Effectiveness of Epidermal Growth Factor Loaded Carboxymethylcellulose (EGF-CMC) Hydrogel in Biofilm Formation in Wounds of Diabetic Patients: A Randomized Clinical Trial

Author:

Pessanha Fernanda Soares1ORCID,Oliveira Beatriz Guitton Renaud Baptista de2,Oliveira Bianca Campos2ORCID,Deutsch Gabriela3,Teixeira Felipe Lopes3,Bokehi Luciana Castilho3,Calomino Mariana Alcântara3,Rodrigues de Castilho Selma3,Thiré Rossana Mara da Silva Moreira4ORCID,Teixeira Lenise Arneiro3,Paula Geraldo Renato de3ORCID

Affiliation:

1. Nursing School, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20551-030, Brazil

2. Aurora de Afonso Costa College of Nursing, Universidade Federal Fluminense, Niterói 24020-091, Brazil

3. College of Pharmacy, Universidade Federal Fluminense, Niterói 24241-000, Brazil

4. COPPE/Program of Metallurgical and Materials Engineering—PEMM, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-599, Brazil

Abstract

Diabetic patients frequently develop wounds, which can be colonized by bacteria, mainly Staphylococcus aureus and Pseudomonas aeruginosa, with the ability to form biofilms. This study aimed to evaluate the colonization and biofilm formation of Staphylococcus aureus and Pseudomonas aeruginosa in chronic wounds of diabetic patients treated with a bioactive dressing (EGF-CMC), which consisted of a 2% carboxymethylcellulose (CMC) hydrogel loaded with epidermal growth factor (EGF). This randomized clinical trial was conducted with 25 participants: 14 treated with EGF-CMC hydrogel and 11 treated with CMC hydrogel for 12 weeks. Participants with type 2 diabetes mellitus were selected. All had diabetic foot ulcers or chronic venous ulcers. Swab collections were performed on weeks 1, 6, and 12. The laboratory analyses included the identification of strains, microbial quantification, virulence gene investigation, and the evaluation of biofilm formation. In total, 13 S. aureus strains and 15 P. aeruginosa strains were isolated. There were no statistically significant differences regarding bacterial loads and virulence genes. However, EGF-CMC-hydrogel-treated wounds were colonized by strains with lower biofilm formation abilities. The probability of isolating biofilm-producing strains from CMC-hydrogel-treated wounds was 83% greater than the probability of isolating biofilm-producing strains from EGF-CMC-treated wounds.

Funder

Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Publisher

MDPI AG

Subject

Polymers and Plastics,Organic Chemistry,Biomaterials,Bioengineering

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