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Bacterial colonization and healing of venous leg ulcers
Abstract
The aim of the study was to evaluate a possible influence of selected bacterial species on healing of venous leg ulcers. Fifty‐nine patients with venous leg ulcers were followed via frequent semiquantitative culture of bacteria from the ulcer surface and determination of the ulcer area over a period of 180 days. Occurrences of cellulitis were treated with systemic antibiotics. There was a significant difference in relative areas on days 90 and 180 when ulcers with growth of Pseudomonas aeruginosa were compared to those without (p=0.0080 and 0.0133, respectively). Ulcers with P. aeruginosa were characterized to a great extent by enlargement in contrast to those without. Ulcers with growth of Staphylococcus aureus or haemolytic streptococci healed significantly more slowly than those without when relative areas were compared on day 180 (p=0.0079 and 0.0492, respectively). Complete healing within the observation period of 180 days was observed in 10.5% of patients with P. aeruginosa and 35% of those without (p=0.0631), in 21.6% of patients with S. aureus and 62.5% of those without (p=0.0278), and in 10.5% of patients with haemolytic streptococci and 35% of those without (p = 0.0631). The initial areas of ulcers colonized with P. aeruginosa or 5. aureus were significantly larger than those without, but no significant correlation between initial areas and ulcer healing was revealed. Conclusion: Our results suggest that P. aeruginosa in venous leg ulcers can induce ulcer enlargement and/or cause a healing delay. The results also suggest a healing delay caused by 5. aureus and haemolytic streptococci. However, conclusions have to be treated with caution since P. aeruginosa was found in combination with haemolytic streptococci in 15.3% of the patients.
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“wounds infected with Pseudomonas are slower to heal [31], [37], [38]”
From Interactions of Methicillin Resistant Staphylococcus aureus USA300 and Pseudomonas aeruginosa in Polymicrobial Wound Infection (2013) · cites this paper as [38]
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Nolff, M. C., Reese, S., Fehr, M., Dening, R., & Meyer‐Lindenberg, A. (2016) · Journal of Small Animal Practice · doi:10.1111/jsap.12476 · Cited by 36
Antibiotics and antiseptics for pressure ulcers
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“Venous stasis ulcers are commonly colonized by bacteria, such as Pseudomonas aeruginosa and Staphylococcus aureus(1), and chronic infection prolongs healing and may increase the ulcer size over time.(1,2) Currently, intermittent compression, elevation, and surgical debridement constitute the major treatment modalities…”
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“aureus is known to interfere with wound healing and poses a significant risk factor for infections and invasive disease [23].”
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Advances in the Sensing and Treatment of Wound Biofilms
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“paired healing, the mechanisms of which are not fully understood [4].”
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“aureus and haemolytic streptococci [19-21].”
Self-citationSingle cells and bacterial biofilm populations in chronic wound infections
Lichtenberg, M., Kirketerp‐Møller, K., Kvich, L. A., Christensen, M. H., Fritz, B., Jakobsen, T. H., & Bjarnsholt, T. (2024) · APMIS · doi:10.1111/apm.13344 · Cited by 26
“…opportunistic biofilm forming pathogens Pseudomonas aeruginosa and Staphylococcus aureus have long been recognized as poor prognostic factors for wound healing [7, 8], and in general the presence of bacterial biofilms has been suggested to contribute to the chronicity of the chronic wounds [9 – 11].”
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“Secondary efficacy criteria were: (1) wound bed conditions (percentage of necrotic, fibrinous and granulation tissues); (2) surrounding skin conditions (intensity of oedema, purpura, erythema, oozing, maceration, horny edges and smell); (3) day of complete ulcer healing; (4) severity of symptoms (pain, itching), evalu…”
MethodEffcacy of a silver lipidocolloid dressing on heavily colonised wounds: a republished RCT
Lazareth, I., Meaume, S., Sigal-Grinberg, M., Combemale, P., Guyadec, T. L., Zagnoli, A., Perrot, J., Sauvadet, A., & Bohbot, S. (2012) · Journal of Wound Care · doi:10.12968/jowc.2012.21.2.96 · Cited by 24
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Self-citationThe Economic Impact of Hard-to-Heal Leg Ulcers
Rippon, M. G., Davies, P., White, R. J., & Bosanquet, N. (2007) · Worcester Research and Publications (University of Worcester) · Cited by 23
Metadata
- Authors
- Madsen, S. M., Westh, H., Danielsen, L., & Rosdahl, V. T.
- Affiliations
- Bispebjerg Hospital (DK)
- Statens Serum Institut (DK)
- Corresponding author
- Danielsen, Lis
- ORCID
- Westh, Henrik
- Venue
- APMIS
- Publisher
- Wiley
- Published
- 1996-07-08
- Volume
- 104
- Issue
- 7-8
- Pages
- 895-899
- ISSN
- 0903-4641 (ISSN-L)
- 1600-0463
- OpenAlex
- W1990659092
- Cited by
- 164
- References
- 13
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 6 · 2022: 6 · 2021: 4 · 2020: 8 · 2019: 6 · 2018: 3 · 2017: 5 · 2016: 13 · 2015: 8 · 2014: 16 · 2013: 15 · 2012: 7
- FWCI
- 4.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Apmis (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Wound Healing and Treatments
- Health Sciences › Medicine › Surgery › Diagnosis and Treatment of Venous Diseases
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
- Keywords
- venous leg ulcers, bacterial colonization, ulcer healing, Pseudomonas aeruginosa, Staphylococcus aureus, hemolytic streptococci, cellulitis, wound infection
- MeSH terms
- Bacterial Infections, Cellulitis, Humans, Pseudomonas Infections, Staphylococcal Infections, Streptococcal Infections, Varicose Ulcer, Wound Healing
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