The Association of Systemic Inflammation, Wound Bioburden and Total Bacterial Counts With Healing Outcomes in Older Adults With Chronic Venous Leg Ulcers

Abstract

This substudy utilised data from a prospective, longitudinal study aimed to investigate associations between systemic inflammation, wound bioburden, total bacterial counts and wound healing outcomes over 8 weeks in older adults with chronic venous leg ulcers (CVLUs). Participants were receiving standardised weekly wound debridement. Blood and wound tissue samples were collected at baseline and Weeks 2, 4, 6 and 8, or until the wound was healed. Wound healing status was categorised by two parameters: healed versus nonhealed and healing versus nonhealing. A linear mixed model assessed associations among clinical and laboratory variables with wound healing status over time. Of the 117 participants, 47 (40%) had wounds that healed within the 8-week period. In nonhealed wounds, C-reactive protein (CRP) was positively associated with total bacterial counts (p < 0.001), wound bioburden (p = 0.01) and wound diameter (p = 0.004) over time. Total bacterial counts were positively associated with CRP (p = 0.023), interleukin-6 (IL-6) (p = 0.034) and tumour necrosis factor-alpha (TNF-α) (p < 0.001) in nonhealing wounds. The results suggest that CRP, IL-6 and TNF-α may be useful markers in predicting wound healing trajectories. Ongoing monitoring of inflammatory markers and bacterial counts could aid in assessing wound healing progress in older adults with CVLUs.

Keywords: C‐reactive protein; chronic venous leg ulcers; cytokines; wound bioburden; wound healing.