Bjarnsholt T, Kirketerp-Møller K, Jensen PØ, Madsen KG, Phipps R, Krogfelt K, Høiby N, Givskov M, et al.
Wound repair and regeneration : official publication of the Wound Healing Society [and] the Eur.... Date of publication 2008 Jan 1;volume 16(1):2-10.
1. Wound Repair Regen. 2008 Jan-Feb;16(1):2-10. doi:
10.1111/j.1524-475X.2007.00283.x.
Why chronic wounds will not heal: a novel hypothesis.
Bjarnsholt T(1), Kirketerp-Møller K, Jensen PØ, Madsen KG, Phipps R, Krogfelt K,
Høiby N, Givskov M.
Author information:
(1)Bioscience and Technology, Bldg 227 BioCentrum, Technical University of
Denmark, Lyngby, Denmark.
The present paper presents a hypothesis aimed at explaining why venous leg
ulcers, pressure ulcers, and diabetic foot ulcers develop into a chronic state.
We propose that the lack of proper wound healing is at least in part caused by
inefficient eradication of infecting, opportunistic pathogens, a situation
reminiscent of chronic Pseudomonas aeruginosa infections found in patients
suffering from cystic fibrosis (CF). We have analyzed sections from chronic
wounds by fluorescence in situ hybridization and found distinct
microcolonies--the basal structures of bacterial biofilms. Several researchers
have previously reported that another important hallmark of biofilm formation is
development of increased tolerance to various antimicrobial measures and
treatments. Furthermore, the immune response to infecting bacteria in the cystic
fibrosis lung is dominated by polymorphonuclear neutrophils (PMNs), and we have
recently shown that in vitro biofilms of P. aeruginosa produce a shielding
mechanism that offers protection from the phagocytic activity of PMNs. We
hypothesize that the presence of P. aeruginosa in biofilms, and the lack of
concomitant elimination by attended PMNs, are the main causes of inefficient
eradication by antibiotic treatment and antimicrobial activity of the innate
immune system, respectively.
DOI: 10.1111/j.1524-475X.2007.00283.x
PMID: 18211573 [Indexed for MEDLINE]
