Author:
Hirsch Tobias,Spielmann Malte,Zuhaili Baraa,Koehler Till,Fossum Magdalena,Steinau Hans-Ulrich,Yao Feng,Steinstraesser Lars,Onderdonk Andrew B,Eriksson Elof
Abstract
Abstract
Background
Wound infection is a common complication in diabetic patients. The progressive spread of infections and development of drug-resistant strains underline the need for further insights into bacterial behavior in the host in order to develop new therapeutic strategies. The aim of our study was to develop a large animal model suitable for monitoring the development and effect of bacterial infections in diabetic wounds.
Methods
Fourteen excisional wounds were created on the dorsum of diabetic and non-diabetic Yorkshire pigs and sealed with polyurethane chambers. Wounds were either inoculated with 2 × 108 Colony-Forming Units (CFU) of Staphylococcus aureus or injected with 0.9% sterile saline. Blood glucose was monitored daily, and wound fluid was collected for bacterial quantification and measurement of glucose concentration. Tissue biopsies for microbiological and histological analysis were performed at days 4, 8, and 12. Wounds were assessed for reepithelialization and wound contraction.
Results
Diabetic wounds showed a sustained significant infection (>105 CFU/g tissue) compared to non-diabetic wounds (p < 0.05) over the whole time course of the experiment. S. aureus-inoculated diabetic wounds showed tissue infection with up to 8 × 107 CFU/g wound tissue. Non-diabetic wounds showed high bacterial counts at day 4 followed by a decrease and no apparent infection at day 12. Epidermal healing in S. aureus-inoculated diabetic wounds showed a significant delay compared with non-inoculated diabetic wounds (59% versus 84%; p < 0.05) and were highly significant compared with healing in non-diabetic wounds (97%; p < 0.001).
Conclusion
Diabetic wounds developed significantly more sustained infection than non-diabetic wounds. S. aureus inoculation leads to invasive infection and significant wound healing delay and promotes invasive co-infection with endogenous bacteria. This novel wound healing model provides the opportunity to closely assess infections during diabetic wound healing and to monitor the effect of therapeutical agents in vivo.
Publisher
Springer Science and Business Media LLC
Reference35 articles.
1. Ferringer T, Miller F: Cutaneous manifestations of diabetes mellitus. Dermatol Clin. 2002, 20 (3): 483-492. 10.1016/S0733-8635(02)00018-9.
2. (ADA) ADA: Complications of Diabetes in the United States. wwwdiabetesorg/diabetes-statistics/complicationsjsp. 2006, 2006 (3/13):
3. Jude EB, Abbott CA, Young MJ, Anderson SG, Douglas JT, Boulton AJ: The potential role of cell adhesion molecules in the pathogenesis of diabetic neuropathy. Diabetologia. 1998, 41 (3): 330-336. 10.1007/s001250050911.
4. Jeffcoate WJ, Harding KG: Diabetic foot ulcers. 133. 2003, 361 (9368): 1545-1551.
5. Ferguson MW, Herrick SE, Spencer MJ, Shaw JE, Boulton AJ, Sloan P: The histology of diabetic foot ulcers. Diabet Med. 1996, 13 Suppl 1: S30-3.
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