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Electric Field Based Dressing Disrupts Mixed-Species Bacterial Biofilm Infection and Restores Functional Wound Healing

Barki, Kasturi Ganesh MD; Das, Amitava PhD; Dixith, Sriteja MS; Ghatak, Piya Das MS; Mathew-Steiner, Shomita PhD; Schwab, Elizabeth BS; Khanna, Savita PhD; Wozniak, Daniel J. PhD; Roy, Sashwati PhD; Sen, Chandan K. PhD
doi: 10.1097/SLA.0000000000002504
Original Article: PDF Only

Objective:

This study was designed to employ electroceutical principles, as an alternative to pharmacological intervention, to manage wound biofilm infection. Mechanism of action of a United States Food and Drug Administration-cleared wireless electroceutical dressing (WED) was tested in an established porcine chronic wound polymicrobial biofilm infection model involving inoculation with Pseudomonas aeruginosa PAO1 and Acinetobacter baumannii 19606.

Background:

Bacterial biofilms represent a major wound complication. Resistance of biofilm toward pharmacologic interventions calls for alternative therapeutic strategies. Weak electric field has anti-biofilm properties. We have previously reported the development of WED involving patterned deposition of Ag and Zn on fabric. When moistened, WED generates a weak electric field without any external power supply and can be used as any other disposable dressing.

Methods:

WED dressing was applied within 2 hours of wound infection to test its ability to prevent biofilm formation. Alternatively, WED was applied after 7 days of infection to study disruption of established biofilm. Wounds were treated with placebo dressing or WED twice a week for 56 days.

Results:

Scanning electron microscopy demonstrated that WED prevented and disrupted wound biofilm aggregates. WED accelerated functional wound closure by restoring skin barrier function. WED blunted biofilm-induced expression of (1) P. aeruginosa quorum sensing mvfR (pqsR), rhlR and lasR genes, and (2) miR-9 and silencing of E-cadherin. E-cadherin is critically required for skin barrier function. Furthermore, WED rescued against biofilm-induced persistent inflammation by circumventing nuclear factor kappa B activation and its downstream cytokine responses.

Conclusion:

This is the first pre-clinical porcine mechanistic study to recognize the potential of electroceuticals as an effective platform technology to combat wound biofilm infection.

Reprints: Chandan K. Sen, PhD, 473 West 12th Avenue, 513 DHLRI, The Ohio State University Medical Center, Columbus, OH 43210. E-mail: chandan.sen@osumc.edu.

This work was partly supported by National Institute of Health NR015676 and NR013898. In addition, it benefited from the following National Institutes of Health awards: GM077185, GM069589, DK076566, AI097511, and NS42617.

Financial competing interest includes ownership of shares with Vomaris Innovations, Inc. (CKS).

The authors declare no conflict of interests.

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