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We used laboratory confirmed number of Salmonella cases and corresponding multipliers to estimate the burden of illness using the method adopted by Foodborne Diseases Active Surveillance Network (FoodNet) at Centers for Disease Control and Prevention (CDC). 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J.", "lastName": "De Keersmaecker" } ], "abstractNote": "The ability of Salmonella to form complex surface-associated communities, called biofilms, contributes to its resistance and persistence in both host and non-host environments and is especially important in food processing environments. In this review, the different types of abiotic (plastic, glass, cement, rubber, and stainless steel) and biotic surfaces (plant surfaces, epithelial cells, and gallstones) on which Salmonella biofilms have been described are discussed, as well as a number of commonly used laboratory setups to study Salmonella biofilm formation (rdar morphotype, pellicle formation, and biofilms on polystyrene pegs). Furthermore, the structural components important during Salmonella biofilm formation are described (curli and other fimbriae, BapA, flagella, cellulose, colanic acid, anionic O-antigen capsule and fatty acids), with special attention to the structural variations of biofilms grown on different surfaces and under different conditions. Indeed, biofilm formation is strongly influenced by different environmental signals, via a complex regulatory network. An extensive overview is given on the current understanding of this genetic network and the interactions between its different components (CsgD, RpoS, Crl, OmpR, IHF, H-NS, CpxR, MlrA, c-di-GMP, BarA/SirA, Csr, PhoPQ, RstA, Rcs, metabolic processes and quorum sensing). To further illustrate that biofilm formation is a mechanism of Salmonella to adapt to different environments, the resistance of Salmonella biofilms against different stress factors including desiccation stress, disinfectants (e.g. hypochlorite, glutaraldehyde, cationic tensides and triclosan) and antibiotics (e.g. ciprofloxacin) is described. Finally, a number of Salmonella biofilm inhibitors, identified through bottom-up- and top-down-approaches, are discussed, such as surfactin, glucose, halogenated furanones, 4(5)-aryl 2-aminoimidazoles, furocoumarins and salicylates. Also the potential of combination therapy (e.g. combinations of triclosan and quaternary ammonium salts or halogenated furanones and antibiotics/disinfectants) and nano- and micro-emulsions to inhibit Salmonella biofilm formation is discussed. Insight into the pathogen's complex biofilm process will eventually lead to further unraveling of its intricacies and more efficient strategies to combat Salmonella biofilms.", "publicationTitle": "Food Research International", "publisher": "", "place": "", "date": "March 2012", "volume": "45", "issue": "2", "section": "", "partNumber": "", "partTitle": "", "pages": "502-531", "series": "Salmonella in Foods: Evolution, Strategies and Challenges", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Food Research International", "DOI": "10.1016/j.foodres.2011.01.038", "citationKey": "", "url": "http://www.sciencedirect.com/science/article/pii/S0963996911000615", "accessDate": "2014-12-18T15:15:18Z", "PMID": "", "PMCID": "", "ISSN": "0963-9969", "archive": "", "archiveLocation": "", "shortTitle": "Salmonella biofilms", "language": "", "libraryCatalog": "ScienceDirect", "callNumber": "", "rights": "", "extra": "", "tags": [ { "tag": "Salmonella", "type": 1 }, { "tag": "biofilm", "type": 1 } ], "collections": [ "S4NE3ZJF" ], "relations": {}, "dateAdded": "2014-12-18T15:15:18Z", "dateModified": "2014-12-18T15:15:18Z" } }, { "key": "B7S7XAZD", "version": 474, "library": { "type": "group", "id": 299845, "name": "Business of Bioscience Biofilms", "links": { "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299845/items/B7S7XAZD", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms/items/B7S7XAZD", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/299845/items/ZHB8BUS9", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2042735, "username": "hpetty14", "name": "", "links": { "alternate": { "href": "https://www.zotero.org/hpetty14", "type": "text/html" } } } }, "data": { "key": "B7S7XAZD", "version": 