Evaluation of a Novel Antimicrobial Topical Spray to Reduce Bioburden

Abstract Body: Purpose/Problem: Chronic infection of wounds are commonplace1,2, accounting for significant economic and quality of life burdens for patients1,3. High levels of bacteria, multi-resistant organisms, and biofilm may be imperceptible to the naked eye with providers.  Currently, weekly surgical debridement is used to disrupt biofilm and prophylactic antibiotics are often employed in attempt to control local wound infection and prevent its systemic spread . The overuse of antibiotics has led to serious consequences in the overall management of patients, and weekly surgical debridement options are not practical for all patients or within the scope of some care providers. A previous study5 demonstrated that normal saline was not effective in reducing wound bioburden. Objective: To evaluate a new, novel antimicrobial wound cleanser*(AWC) on wound bioburden in chronic wounds that demonstrates in vitro4 ability to impact immature and mature biofilm. Method: Wound bioburden was documented using a hand-held bacterial tissue fluorescence device** prior to treatment, after standard saline cleansing procedure, 15 seconds after AWC application and after a 10-minute dressing application of AWC in wounds of multiple etiology, at multiple sites. Bacterial tissue fluorescence provides real time noninvasive results of bacterial bioburden and activity of bacterial species. Outcomes: The wound microbial biofilms demonstrated biocidal activity by both AWC spray and soak applications. Reduction in wound bioburden with AWC may allow for the discontinuation of prophylactic antibiotic therapy in chronic wounds consistent with Centers for Disease Control recommendations for antibiotic stewardship programs. Conclusions: Use of a novel AWC can be readily implemented during standard wound care in any clinical setting by any provider to impact the wound bioburden that is present in most wounds. Further study is warranted including long-term healing outcomes and systemic antibiotic usage.