The Effects of Probiotics, Prebiotics and Synbiotics on Wound Infection: A Systematic Review

This systematic review aimed to summarize the currently available evidence on the effect of oral probiotic therapy on infected wound healing among patients who underwent surgery.

An electronic search was conducted for articles published during 2010- 2022 in Embase, PubMed/Medline, Scopus, Web of Science, and Google Scholar using the keywords "probiotics," "prebiotics," "synbiotics," and "wound infection." The titles and abstracts of 2625 articles were screened, and 22 publications that fulfilled the inclusion criteria were included.

The current review provides evidence of the beneficial effects of probiotics on wound infection, significantly reducing the duration of antibiotic usage and the length of hospital stay for patients, with no serious side effects reported. Wound infections following various surgeries, such as abdominal wound surgery, colorectal cancer resection, periampullary neoplasms treatment, liver and bile duct resection, pancreaticoduodenectomy, esophagostomy, dental wound surgery, plastic surgery, and burns, are shown to be positively affected by probiotic usage. Although, in some cases, the improvements were not statistically significant, overall, the administration of probiotics appears to be satisfactory in this regard.

Probiotics demonstrate the ability to prevent the growth of pathogens and maintain wound space sterility by recruiting M2 macrophages, which produce anti-inflammatory markers and enhance the activity of phagocytic cells. Additionally, probiotics can reduce bacterial translocation from their niche to other areas and inhibit the production of bacterial mediators that lead to bacterial invasion.