474, "parentItem": "ZHB8BUS9", "itemType": "attachment", "linkMode": "imported_url", "title": "Snapshot", "accessDate": "2014-12-18T15:14:59Z", "url": "https://www.mysciencework.com/publication/read/1444147/economic-burden-of-salmonella-infections-in-the-united-states", "note": "", "contentType": "text/html", "charset": "utf-8", "filename": "economic-burden-of-salmonella-infections-in-the-united-states.html", "md5": "ee1b783d1b9a8c3ef59ce41b41f50eab", "mtime": 1418915699973, "tags": [], "relations": {}, "dateAdded": "2014-12-18T15:14:59Z", "dateModified": "2014-12-18T15:14:59Z" } }, { "key": "2FJEKBSW", "version": 470, "library": { "type": "group", "id": 299845, "name": "Business of Bioscience Biofilms", "links": { "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299845/items/2FJEKBSW", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms/items/2FJEKBSW", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/299845/items/XKD6VPJM", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2096426, "username": "ckwhiteside", "name": "Claire Whiteside", "links": { "alternate": { "href": "https://www.zotero.org/ckwhiteside", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "2FJEKBSW", "version": 470, "parentItem": "XKD6VPJM", "itemType": "attachment", "linkMode": "imported_url", "title": "PubMed Central Full Text PDF", "accessDate": "2014-12-13T20:38:32Z", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4046891/pdf/nihms512010.pdf", "note": "", "contentType": "application/pdf", "charset": "", "filename": "Nguyen et al. - 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The inactivity of antibiotic targets caused by starvation-induced growth arrest is thought to be a key mechanism producing tolerance (). Here we show that the antibiotic tolerance of nutrient-limited and biofilm Pseudomonas aeruginosa is mediated by active responses to starvation, rather than by the passive effects of growth arrest. The protective mechanism is controlled by the starvation-signaling stringent response (SR), and our experiments link SR–mediated tolerance to reduced levels of oxidant stress in bacterial cells. Furthermore, inactivating this protective mechanism sensitized biofilms by several orders of magnitude to four different classes of antibiotics, and markedly enhanced the efficacy of antibiotic treatment in experimental infections.", "publicationTitle": "Science (New York, N.Y.)", "publisher": "", "place": "", "date": "2011-11-18", "volume": "334", "issue": "6058", "section": "", "partNumber": "", "partTitle": "", "pages": "982-986", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Science", "DOI": "10.1126/science.1211037", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4046891/", "accessDate": "2014-12-13T20:38:32Z", "PMID": "", "PMCID": "", "ISSN": "0036-8075", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "PubMed Central", "callNumber": "", "rights": "", "extra": "PMID: 22096200\nPMCID: PMC4046891", "tags": [], "collections": [ "66S93C8S" ], "relations": {}, "dateAdded": "2014-12-18T08:40:50Z", "dateModified": "2014-12-18T08:40:50Z" } }, { "key": "XNSA686R", "version": 468, "library": { "type": "group", "id": 299845, "name": "Business of Bioscience Biofilms", "links": { "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299845/items/XNSA686R", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms/items/XNSA686R", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/299845/items/VB7T9NJQ", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2096426, "username": "ckwhiteside", "name": "Claire Whiteside", "links": { "alternate": { "href": "https://www.zotero.org/ckwhiteside", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "XNSA686R", "version": 468, "parentItem": "VB7T9NJQ", "itemType": "attachment", "linkMode": "imported_url", "title": "PubMed Central Full Text PDF", "accessDate": "2014-12-13T19:39:22Z", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2289825/pdf/1471-2180-8-43.pdf", "note": "", "contentType": "application/pdf", "charset": "", "filename": "Dowd et al. - 2008 - Survey of bacterial diversity in chronic wounds us.pdf", "md5": "de36a6e57a0411db216cb7a23e646e8f", "mtime": 