Does the use of a cleanser on skin surrounding pressure ulcers in older people promote healing?

Understanding the impact of spinal cord injury on the microbiota of healthy skin and pressure injuries

Pressure injuries (PI) are a common issue among individuals with spinal cord injury (SCI), especially in the sitting areas of the body. Considering the risk of infections occurring to PI during the wound healing process, the skin microbiome is likely to be a source of bacteria. We investigated the relationship between skin and PI microbiomes, and assessed any correlation with clinically relevant outcomes related to PI. Samples were isolated from SCI patients undergoing reconstructive surgery of PI, severity grades III and IV. DNA samples from skin and PI were analysed using 16S rRNA gene sequencing. Our results showed disparities in microbiome composition between skin and PI. The skin had lower diversity, while PI showed increased bacterial homogeneity as the severity grade progressed. The skin bacterial composition varied based on its location, influenced by Cutibacterium. Compositional differences were identified between PI grades III and IV, with clusters of bacteria colonizing PI, characterized by Pseudomonas, Proteus and Peptoniphilus. The skin and PI microbiomes were not affected by the level of the SCI. Our study highlights the differences in the microbiome of skin and PI in SCI patients. These findings could be used to target specific bacteria for PI treatment in clinical practice.

Wound, pressure ulcer and burn guidelines - 1: Guidelines for wounds in general, second edition

The Japanese Dermatological Association prepared the clinical guidelines for the "Wound, pressure ulcer and burn guidelines", second edition, focusing on treatments. Among them, "Guidelines for wounds in general" is intended to provide the knowledge necessary to heal wounds, without focusing on particular disorders. It informs the basic principles of wound treatment, before explanations are provided in individual chapters of the guidelines. We updated all sections by collecting references published since the publication of the first edition. In particular, we included new wound dressings and topical medications. Additionally, we added "Question 6: How should wound-related pain be considered, and what should be done to control it?" as a new section addressing wound pain, which was not included in the first edition.

Antibacterial activity of tetraaryl-porphyrin photosensitizers: an in vitro study on Gram negative and Gram positive bacteria

BACKGROUND

Photodynamic therapy exploits visible light and photosensitizers to inactivate cells and this methodology is currently used for the treatment of several types of malignancy. Although various tumours are successfully treated with PSs and light, the application on microorganisms (photodynamic antimicrobial chemotherapy) has not yet found specific medical applications and still remains an open field of fundamental research.

PURPOSE

The assessment of the effect of a panel of seven tetraaryl-porphyrins, two commercial (PS 1 and 2) and five synthetic (PS 3-7) in in vitro experiments against Escherichia coli, Pseudomonas aeruginosa and Staphylococcus aureus.

METHODS

Three of the new photosensitizers (PS 3, 4 and 5) are tetracationic porphyrins and were prepared by N-alkylation of 5,10,15,20-tetra-4-pyridylporphyrin with a large excess of different benzyl chlorides; compound 7 is a dicationic porphyrin and was obtained in a similar way using a lower excess of 4-methoxybenzyl chloride. The neutral porphyrin (PS 6) was previously described. Dose-response curves were obtained titrating the survivors of cell suspensions (10(8)cfu/ml) exposed to the PSs and irradiated with visible light (total fluence rate 266 J/cm2).

RESULTS

The non ionic porphyrin 6 was the least active PS against all the tested bacteria. Cationic PSs 3, 4, 5 and 7 were more active than the commercial 1 and 2. The Gram positive S. aureus was more sensitive to all the PSs than the Gram negative E. coli and P. aeruginosa, the latter being the more resistant one. Compound 7 was found particularly efficient against P. aeruginosa, causing a 7 log units reduction of survivors at a concentration of 8 microM.

CONCLUSIONS

The reported results confirm that the presence of positively charged groups on porphyrin frame is fundamental for PSs antibacterial activity, however our data suggest that a moderate degree of lipophilicity, achievable by the introduction of aromatic hydrocarbon side chains on the pyridyl moieties, may improve PSs efficiency. Furthermore dicationic porphyrin 7 seems to be more efficient than the corresponding tetracationic derivatives thus emphasizing an interesting feature involved in the PSs activity.