Time to Abandon Antimicrobial Approaches in Wound Healing

A Paradigm Shift

Jeanette Sams-Dodd, BSc, BScVet; Frank Sams-Dodd, PhD, Dr.med

Disclosures

Wounds. 2018;30(11):345-352. 

In This Article

Implications

In a comprehensive analysis of the burden of wound care in the United Kingdom, Guest et al[60] found that 2.2 million wounds require extended treatment annually, placing a financial burden of £5.3 billion in direct cost on the health care system. These numbers highlight the significance of wounds in health care, but more worrying is the fact that the study found 39% of the wounds were unhealed during the observation period of 1 year and a subsequent study by the same group[57] reported 48% of the wounds managed in primary care are chronic. These statistics strongly signal that wound healing represents a substantial unmet medical need in terms of treatment options. Several reviews[23–33] have reached the conclusion that most of the existing approaches to wound care are ineffective and some may even interfere with healing. The limitations of these treatment options can explain the large proportion of chronic wounds seen and also the substantial costs associated with wound care, such as the average cost of a wound in the United Kingdom being £2410.

Newer research[1–5] has found that the body actively supports a microbiome on its external surfaces and that it uses these microorganisms as part of its defense against pathogens in the environment. An antimicrobial approach necessarily will interfere with this environment and this may explain why antimicrobial approaches that have proven so effective for internal infections have minimal efficacy against skin and wound infections as they work in disagreement with the immune system.

Micropore particle technology is not antimicrobial, but instead acts as a passive immunotherapy, which by physical action disrupts the defense systems of bacteria and fungi. This results in 60% quicker removal of wound infections compared with antibiotics and antiseptics across many wound types. Furthermore, it has been able to initiate the healing of a number of nonhealing wounds that had failed to respond to existing approaches. These effects of MPPT clearly demonstrate the removal of wound infections does not require antimicrobial actions, but the data also suggest supporting the existing microbiome and the immune system will lead to substantially improved clinical outcomes compared with those achieved by an antimicrobial approach.

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