1418499574209, "tags": [], "relations": {}, "dateAdded": "2014-12-18T08:39:26Z", "dateModified": "2014-12-18T08:39:26Z" } }, { "key": "TAWTNCGV", "version": 467, "library": { "type": "group", "id": 299845, "name": "Business of Bioscience Biofilms", "links": { "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299845/items/TAWTNCGV", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms/items/TAWTNCGV", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/299845/items/VB7T9NJQ", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2096426, "username": "ckwhiteside", "name": "Claire Whiteside", "links": { "alternate": { "href": "https://www.zotero.org/ckwhiteside", "type": "text/html" } } } }, "data": { "key": "TAWTNCGV", "version": 467, "parentItem": "VB7T9NJQ", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed Central Link", "accessDate": "2014-12-13T19:39:22Z", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2289825/", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2014-12-18T08:39:26Z", "dateModified": "2014-12-18T08:39:26Z" } }, { "key": "VB7T9NJQ", "version": 467, "library": { "type": "group", "id": 299845, "name": "Business of Bioscience Biofilms", "links": { "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299845/items/VB7T9NJQ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms/items/VB7T9NJQ", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2096426, "username": "ckwhiteside", "name": "Claire Whiteside", "links": { "alternate": { "href": "https://www.zotero.org/ckwhiteside", "type": "text/html" } } }, "creatorSummary": "Dowd et al.", "parsedDate": "2008-03-06", "numChildren": 2 }, "data": { "key": "VB7T9NJQ", "version": 467, "itemType": "journalArticle", "title": "Survey of bacterial diversity in chronic wounds using Pyrosequencing, DGGE, and full ribosome shotgun sequencing", "creators": [ { "creatorType": "author", "firstName": "Scot E", "lastName": "Dowd" }, { "creatorType": "author", "firstName": "Yan", "lastName": "Sun" }, { "creatorType": "author", "firstName": "Patrick R", "lastName": "Secor" }, { "creatorType": "author", "firstName": "Daniel D", "lastName": "Rhoads" }, { "creatorType": "author", "firstName": "Benjamin M", "lastName": "Wolcott" }, { "creatorType": "author", "firstName": "Garth A", "lastName": "James" }, { "creatorType": "author", "firstName": "Randall D", "lastName": "Wolcott" } ], "abstractNote": "Background\nChronic wound pathogenic biofilms are host-pathogen environments that colonize and exist as a cohabitation of many bacterial species. These bacterial populations cooperate to promote their own survival and the chronic nature of the infection. Few studies have performed extensive surveys of the bacterial populations that occur within different types of chronic wound biofilms. The use of 3 separate16S-based molecular amplifications followed by pyrosequencing, shotgun Sanger sequencing, and denaturing gradient gel electrophoresis were utilized to survey the major populations of bacteria that occur in the pathogenic biofilms of three types of chronic wound types: diabetic foot ulcers (D), venous leg ulcers (V), and pressure ulcers (P).\n\nResults\nThere are specific major populations of bacteria that were evident in the biofilms of all chronic wound types, including Staphylococcus, Pseudomonas, Peptoniphilus, Enterobacter, Stenotrophomonas, Finegoldia, and Serratia spp. Each of the wound types reveals marked differences in bacterial populations, such as pressure ulcers in which 62% of the populations were identified as obligate anaerobes. There were also populations of bacteria that were identified but not recognized as wound pathogens, such as Abiotrophia para-adiacens and Rhodopseudomonas spp. Results of molecular analyses were also compared to those obtained using traditional culture-based diagnostics. Only in one wound type did culture methods correctly identify the primary bacterial population indicating the need for improved diagnostic methods.