(WHS-P86) SYSTEMIC INFLAMMATION, WOUND-RELATED SYMPTOMS AND BIOFILM IN OLDER ADULTS WITH CHRONIC VENOUS LEG ULCERS (CVLU)
Friday, May 17, 2024
7:30 AM – 5:00 PM East Coast USA Time
Background: About 8.2 million people are suffering from chronic wounds, and the treatment costs of chronic wounds ranged from $28.1 to 96.8 billion in 2014 in US. Since venous leg ulcers(VLUs) tend to be chronic due to their high susceptibility to infection and high recurrence rate, they account for the majority of chronic wounds. Patients with venous leg ulcers suffer from diverse symptoms, including pain, fatigue, depression, swelling and exudate, and most patients with VLUs who have delayed healing experience significant symptoms. Biofilm is recognized as an important component of wound non-healing and it is believed that the formation of biofilm delays wound healing. Therefore, by examining wound-related symptoms corresponding to biofilm and inflammatory markers, such as CRP, during the course of wound treatments, clinicians may predict wound healing trajectories. The purpose of this observational prospective study was to 1) characterize the wound-related symptoms (fatigue, pain, exudate, itching, and edema or swelling) and wound related factors (wound area, the presence of biofilm, total bacteria, the level of serum CRP), and 2) explore associations between biofilm and levels of systemic inflammation and the severity of wound-related symptoms in individuals with chronic venous leg ulcers (CVLU) over 8 weeks of wound treatment.
Methods: A total of 117 subjects who received weekly sharp debridement at a wound clinic were enrolled. We collected clinical data every two weeks during the 8 weeks of the study period. Associations among variables were estimated using a Bayesian approach applied to general linear mixed models.
Results: Based on Bayes Factor (BF) value, there was moderate evidence of a direct association between biofilm presence and levels of C-reactive protein (CRP) (BF 4.3) and moderate evidence of direct associations between biofilm and wound-related symptoms; pain and exudate (BF 5.12, 8.49 respectively). There was extremely strong evidence for the association of biofilm with mean total bacteria.
Conclusion: This study is the first to examine associations among biofilm, inflammatory response, wound-related symptoms, and wound healing in clinical settings. Wound-related symptoms and the level of systemic CRP were associated with biofilm among patients who were receiving weekly sharp debridement. Symptom severity associated with CVLU requires clinical assessment and management. Symptom severity and level of systemic CRP may be biobehavioral markers for predicting wound healing trajectories.