Does pH Influence the Bacterial Profile of Chronic Lesions? An Analysis of Venous Ulcer Samples.

OBJECTIVE: To analyze the pH of venous ulcers and their relationship with the quantitative and qualitative bacterial profile of the wounds. METHODS: Cross-sectional study carried out through data collection and microbiologic analyses of samples obtained from 35 venous ulcers. Investigators performed pH measurement with indicator strips and collected biologic material using swabs. After aerobic and anaerobic cultivation, colony-forming units (CFUs) were counted and used for bacterial identification via mass spectrometry. RESULTS: The pH values ranged from 7.9 to 8.7; 8.5 (37.1%) was the most frequent, followed by 8.3 (28.6%). The most common species were Staphylococcus aureus (68.6%), Pseudomonas aeruginosa (62.9%), Proteus mirabilis (45.7%), and Corynebacterium striatum (40.0%). The number of CFUs ranged from 0 to 200,000 in both anaerobiosis and aerobiosis and was predominantly between 1,000 and 10,000 (37.1%) in anaerobiosis and between 10,000 and 100,000 (37.1%) in aerobiosis. No association was found between the different pH values and the variation in CFUs in anaerobiosis (P = .21) and aerobiosis (P = .55) or by bacterial species identified: S aureus (P = .41), P aeruginosa (P = .29), P mirabilis (P = .19), and C striatum (P = .96). CONCLUSIONS: The pH of venous ulcers did not influence bacterial profile in quantitative or qualitative parameters.

Clinical and Microbiological Outcomes Associated With Use of Platelet-Rich Plasma in Chronic Venous Leg Uclers: A Randomized Controlled Trial.

PURPOSE: To evaluate the susceptibility profiles of Staphylococcus aureus and Pseudomonas aeruginosa strains identified in chronic venous ulcers treated with platelet-rich plasma (PRP) and petrolatum gauze or petrolatum gauze alone and to quantitatively evaluate the bacterial load and biofilm-forming capacities of the detected S. aureus and P. aeruginosa strains. DESIGN: Randomized controlled trial. SUBJECTS AND SETTING: The convenience sample included 36 participants; 18 were allocated to the PRP combined with the petrolatum gauze group, and 18 were allocated to the control group, which was treated with petrolatum gauze alone. METHODS: Thirty-six patients presenting with chronic venous ulcers were consecutively randomized to the PRP group (n = 18) or the petrolatum gauze control group (n = 18). We followed participants for 3 months during treatment and collected swab cultures from their wounds during weeks 1, 6, and 12 or until the wounds healed. The samples were analyzed using mass spectrometry. Antimicrobial susceptibility tests were performed using disk diffusion. RESULTS: P. aeruginosa was identified in 39 (39%) of 100 samples, and S. aureus was detected in only 10 (10%) samples collected over the study period. At the end of the 12-week treatment period, the wound infections reduced in both the PRP (P = .0078) and control groups (P = .01). The microorganisms were susceptible to most of the tested antimicrobials. The PRP did not increase the bacterial load in the wounds. All S. aureus strains identified showed biofilm-forming capacities and were classified as weak biofilm producers. All P. aeruginosa strains produced biofilm, with 17 strains being classified as weak, 14 as moderate, and 8 as strong biofilm producers. CONCLUSIONS: The PRP plus petrolatum gauze did not increase bacteriological growth or the microbial load in chronic venous ulcers compared with petrolatum gauze alone and could be a considered as an advanced treatment option for these types of chronic wounds.