\n\nConclusion\nIf clinicians can gain a better understanding of the wound's microbiota, it will give them a greater understanding of the wound's ecology and will allow them to better manage healing of the wound improving the prognosis of patients. This research highlights the necessity to begin evaluating, studying, and treating chronic wound pathogenic biofilms as multi-species entities in order to improve the outcomes of patients. This survey will also foster the pioneering and development of new molecular diagnostic tools, which can be used to identify the community compositions of chronic wound pathogenic biofilms and other medical biofilm infections.", "publicationTitle": "BMC Microbiology", "publisher": "", "place": "", "date": "2008-3-6", "volume": "8", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "43", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "BMC Microbiol", "DOI": "10.1186/1471-2180-8-43", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2289825/", "accessDate": "2014-12-13T19:39:22Z", "PMID": "", "PMCID": "", "ISSN": "1471-2180", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "PubMed Central", "callNumber": "", "rights": "", "extra": "PMID: 18325110\nPMCID: PMC2289825", "tags": [], "collections": [ "66S93C8S" ], "relations": {}, "dateAdded": "2014-12-18T08:39:26Z", "dateModified": "2014-12-18T08:39:26Z" } }, { "key": "EASDHXKG", "version": 466, "library": { "type": "group", "id": 299845, "name": "Business of Bioscience Biofilms", "links": { "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299845/items/EASDHXKG", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms/items/EASDHXKG", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/299845/items/D948MSDX", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2096426, "username": "ckwhiteside", "name": "Claire Whiteside", "links": { "alternate": { "href": "https://www.zotero.org/ckwhiteside", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "EASDHXKG", "version": 466, "parentItem": "D948MSDX", "itemType": "attachment", "linkMode": "imported_url", "title": "PubMed Central Full Text PDF", "accessDate": "2014-12-14T06:11:04Z", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3911840/pdf/zii00114000092.pdf", "note": "", "contentType": "application/pdf", "charset": "", "filename": "Watters et al. - 2014 - Insulin Treatment Modulates the Host Immune System.pdf", "md5": "d22bd0cabb4ce1551fe33ce773a57e62", "mtime": 1418537467160, "tags": [], "relations": {}, "dateAdded": "2014-12-18T08:39:01Z", "dateModified": "2014-12-18T08:39:01Z" } }, { "key": "3EGV44PZ", "version": 465, "library": { "type": "group", "id": 299845, "name": "Business of Bioscience Biofilms", "links": { "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299845/items/3EGV44PZ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms/items/3EGV44PZ", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/299845/items/D948MSDX", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2096426, "username": "ckwhiteside", "name": "Claire Whiteside", "links": { "alternate": { "href": "https://www.zotero.org/ckwhiteside", "type": "text/html" } } } }, "data": { "key": "3EGV44PZ", "version": 465, "parentItem": "D948MSDX", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed Central Link", "accessDate": "2014-12-14T06:11:04Z", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3911840/", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2014-12-18T08:39:01Z", "dateModified": "2014-12-18T08:39:01Z" } }, { "key": "D948MSDX", "version": 465, "library": { "type": "group", "id": 299845, "name": "Business of Bioscience Biofilms", "links": { "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299845/items/D948MSDX", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms/items/D948MSDX", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2096426, "username": "ckwhiteside", "name": "Claire Whiteside", "links": { "alternate": { "href": "https://www.zotero.org/ckwhiteside", "type": "text/html" } } }, "creatorSummary": "Watters et al.", "parsedDate": "2014-01", "numChildren": 2 }, "data": { "key": "D948MSDX", "version": 465, "itemType": "journalArticle", "title": "Insulin Treatment Modulates the Host Immune System To Enhance Pseudomonas aeruginosa Wound Biofilms", "creators": [ { "creatorType": "author", "firstName": "Chase", "lastName": "Watters" }, { "creatorType": "author", "firstName": "Jake A.", "lastName": "Everett" }, { "creatorType": "author", "firstName": "Cecily", "lastName": "Haley" }, { "creatorType": "author", "firstName": "Allie", "lastName": "Clinton" }, { "creatorType": "author", "firstName": "Kendra