Medical Chronicle November/December 2013 | Page 49

WOUND CARE

Simple removal of biofilm?

Binding of biofilm to Cutimed® Sorbact®
ROSE COOPER, LEIGHTON JENKINS Cardiff School of Health Sciences, University of Wales Institute Cardiff, Western Avenue, Cardiff, UK
Binding of bacteria
by ‘blinded’
Aim
to host cell surfaces is
volunteers.
The aim of the
an essential step in the
Biofilm remaining
study was to
initiation of infection
on coverslips
investigate
that involves specific
was estimated
the efficacy
macromolecular
by staining with
of DACC in
interactions. However,
crystal violet and
promoting
adherence of bacteria
bacteria bound to
binding of
to wound dressings
dressings were
biofilm to
provides a means of
estimated by total
Cutimed®
lowering the bioburden
viable counts.
Sorbact®.
within the wound
environment and
Results
Methods
reducing the risk of
SEM images gave
Sterile samples
infection. Planktonic
clear evidence that
of Cutimed®
bacteria have been
biofilms of MRSA and
Sorbact® with
shown to bind to
P aeruginosa bound
and without
Cutimed® Sorbact® via
more extensively
DACC coating
hydrophobic interaction1.
to coated dressing
were tested.
This dressing is coated
samples than
Cultures of
Binding of MRSA biofilm
Binding of MRSA biofilms
with dialkyl carbamoyl
uncoated ones. Using
each of MRSA
to uncoated dressing
to DACC coated dressing
chloride (DACC), which
an arbitrary scoring
and P aeruginosa after 1,2 and 3 hours
after 1, 2 and 3 hours
is a fatty acid derivative.
system, six ‘blinded’
(isolated from
Our study was designed to
volunteers were asked to judge the
patients with chronic leg ulcers) were
determine the ability of biofilms of
quantity of biofilm bound to each of
cultivated in 24 well microtitre plates
two wound pathogens, Methicillinthree samples of each dressing and
containing plastic coverslips for 25
resistant Staphylococcus aureus
their mean scores were presented
hours to allow biofilms to establish. At
(MRSA) and Pseudomonas
in graph format. Total viable counts
known intervals of up to three hours,
aeruginosa (P aeruginosa), to
of bacteria released from dressing
dressing samples were removed,
bind to Cutimed® Sorbact® and
samples and estimations of biofilm
fixed, dehydrated and examined by
to investigate the efficacy of the
remaining on plastic cover slips did
scanning electron microscopy (SEM)
DACC coating by comparison with
not provide sufficiently sensitive
to determine the presence of biofilm.
an uncoated dressing.
means of monitoring biofilm binding.
The extent of coverage was estimated

Discussion
Scanning electron images showed
that biofilm bound more readily to
dressings coated with DACC than
to uncoated dressings. This study
confirms that DACC enhanced biofilm
binding to Cutimed® Sorbact®.
Biofilms of P aeruginosa showed
a greater affinity to Cutimed®
Sorbact® than MRSA. This is the first
demonstration of binding of bacterial
biofilms to Cutimed® Sorbact® in the
laboratory when the dressing and
biofilm were in direct contact. The
ability of Cutimed® Sorbact® to bind
and remove biofilm from wounds must
be tested in vivo.
Reference

1. Ljungh A, Yanagisawa, Wadstrom T. Using the
principle of hydrophobic interaction to bind and remove
wound bacteria. J Wound care 2006;15:175-180.
*This study was supported by BSN Medical Ltd.

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1. Hands on case report No 7: Chronic venous insufficiency and venous leg ulcers by Bernd von Hallern (2008).
2. Ljungh Å, Wadström T. Growth conditions influence expression of cell surface hydrophobicity of Staphylococci and other wound infection pathogens. Microbiological Immunology 1995; 39: 753-757
3. Ljungh Å, Hjerten S, Wadström T. High surface hydrophobicity of autoaggregating Staphylococcus aureus strains isolated from human infections studied with the salt aggregation test. Infection and Immunity 1985; 2: 522-526
4. Hampton S. An evaluation of the efficacy of Cutimed Sorbact in different types of nonhealing wounds. Wounds UK 2007; Vol 3 No 4
5. Meuleneire F. Dressing choice for infected wounds with resistant bacteria and problems of contact allergy. EWMA Journal, Supplement, 2007; 7: P77
6. K. F. Cutting. DACC antimicrobial technology: a new paradigm in bioburden management, Journal of Wound Care, Supplement, 2011
7. Powell G. Evaluating Cutimed Sorbact: using a Case Study Approach. British Journal of Nursing 2009; 18 (15): S30. S32-S36

For further information contact: BSN Medical (Pty) Ltd, South Africa Tel. [phone] • Fax. [phone] • www.bsnmedical.co.za
30 Gillitts Road, Pinetown, 3610 • PO Box 526, Pinetown, 3600 • TollFree (orders) 0800 202 858/9 • TollFree (fax) 0800 203 555

MEDICAL CHRONICLE NOVEMBER/DECEMBER 2013 49