Impact of antimicrobial gauze on bacterial colonies in wounds that require packing

Abstract

Heavy microbial contamination has been associated with delayed wound healing and infection in both acute and chronic wounds. A prospective, randomized, 5-week controlled, open label, multicenter study was conducted to determine whether using antimicrobial gauze containing polyhexamethylene biguanide in wounds that require packing will result in a greater reduction of bacterial colony counts than using a gauze without polyhexamethylene biguanide (the control). Twenty-one subjects were randomized to the treatment or control dressing. Wounds were evenly distributed with respect to etiology and both study groups had a median baseline wound size of 7 cm2. At baseline, 15 microbial isolates were recovered and counted in treatment group wounds and 12 were recovered in the controls. At Week 1, six isolates were recovered from subjects in the polyhexamethylene biguanide antimicrobial gauze treatment group while 10 were recovered in the control. Change in polymicrobial bioburden was most prominent during the first few weeks of the study in the polyhexamethylene biguanide group. Polymicrobial counts in the treatment group remained reduced for the following three study weeks, returning to baseline at Week 4. In the control group, the number of polymicrobial cultures rose to 60% above baseline at Week 4. Two wounds of subjects randomized to the polyhexamethylene biguanide antimicrobial gauze healed; one wound in the control group healed. Polyhexamethylene biguanide antimicrobial gauze dressing could be an important adjunct to control the polymicrobial bioburden of delayed closure surgical wounds, pressure ulcers, and diabetic foot ulcers. Additional studies seem warranted.