P.", "lastName": "Rumbaugh" } ], "abstractNote": "Diabetes affects 25.8 million people in the United States, or 8.3% of the population, and these numbers are even higher in developing countries. Diabetic patients are more susceptible to the development of chronic wounds with debilitating bacterial infections than nondiabetics. Previously, we compared the ability of the opportunistic pathogen Pseudomonas aeruginosa to cause biofilm-associated infections in chronic wounds of diabetic and nondiabetic mice (C. Watters, K. DeLeon, U. Trivedi, J. A. Griswold, M. Lyte, K. J. Hampel, M. J. Wargo, and K. P. Rumbaugh, Med. Microbiol. Immunol. 202:131–141, 2013). Unexpectedly, we observed that insulin-treated diabetic mice had significantly more biofilm in their wounds, which correlated with higher antibiotic tolerance. Here, we investigated whether insulin treatment modulates the diabetic immune system to favor P. aeruginosa biofilm formation. Utilizing a murine chronic wound model, we found that DNA protected P. aeruginosa in the wounds of insulin-treated diabetic mice from antibiotic treatment. We also observed increased numbers of neutrophils, reduced numbers of macrophages, and increased cell death in the wounds of diabetic mice on insulin therapy. Taken together, these data suggest that high levels of lysed neutrophils in the wounds of diabetic mice on insulin, combined with fewer macrophages to remove the cellular debris, contribute to increased DNA levels, which enhance P. aeruginosa biofilms.", "publicationTitle": "Infection and Immunity", "publisher": "", "place": "", "date": "2014-1", "volume": "82", "issue": "1", "section": "", "partNumber": "", "partTitle": "", "pages": "92-100", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Infect Immun", "DOI": "10.1128/IAI.00651-13", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3911840/", "accessDate": "2014-12-14T06:11:04Z", "PMID": "", "PMCID": "", "ISSN": "0019-9567", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "PubMed Central", "callNumber": "", "rights": "", "extra": "PMID: 24126517\nPMCID: PMC3911840", "tags": [], "collections": [ "66S93C8S" ], "relations": {}, "dateAdded": "2014-12-18T08:39:01Z", "dateModified": "2014-12-18T08:39:01Z" } }, { "key": "XQWJKCWH", "version": 466, "library": { "type": "group", "id": 299845, "name": "Business of Bioscience Biofilms", "links": { "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299845/items/XQWJKCWH", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms/items/XQWJKCWH", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/299845/items/VC2HI95U", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2096426, "username": "ckwhiteside", "name": "Claire Whiteside", "links": { "alternate": { "href": "https://www.zotero.org/ckwhiteside", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "XQWJKCWH", "version": 466, "parentItem": "VC2HI95U", "itemType": "attachment", "linkMode": "imported_file", "title": "wound bed preparation for chronic diabetic foot ulcers.pdf", "accessDate": "", "url": "", "note": "", "contentType": "application/pdf", "charset": "", "filename": "wound bed preparation for chronic diabetic foot ulcers.pdf", "md5": "524875130548f6bd8070de612d3f64d9", "mtime": 1417721350331, "tags": [], "relations": {}, "dateAdded": "2014-12-18T08:38:20Z", "dateModified": "2014-12-18T08:38:20Z" } }, { "key": "VC2HI95U", "version": 464, "library": { "type": "group", "id": 299845, "name": "Business of Bioscience Biofilms", "links": { "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299845/items/VC2HI95U", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms/items/VC2HI95U", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2096426, "username": "ckwhiteside", "name": "Claire Whiteside", "links": { "alternate": { "href": "https://www.zotero.org/ckwhiteside", "type": "text/html" } } }, "creatorSummary": "Mat Saad et al.", "parsedDate": "2013-02-13", "numChildren": 2 }, "data": { "key": "VC2HI95U", "version": 464, "itemType": "journalArticle", "title": "Wound Bed Preparation for Chronic Diabetic Foot Ulcers", "creators": [ { "creatorType": "author", "firstName": "Arman Zaharil", "lastName": "Mat Saad" }, { "creatorType": "author", "firstName": "Teng