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Inflammatory response is associated with critical colonization in combat wounds
Trevor S Brown1, Jason S Hawksworth, Forest R Sheppard
1Department of Regenerative Medicine, Naval Medical Research Center, Silver Spring, Maryland 20910, USA.
Surgical Infections
|September 23, 2011
Summary
Combat wound healing depends on the immune response. Increased inflammatory cytokines and chemokines correlate with critical colonization, impacting healing outcomes in combat casualties.
Area of Science:
- Trauma and Regenerative Medicine
- Immunology of Wound Healing
- Combat Injury Research
Background:
- Combat injuries involve extensive soft tissue, bone, and neurovascular damage.
- Immune response is critical for healing traumatic combat wounds.
- Bacterial colonization correlates with inflammatory cytokine and chemokine levels.
Purpose of the Study:
- To investigate the correlation between inflammatory markers and microbial colonization in combat wounds.
- To evaluate the relationship between systemic and local inflammatory responses and wound healing outcomes.
- To identify potential biomarkers for predicting successful wound closure.
Main Methods:
- Prospective study of patients with penetrating extremity combat wounds followed for 30 days.
- Repeated surgical debridement every 48-72 hours with sample collection.
- Analysis of serum and wound effluent for cytokines/chemokines and wound tissue for microbial colonization.
Main Results:
- 154 debridements from 38 wounds in 25 patients were analyzed.
- Healing failure occurred in 23.7% of wounds.
- Increased serum and wound effluent cytokines/chemokines were associated with critical colonization.
Conclusions:
- Systemic and local inflammatory responses correlate with wound colonization and healing outcomes.
- The interplay between systemic response and local wound environment determines healing success.
- Biomarker panels may offer objective criteria for appropriate wound closure.
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