Bacteriology of chronic leg ulcers

Area of Science:

• Medical Microbiology
• Dermatology
• Wound Care

Background:

• Chronic leg ulcers present a significant clinical challenge.
• Bacterial burden is a key factor in non-healing wounds.
• Effective assessment of wound microbiology is crucial for treatment.

Purpose of the Study:

• To evaluate the quantitative bacteriology of chronic leg ulcers.
• To compare swab and biopsy culture techniques for bacterial assessment.
• To determine the effect of benzoyl peroxide on ulcer bacterial flora and healing.

Main Methods:

• Sequential quantitative bacterial assessment of 13 chronic leg ulcers.
• Comparison of swab and biopsy culture techniques.
• Evaluation of 10% benzoyl peroxide lotion versus placebo.

Main Results:

• Good correlation (12/17 instances) between swab and biopsy culture techniques.
• Benzoyl peroxide did not significantly alter bacterial flora.
• Ulcer healing correlated with bacterial load: 3/5 ulcers with <10(5) organisms/gram healed, while 0/8 ulcers with >10(5) organisms/gram healed.

Conclusions:

• Quantitative bacteriology is a valuable tool for assessing leg ulcer healing.
• Bacterial load, rather than benzoyl peroxide treatment, appears critical for healing.
• Threshold of <10(5) organisms per gram may indicate favorable healing potential.