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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.

*The Ohio State University Comprehensive Wound Center, Center for Regenerative Medicine and Cell Based Therapies, Department of Surgery, Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH

The Ohio State University, Department of Microbial Infection and Immunity, Department of Microbiology, Center for Microbial Interface Biology, The Ohio State University, Columbus, OH.

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.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.annalsofsurgery.com).

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