This study systematically compared the antibacterial and biocompatibility performance of seven antimicrobial agents in acellular dermal matrix (ADM), identifying the unique advantages of 1% acetic acid (AA) in suppressing planktonic and biofilm-forming multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii. It not only demonstrated potent antimicrobial activity but also maintained high fibroblast viability without significant cytotoxicity, offering a promising new material for burn wound infection control.
Literature Overview
This article, 'Antimicrobial Efficacy of Impregnated Human Acellular Dermal Substitutes in Burn Wound Models' published in Antibiotics, reviews the clinical challenges of burn wound infections, current applications of ADM, and the potential of combining ADM with antimicrobial agents, particularly highlighting the distinct antimicrobial enhancement of 1% acetic acid in ADM.
Background Knowledge
Burn wounds are highly susceptible to infections by multidrug-resistant (MDR) Gram-negative bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii, with biofilm formation further complicating antimicrobial therapy. Acellular dermal matrix (ADM), widely used in burn and reconstructive surgeries, lacks inherent antimicrobial properties, necessitating combination with topical antimicrobial agents. Although various antimicrobial dressings and solutions are clinically available, their antimicrobial efficacy and cytotoxicity on ADM have not been systematically evaluated. This study, using in vitro models, systematically compared seven commonly used antimicrobial agents on ADM, revealing the unique balance of 1% acetic acid between antimicrobial activity and biocompatibility, providing novel insights for burn wound management.
Research Methods and Experiments
The study employed in vitro burn wound models, including planktonic and biofilm bacterial assays, to evaluate the antimicrobial activity of seven topical agents (1% acetic acid, vancomycin, polymyxin, povidone-iodine, Octenilin®, Aqvitox-D®, and Prontosan®) against MDR Pseudomonas aeruginosa and Acinetobacter baumannii. ADM was decellularized and impregnated with antimicrobial agents, followed by co-culturing with bacteria for 24 hours. Antimicrobial efficacy was assessed via colony counting and log10 CFU/mL reduction. Cell toxicity was evaluated using NIH 3T3 fibroblasts by quantifying live cell viability after 5 days of exposure.
Key Conclusions and Perspectives
Research Significance and Prospects
This study provides a novel ADM modification strategy for burn wound infection control, particularly relevant for managing MDR and biofilm-associated infections. Future studies should validate in vivo antimicrobial and tissue repair capabilities using animal models and explore broader applications in chronic wounds and implantable biomaterials.
Conclusion
This study systematically evaluated antimicrobial agents' antibacterial and cytotoxic profiles on acellular dermal matrix, highlighting 1% acetic acid's remarkable efficacy against MDR Pseudomonas aeruginosa and Acinetobacter baumannii in vitro. It effectively suppresses both planktonic bacteria and biofilm formation while maintaining excellent cell compatibility, offering a safe, economical, and sustainable local antimicrobial strategy for burn wound management. Future research should focus on validating its antimicrobial and regenerative properties in animal models and assessing clinical applicability, providing new material options for combating antimicrobial-resistant wound infections.
