Day A, Alkhalil A, Carney BC, Hoffman HN, Moffatt LT, Shupp JW, et al.
Advances in skin & wound care. Date of publication 2017 Dec 1;volume 30(12):543-551.
1. Adv Skin Wound Care. 2017 Dec;30(12):543-551. doi:
10.1097/01.ASW.0000526607.80113.66.
Disruption of Biofilms and Neutralization of Bacteria Using Hypochlorous Acid
Solution: An In Vivo and In Vitro Evaluation.
Day A(1), Alkhalil A, Carney BC, Hoffman HN, Moffatt LT, Shupp JW.
Author information:
(1)Anna Day, BS, is a Research Associate; Abdulnaser Alkhalil, PhD, is a Senior
Research Scientist; Bonnie C. Carney, BS, is a Research Associate; Hilary N.
Hoffman, BS, is a Research Associate; Lauren T. Moffatt, PhD, is the Laboratory
Director; and Jeffrey W. Shupp, MD, is the Director, Firefighters' Burn and
Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC.
OBJECTIVES: The aims of this study were to assess the effectiveness of a
hypochlorous acid-based wound cleanser (Vashe Wound Solution [VWS], SteadMed
Medical, Fort Worth, Texas) in disrupting methicillin-resistant Staphylococcus
aureus and Pseudomonas aeruginosa biofilms relative to other cleansers using an
in vitro collagen biofilm model and to evaluate cleansers' cytotoxicity. The
bioburden reduction of venous stasis wounds by VWS and another cleanser was
evaluated.
METHODS: Plates coated with collagen films incubated with active bacteria
cultures to yield biofilm mimics were treated with VWS, 1% and 10%
povidone-iodine (PI), 0.05% chlorhexidine wound solution (CWS), or normal saline
for 3 or 10 minutes. Biofilms were then analyzed for biomass density using a
crystal violet assay, quantitative cultures, and fluorescent microscopy.
Cytotoxicity was measured using neutral red uptake by primary human dermal
fibroblasts. Pre- and postcleansing exudates and swab samples obtained from
venous stasis wounds of patients were processed and plated on a series of
selective agar plates for bacteria typing and quantification.
RESULTS: All agents tested significantly neutralized methicillin-resistant S
aureus and P aeruginosa biofilms compared with saline control as assessed by
crystal violet assay and fluorescent microscopy assays. Undiluted VWS was
significantly less cytotoxic compared with 1% PI, CWS, and 10% PI (in increasing
order of cytotoxicity). There was no significant difference in bacterial
reduction in wounds after treatment with VWS or CWS for any type of bacteria
examined using selective media. In wounds that were treated with VWS or CWS,
there was a similar percentage reduction in bacterial colony-forming units from
precleansing levels when plated on tryptic soy agar, MacConkey, streptococcal,
and mannitol salt agar plates. Plates treated with CWS trended toward higher
bacterial reduction on nonselective and gram-negative agars, whereas VWS trended
toward higher bacterial reduction in Streptococcus-selective agars.
CONCLUSIONS: These findings support the use of VWS in the treatment of wounds
with biofilms and to reduce the bioburden of venous stasis ulcers. While
VWS-treated biofilms had higher biomass than CWS- and saline-treated biofilms,
most of the cellular component was not viable. Ultimately, VWS had a similar
effectiveness to CWS in eliminating bacteria but with lower cytotoxicity.
DOI: 10.1097/01.ASW.0000526607.80113.66
PMID: 29140837 [Indexed for MEDLINE]
