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Comparative Antimicrobial Activity of Commercial Wound Care Solutions on Bacterial and Fungal Biofilms

Harriott, Melphine M. PhD*; Bhindi, Nayan MD; Kassis, Salam MD; Summitt, Blair MD; Perdikis, Galen MD; Wormer, Blair A. MD; Rankin, Timothy M. MD; Kaoutzanis, Christodoulos MD; Samaha, Mario MD; Stratton, Charles MD*; Schmitz, Jonathan E. MD, PhD*

doi: 10.1097/SAP.0000000000001996
Burn Surgery and Research
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Background Biofilms represent a complex milieu of matrix-enclosed microorganisms, which can significantly contribute to the pathology of chronic wounds. In this study, we compare the activity of 3 commercial antimicrobial wound care solutions, Vashe (HOCl based), PhaseOne (HOCl based), and Sulfamylon (mafenide acetate), for their in vitro activity against bacterial and fungal biofilms.

Methods Reference and clinical isolates of 6 Gram-negative bacterial species (36 total strains), 3 Gram-positive bacteria (21 strains), and 3 Candida species (9 strains) were used to create biofilms. Various working concentrations of the 3 antiseptic agents were incubated with the biofilms in microwell plates; they were monitored from 1 minute to 24 hours to compare bacterial and fungal viability through colony forming unit analysis.

Results Vashe and PhaseOne displayed excellent bactericidal and fungicidal activity, whereas Sulfamylon demonstrated minimal activity against the biofilms tested. With the exception of Candida albicans, all biofilms were eliminated at either 1 or 10 minutes using Vashe and PhaseOne solutions. In most cases, mafenide was unable to eliminate both bacterial and fungal biofilms, even with 24 hours of treatment.

Conclusions Biofilms represent a major clinical challenge, with no clear consensus for treatment of chronic wounds or prosthetic devices. Our results suggest that hypochlorous acid–based wound solutions such as Vashe and PhaseOne are more efficacious than mafenide in eliminating bacterial and fungal biofilms. Further studies are necessary to investigate and compare the in vivo efficacy of these products in clinical care.

From the *Departments of Pathology, Microbiology and Immunology

Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.

Received November 7, 2018, and accepted for publication, after revision April 25, 2019.

Conflicts of interest and sources of funding: none declared.

Reprints: Salam Kassis, MD, Department of Plastic Surgery, Vanderbilt University Medical Center, 1161 21st Avenue S, MCN D4207, Nashville, TN 37232-2345. E-mail: salam.al.kassis@vumc.org.

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Online date: August 28, 2019

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