcus aureus biofilm-infected wounds.
abstract: Chronic wounds colonized with biofilm present a major burden to our healthcare system. While the current paradigm for wound healing is to maintain a moist environment, we sought to evaluate the effects of desiccation, and the ability of honey to desiccate wounds, on wound healing characteristics in Staphylococcus aureus biofilm wounds. In vivo biofilm wound healing after exposure to open-air desiccation, honey, molasses, and saline was analyzed using a rabbit ear model of S. aureus biofilm wounds previously developed by our group. Wound morphology was examined using scanning electron microscopy and granulation tissue deposition was measured using light microscopy with hematoxylin and eosin staining. Viable bacterial counts in rabbit ear biofilm wounds and scabs were measured using a drop dilution method. In vitro S. aureus growth curves were established using tryptic soy broth containing honey and glycerol. Gene expression analysis of rabbit ear wounds was performed using reverse transcription quantitative PCR. Rabbit ear S. aureus biofilm wounds exposed to open-air desiccation, honey, and molasses developed a dry scab, which displaced the majority of biofilm bacteria off of the wound bed. Wounds treated with open-air desiccation, honey, and molasses expressed lower levels of the inflammatory markers tumor necrosis factor-α and interleukin-1β at postoperative day 12 compared with wounds treated with saline, and had increased levels of granulation tissue formation. In vitro growth of S. aureus in tryptic soy broth was inhibited by the presence of honey to a greater extent than by the presence of osmolality-matched glycerol. Desiccation of chronic wounds colonized with biofilm via exposure to open air or honey leads to improved wound healing by decreasing bacterial burden and inflammation, and increasing granulation tissue formation. The ability of honey to help heal chronic wounds is at least in part due to its ability to desiccate bacterial biofilm, but other factors clearly contribute.
authors.affiliation: Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Eugene
authors.initials: E
authors.lastname: Park
authors.affiliation: Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Long
authors.affiliation: Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Akhil K
authors.initials: AK
authors.lastname: Seth
authors.affiliation: Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Matthew
authors.initials: M
authors.lastname: Geringer
authors.affiliation: Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
authors.affiliation: Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Claudia
authors.initials: C
authors.lastname: Chavez-Munoz
authors.affiliation: Microbiology Branch, US Army Dental and Trauma Research Detachment, Institute of Surgical Research, Fort Sam Houston, Texas.
authors.forename: Kai
authors.initials: K
authors.lastname: Leung
authors.affiliation: Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Seok Jong
authors.initials: SJ
authors.lastname: Hong
authors.affiliation: Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Galiano
authors.affiliation: Division of Plastic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Mustoe
mesh_terms: D000818:Animals; D000891:Anti-Infective Agents, Local / Q000494:pharmacology; D018441:Biofilms / Q000187:drug effects / Q000254:growth & development*; D003890:Desiccation / Q000379:methods*; D004195:Disease Models, Animal; D004423:Ear / Q000293:injuries / Q000382:microbiology / Q000473:pathology; D006722:Honey / Q000706:statistics & numerical data; D008855:Microscopy, Electron, Scanning; D011817:Rabbits; D013203:Staphylococcal Infections / Q000188:drug therapy / Q000382:microbiology* / Q000628:therapy*; D013211:Staphylococcus aureus / Q000187:drug effects / Q000502:physiology; D014945:Wound Healing; D014946:Wound Infection / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D014947:Wounds and Injuries / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology / Q000628:therapy*
chemical_list: D000891:Anti-Infective Agents, Local