Skin wounds — and the infections that come with them — pose a big challenge for medical professionals. Bacterial skin infections are the 28th most common diagnosis in hospitalized patients, and treating them is becoming more difficult with the rise of drug-resistant bacteria.
But researchers have developed a new type of wound dressing that may help treat these difficult cases.
About $25 billion is spent annually on the treatment of chronic wounds, and the burden is growing due to increasing healthcare costs, an aging population and a continual rise in the incidence of diabetes and obesity worldwide. Preventing wound infections should be a primary management objective for all healthcare practitioners, with particular concern about wounds in patients with diabetes mellitus, autoimmune disorders, hypoxia/poor tissue perfusion and immunosuppression.
Antimicrobial therapy may be required when other methods of reducing wound bacteria are not effective or when the infection is spreading. Antimicrobial agents, including antiseptics and antibiotics, act directly to reduce numbers of micro-organisms.
However, indiscriminate use of antibiotics has contributed to the development of antibiotic-resistant strains of bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin resistant Staphylococcus aureus (VRSA) and multidrug-resistant Pseudomonas and Acinetobacter species. It has also led to the emergence of healthcare-associated infections such as Clostridium difficile associated diarrhea.
Drug-resistant infections are increasing, with up to 50,000 lives lost each year to antibiotic-resistant infections in Europe and the United States. According to a report by the Review on Antimicrobial Resistance, antimicrobial resistance could kill 10 million people each year by 2050. Drug resistance is starting to complicate treatment for HIV and malaria and is a threat in hospitals, nursing homes and among patients whose care involves ventilators and blood catheters.
A new type of wound dressing, using a substance extracted from the shells of crustaceans, may represent the future of treatment. Developed by Dr. Radoslaw Wach and his colleagues from Lodz University of Technology in Poland, the wound dressing incorporates an antibacterial and biodegradable substance, chitosan, which they extracted from the shells of crustaceans into well-established hydrogel dressings known to speed up healing and cool the wound.
During extraction, the team changed the structure of chitin, a substance found in the shells, by removing most chemical branches from its acetyl groups. Next, the resulting chitosan, used in bandages to stop bleeding, was purified. The team combined the chitosan with hydrogel dressings via irradiation, a process that includes cross-linking of hydrophilic polymers next to water to form the firm structure of the dressing and sterilize it in a single step.
In order for the chitosan to become part of the dressing itself, the research team shone an electron beam at the polymer containing a solution of chitosan in lactic acid while making the dressing. This new hydrogel wound dressing, which is biologically active, could be used in place of classic hydrogel dressings.
Preventing infections from wounds has never been more important in both economic and human terms. Because wound healing can take several weeks, bacterial infections are highly probable. This novel hydrogel dressing, a type of compression held in place by a bandage, could prevent infections and serious complications.
