Burns are some of the most difficult wounds to treat. Large open sores are easy for bacteria to colonize, and most serious burns require hospitalization, which can lead to exposure to infectious pathogens. The pathophysiologic response to a burn, as well as its involvement with skin that is colonized by opportunistic pathogens, are the major reasons for infections. A burn compromises the innate protection of the skin, decreases T-cell activity by decreasing the number of helper cells, decreases the levels of inflammatory cytokines and complements, and decreases the bactericidal activity of neutrophils. Common bacteria that infect burn wounds include Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Acinetobacter baumannii.
Currently, if an infection is suspected, the wound dressing is removed so a swab or scraping can be obtained. This exposes the wound, increases healing time and the likeliness a scar will develop. Testing of the sample can take several days to culture and identify the bacteria. The University of Bath's biochemistry department has developed a wound dressing patch that fluoresces in the presence of infectious bacteria. Most bacteria causing infections release toxins. These toxins break down nanocapsules which are filled with a fluorescent compound and bacteriophages. The fluorescent chemical glows under UV light, alerting doctors to an infection without removing the dressing, and can even detect toxins at concentrations below that which the body starts reacting, allowing doctors to start treatment before the bacteria cause an actual infection. The bacteriophages are viruses that attack and kill bacteria. They can help prevent and stop infections, even by those caused by microbes like MSRA that are resistant to antibiotics. The patches work well in the laboratory, but it will be some time before human trials begin.
University of Bath Research
Burn Wound Pathophysiology
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