Managing Antimicrobial Resistance in Chronic Wound Care

Slow-healing wounds, like diabetic foot ulcers, venous leg wounds, and pressure ulcers, frequently turn into long-term battles. When dealing with chronic wounds, treatment can be difficult to target due to a multitude of complicating factors. Diabetes, vascular disease, and immune suppression all reduce the body’s ability to fight infection and repair tissue. Additionally, microbes within chronic wounds create their own barriers: biofilms, in which microbes embed themselves in a protective matrix that can repel antibiotics and the body’s natural defenses. This environment, if not handled judiciously, provides ample opportunity for antimicrobial resistance (AMR) to develop. AMR makes the traditional methods of fighting infection less dependable, and chronic wound management even more complex. While AMR cannot be eliminated, its progression can be slowed by utilizing biofilm-focused care and adopting innovative strategies.

The Perfect Storm: Chronic Wounds, Comorbidities, and Biofilms

Chronic wounds often involve a complex mix of health issues.

For example, comorbidities like diabetes, vascular disease, and immune suppression increase the frequency of chronic wounds. Additionally, biofilm formation provides another obstacle to chronic wound healing. Within a biofilm, bacteria and other microbes are shielded and can tolerate the antibiotics, antimicrobials, and immune cells that can usually kill them in a non-biofilm form. This tolerance makes traditional therapies far less effective, creating an environment where resistant strains can thrive.

AMR develops as a result of overuse of antibiotics. So, an unintended consequence of treating a difficult chronic wound case with escalating systemic antibiotics is that the microbes in the wound can develop resistance to the antibiotic treatment. This leads to a vicious cycle with the patient in question and increases the potential for the newly resistant microbes to spread to other patients. Increasingly, clinicians are applying innovative new strategies such as testing for antimicrobial resistance markers to help guide treatment.

Core Strategies for Managing Antimicrobial Resistance in Chronic Wounds

Prevention of AMR in chronic wounds frequently requires more than a single intervention, and expert consensus recommends assuming biofilms are present in hard-to-heal wounds.

• Wound hygiene and Debridement: The first line of defense is consistent wound hygiene. This reduces microbial load, lowers the risk of infection, and prepares the wound bed for healing. Clinicians may employ different debridement strategies, where necrotic tissue is removed, returning the chronic wound to an acute stage to promote the healing process.
• Biofilm-targeted interventions: After disruption, biofilms can quickly develop again if not managed carefully. To counter the reformation of biofilms, clinicians increasingly use agents like antimicrobial dressings or topical treatments that weaken biofilm structures. Merging physical disruption with chemical-based treatments helps reduce microbial tolerance and slow the development of AMR.
• Strategic antimicrobial use: Overuse or misuse of antibiotics and antimicrobials can increase resistance to these medications. Clinicians are advised to prescribe these treatments only when absolutely necessary and select narrow-spectrum agents when possible. Patients should follow their clinician’s directions carefully when using these medications.
• Holistic patient management: Wound care is truly full patient care. Managing comorbidities, such as diabetes and vascular disease, is essential to dramatically improving a patient’s healing potential and reducing the risk of resistant infections.

Together, these approaches form a comprehensive framework for managing AMR in wound care.

Next-Generation Wound Care

New innovative products are needed to bring to bear against chronic wounds that don’t promote antimicrobial resistance. iFyber provides comprehensive preclinical research services are specific chronic wound applications. Their expertise in antimicrobial resistance testing and biofilm research empowers developers to create safer, more effective wound care products.

Custom Antimicrobial Testing

iFyber offers a suite of antimicrobial efficacy testing solutions for medical devices and drugs, including antimicrobial dressings, bioengineered tissues, biomaterials, bioactive dressings, and novel anti-infectives. These products can be evaluated for their ability to develop unwanted antimicrobial resistance. iFyber scientists are experienced in developing assays and conducting tests to assess antimicrobial performance across a range of products.

Biofilm Testing Solutions

Given the recent understanding of biofilms, biofilm testing is becoming an increasingly common addition to the screening profile of new antimicrobial technologies. By taking a multi-method biofilm testing approach, treatments can be evaluated for their ability to both prevent biofilm formation and eradicate existing biofilms. iFyber specializes in biofilm testing solutions to verify the efficacy of novel devices and drugs.

Supporting Developers

By providing customized biofilm assays and antimicrobial testing, iFyber supports developers in creating evidence-based, safe, and effective wound care products. Their comprehensive testing services enable developers to evaluate antimicrobial performance, optimize product formulations, and meet regulatory requirements, facilitating the development of innovative solutions that address the challenges of chronic wounds and AMR.

The reality is clear: AMR isn’t going away, but smarter approaches can keep it in check. Effective care depends on thorough wound cleaning and debridement, careful selection of materials that don’t accelerate resistance, and judicious use of antibiotics. iFyber supports this mission by helping wound care developers evaluate products against resistant organisms, evaluating efficacy in biofilm models, and accelerating the developing next-generation solutions that minimize resistance while advancing healing. Their expertise and comprehensive testing services provide developers with the tools necessary to create innovative solutions that improve patient outcomes and combat the growing threat of AMR.

Click here to discover more about iFyber’s custom testing services and how they help developers tackle AMR.