The impact of wound microbiota on chronic pain development in limb injuries: A microbiological perspective
Keywords:
wound microbiota, chronic pain, limb trauma, combat wound healing, microbial profiling, pain and microbiotaAbstract
Background and aim of the work: Undoubtedly, studying the clinical features of wound infection is relevant in the modern world, especially in Ukraine due to war. The main goal was to prevent possible remote consequences of wound healing and we studied the impact of wound microbiota in this aspect.
Research design and Methods: We conducted a microbiological study of wounds among 51 patients with limb injuries. The age characteristics of the groups did not differ from each other. Also, 30 patients were interviewed using VAS pain to conduct an association between pain severity and the wound microbiota composition. Statistical calculations were performed using a computer program MedCalc®Software.
Results: We divided patients into two groups: 1 group with one isolated an opportunistic wound pathogen and group 2 in which two or more types of opportunistic wound pathogens were isolated. The number of microbial associations formed by gram-negative species of microorganisms was determined in 1.78 times more often than the colonization of wounds by gram-positive opportunistic microorganisms. The surveyed respondents were divided into subgroups 1.1 and 2.1. The average value of pain in subgroups 1.1 and 2.1 was 38.46 (SD ± 13.44) and 39.16 (SD ± 13.78) and did not differ statistically (p > 0.05).
Conclusions: The predominance of gram-negative microorganisms as Klebsiella pneumoniae, Acinetobacter baumannii, Staphylococcus spp., Pseudomonas aeruginosa was established. The sensation of pain did not depend on the number of colonizing species. The obtained data encourage further research into the role of microorganisms in the healing process.
References
Thompson KB, Krispinsky LT, Stark RJ. Late immune consequences of combat trauma: a review of trauma-related immune dysfunction and potential therapies. Mil Med Res. 2019;6(1):11. doi: 10.1186/s40779-019-0202-0.
Kao R. Introduction: combat damage-control resuscitation/surgery and beyond. Can J Surg. 2018;61(6):178–179. doi: 10.1503/cjs.014418.
Maurya S, Bhandari PS. Negative Pressure Wound Therapy in the Management of Combat Wounds: A Critical Review. Adv Wound Care. 2016;5(9):379–89. doi: 10.1089/wound.2014.0624.
Yao Y, Zhang H. Better therapy for combat injury. Mil Med Res. 2019;6(1):23. doi: 10.1186/s40779-019-0214-9.
Sen CK, Roy S, Mathew-Steiner SS, Gordillo GM. Biofilm Management in Wound Care. Plast Reconstr Surg. 2021;148(2):275e-288e. doi: 10.1097/PRS.0000000000008142.
Mihai MM, Bălăceanu-Gurău B, Ion A, et al Host-Microbiome Crosstalk in Chronic Wound Healing. Int. J. Mol. Sci. 2024;25(9):4629.doi: 10.3390/ijms25094629.
Euler CW, Raz A, Hernandez A, et al. PlyKp104, a Novel Phage Lysin for the Treatment of Klebsiella pneumoniae, Pseudomonas aeruginosa, and Other Gram-Negative ESKAPE Pathogens. Antimicrob Agents Chemother. 2023;67(5):e0151922. doi: 10.1128/aac.01519-22.
Effah CY, Sun T, Liu S, Wu Y. Klebsiella pneumoniae: an increasing threat to public health. Ann Clin Microbiol Antimicrob. 2020;19(1):1. doi: 10.1186/s12941-019-0343-8.
Nazarchuk O, Denysko T, Dmytriiev D, et al. In vitro evaluation of antimicrobial and anti-biofilm properties of antiseptics against multidrug resistant clinical Escherichia coli strains, isolated from combat wounds. Paediatric surgery. 2023;3(80):8–20. doi.10.15574/PS.2023.80.8.
Lopes A, Seligman Menezes M, Antonio Moreira de Barros G. Chronic postoperative pain: ubiquitous and scarcely appraised: narrative review. Brazilian Journal of Anesthesiology (English Edition). 2021;71(6):649–55. doi: 10.1016/j.bjane.2020.10.014.
Vivcharenko V, Trzaskowska M, Przekora А. Wound Dressing Modifications for Accelerated Healing of Infected Wounds. Int J Mol Sci. 2023;24(8):7193. doi: 10.3390/ijms24087193.
Wylde V, Dennis J, Beswick AD, et al. Systematic review of management of chronic pain after surgery. Br J Surg. 2017;104(10):1293–1306. doi: 10.1002/bjs.10601.
Bruehl S. Complex regional pain syndrome. BMJ. 2015;351:h2730. doi: 10.1136/bmj.h2730.
Tomic-Canic M, Burgess JL, O’Neill KE, Strbo N, Pastar I. Skin Microbiota and its Interplay with Wound Healing. Am J Clin Dermatol. 2020;21(S1):36–43. doi: 10.1007/s40257-020-00536-w.
Liu S, Hur YH, Cai X, et al. A tissue injury sensing and repair pathway distinct from host pathogen defense. Cell. 2023;186(10):2127-2143.e22. doi: 10.1016/j.cell.2023.03.031.
Tipton CD, Sanford NE, Everett JA, et al. Chronic wound microbiome colonization on mouse model following cryogenic preservation. PLOS ONE. 2019;14(8):e0221565. doi: 10.1371/journal.pone.0221565.
Zhao A, Sun J, Liu Y. Understanding bacterial biofilms: From definition to treatment strategies. Front Cell Infect Microbiol. 2023;13:1137947. doi: 10.3389/fcimb.2023.1137947. 13.
Crofford L. Chronic Pain: Where the Body Meets the Brain. Trans Am Clin Climatol Assoc. 2015;126:167-83. PMID: 26330672.
Sung YT, Wu JS. The Visual Analogue Scale for Rating, Ranking and Paired-Comparison (VAS-RRP): A new technique for psychological measurement. Behav Res Methods. 2018;50(4): 1694-1715. doi: 10.3758/s13428-018-1041-8.
Thong ISK, Jensen MP, Miró J, Tan G. The validity of pain intensity measures: what do the NRS, VAS, VRS, and FPS-R measure? Scand J Pain. 2018;18(1):99–107. doi: 10.1515/sjpain-2018-0012.
Fillingim RB, Loeser JD, Baron R, Edwards RR. Assessment of Chronic Pain: Domains, Methods, and Mechanisms. J Pain. 2016;17(9):T10–20. doi: 10.1016/j.jpain.2015.08.010.
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