The Search Is On For Treatment Of Slow-Healing Wounds

Main Category: Infectious Diseases / Bacteria / Viruses
Also Included In: Diabetes;  Dermatology
Article Date: 25 Sep 2006 - 6:00 PDT

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The National Institutes of Health has awarded Montana State University's Center for Biofilm Engineering a $2.9 million grant to find new ways to heal chronic wounds.

The money will allow the center to fund undergraduate research, hire more doctoral-level researchers and purchase equipment for its investigation into the role biofilms play in chronic wounds. The money will be distributed over four years.

Biofilms are bacteria that grab onto a surface, build a colony and then secrete a protective slime that makes them nearly invulnerable to antibiotics and disinfectants. Biofilms can foul drinking water systems, industrial pipelines and cause hard-to-kill infections on medical implants.

"Our hypothesis is that once a biofilm starts in a wound it interferes with the normal healing process and becomes very tough to eradicate," said Phil Stewart, Center for Biofilm Engineering director. "However, there is much science still to be done. Biofilms' involvement in chronic wounds is not widely accepted. This is new territory."

Tens of thousands of long-term medical patients and elderly get bedsores that turn into chronic wounds annually. Due to the poor blood circulation of many diabetics, a foot sore can develop into an open ulcer that won't heal.

For diabetics, such wounds contribute to a foot or lower-leg amputation rate 10 to 15 times higher than non-diabetics. Eighty percent of diabetics who underwent amputation for chronic wounds died within five years, according to a Finnish study.

The incidence of chronic wounds in the United States has grown. That trend is expected to continue with the steady increase in adult and child obesity. One-in-3 Americans born in 2000 are expected to develop diabetes if current trends continue, according to the Centers for Disease Control and Prevention.

The CBE's research into chronic wounds began two years ago, after it was contacted by Dr. Randy Wolcott, who heads the Southwest Regional Wound Care Center in Lubbock, Texas. With his clinic treating up to 100 patients daily, Wolcott suspected biofilms might play a role in his patients' persistent wounds.

Tissue samples analyzed by the CBE from Wolcott's clinic revealed that 60 percent contained biofilms, compared with a mere 6 percent in acute wounds, such as cuts.

Previous center research has shown that bacteria in biofilms activate sets of genes that are dormant in free-floating bacteria. With their new genetic instructions, biofilm bacteria form complicated slimy communities that can be 1000 times more antibiotic resistant than free-floating bacteria.

"If you accept the biofilm theory of chronic wounds, it explains a lot," said Garth James, director of medical projects at the CBE. "It explains why these wounds are slow to heal. It explains why they recur. It explains why certain treatments - like debridement, where a wound is actually scraped clean - works. In that case, the biofilms are removed."

The grant is in partnership with Wolcott, who offers an important clinical perspective, and the division of dermatology at the University of Washington's Department of Medicine, which brings expertise in the biology of wound healing to the project.

"It's a point to relish that much of the data that was gathered to make this grant successful was the result of undergraduate work," Stewart said.

Ellen Swogger, a recent chemical engineering graduate from Miles City, and Pat Secor, a biochemistry graduate from Bozeman, did that undergraduate research. Swogger is headed to Oregon State University for a Ph.D. Secor is pursuing a Ph.D. at MSU.

One of the center's strengths is its unique interdisciplinary team that includes researchers from engineering, the life sciences and medicine, James said.

"If you bring in people from different disciplines they can see the problem in different ways," James said. "The more minds working on a problem, the better."

The NIH grant will represent the largest single medical research project at the center.

"The ultimate goal," James said, "is to heal people's wounds, save their limbs, and their lives,"

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Contact: Phil Stewart
Montana State University

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