National report - A new four-year, $13 million initiative aims to give treatments for chronic wound healing a much-needed shot in the arm through a combination of envelope-pushing science and interdisciplinary teamwork.
Funded by the National Institute of General Medical Sciences (NIGMS), the program has created Centers for Innovative Wound Healing Research around the following projects:
"The National Institutes of Health (NIH, the NIGMS parent organization) is looking for fresh perspectives on wound healing," says Philip S. Stewart, Ph.D., director, Center for Biofilm Engineering (CBE), Montana State University.
Because the CBE employs mainly engineers, he says, "We're bringing in expertise about biofilms that hasn't been married to the problem of chronic wound infection before. It's a new take" that requires the CBE to partner with researchers at the University of Washington and elsewhere.
In a pressure ulcer or diabetic foot ulcer, "A microbial biofilm begins developing," Dr. Stewart says. "It's an infection that's composed of organisms banded together in dense aggregates, secreting a slimy matrix that holds them together largely defended from antibiotics, antiseptics" and host defenses.
Understanding biofilms better and developing strategies to prevent their formation, to disrupt biofilms once they form or to change biofilm back into free-floating or planktonic bacteria may be important in reversing the chronicity of nonhealing wounds, according to Robert S. Kirsner, M.D., Ph.D., professor and vice chairman in the department of dermatology and cutaneous surgery, University of Miami.
To that end, Dr. Fleckman says researchers first will attempt to create chronic wounds in genetically engineered diabetic mice developed at the University of Washington under John Olerud, M.D., who heads the university's dermatology division and wound-healing project.
Dr. Fleckman says the team's major challenge in creating biofilm models is that "Nobody's been able to do it so far. There are no good models for those chronic wounds" that would enable laboratory studies without working on humans, he says.
The CBE project got its start about two years ago, when Randy Wolcott, M.D., who heads the Southwest Regional Wound Care Center in Lubbock, Texas, approached the University of Montana with the idea that biofilms played a role in patients' persistent wounds, Dr. Stewart says.
"We're just gearing up," he says.
However, Dr. Stewart says that unpublished preliminary studies conducted with Dr. Wolcott have revealed much biofilm and various bacteria in chronic wounds.