Lye", "lastName": "Khoo" }, { "creatorType": "author", "firstName": "Ahmad Sukari", "lastName": "Halim" } ], "abstractNote": "The escalating incidence of diabetic mellitus has given rise to the increasing problems of chronic diabetic ulcers that confront the practice of medicine. Peripheral vascular disease, neuropathy, and infection contribute to the multifactorial pathogenesis of diabetic ulcers. Approaches to the management of diabetic ulcers should start with an assessment and optimization of the patient's general conditions, followed by considerations of the local and regional factors. This paper aims to address the management strategies for wound bed preparation in chronic diabetic foot ulcers and also emphasizes the importance of preventive measures and future directions. The “TIME” framework in wound bed preparation encompasses tissue management, inflammation and infection control, moisture balance, and epithelial (edge) advancement. Tissue management aims to remove the necrotic tissue burden via various methods of debridement. Infection and inflammation control restores bacterial balance with the reduction of bacterial biofilms. Achieving a moist wound healing environment without excessive wound moisture or dryness will result in moisture balance. Epithelial advancement is promoted via removing the physical and biochemical barriers for migration of epithelium from wound edges. These systematic and holistic approaches will potentiate the healing abilities of the chronic diabetic ulcers, including those that are recalcitrant.", "publicationTitle": "ISRN Endocrinology", "publisher": "", "place": "", "date": "2013-2-13", "volume": "2013", "issue": "", "section": "", "partNumber": "", "partTitle": "", "pages": "", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "ISRN Endocrinol", "DOI": "10.1155/2013/608313", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586512/", "accessDate": "2014-12-14T06:05:52Z", "PMID": "", "PMCID": "", "ISSN": "2090-4630", "archive": "", "archiveLocation": "", "shortTitle": "", "language": "", "libraryCatalog": "PubMed Central", "callNumber": "", "rights": "", "extra": "PMID: 23476800\nPMCID: PMC3586512", "tags": [], "collections": [ "66S93C8S" ], "relations": {}, "dateAdded": "2014-12-18T08:38:20Z", "dateModified": "2014-12-18T08:38:20Z" } }, { "key": "7ZMDU3DQ", "version": 464, "library": { "type": "group", "id": 299845, "name": "Business of Bioscience Biofilms", "links": { "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299845/items/7ZMDU3DQ", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms/items/7ZMDU3DQ", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/299845/items/VC2HI95U", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2096426, "username": "ckwhiteside", "name": "Claire Whiteside", "links": { "alternate": { "href": "https://www.zotero.org/ckwhiteside", "type": "text/html" } } } }, "data": { "key": "7ZMDU3DQ", "version": 464, "parentItem": "VC2HI95U", "itemType": "attachment", "linkMode": "linked_url", "title": "PubMed Central Link", "accessDate": "2014-12-14T06:05:52Z", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586512/", "note": "", "contentType": "text/html", "charset": "", "tags": [], "relations": {}, "dateAdded": "2014-12-18T08:38:20Z", "dateModified": "2014-12-18T08:38:20Z" } }, { "key": "8CUNW2XE", "version": 463, "library": { "type": "group", "id": 299845, "name": "Business of Bioscience Biofilms", "links": { "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299845/items/8CUNW2XE", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms/items/8CUNW2XE", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/299845/items/U9H7VV8V", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2096426, "username": "ckwhiteside", "name": "Claire Whiteside", "links": { "alternate": { "href": "https://www.zotero.org/ckwhiteside", "type": "text/html" } } }, "numChildren": 0 }, "data": { "key": "8CUNW2XE", "version": 463, "parentItem": "U9H7VV8V", "itemType": "attachment", "linkMode": "imported_file", "title": "Ten top tips.managing surgical site infections.pdf", "accessDate": "", "url": "", "note": "", "contentType": "application/pdf", "charset": "", "filename": "Ten top tips.managing surgical site infections.pdf", "md5": "14787f670b62c778cfe53fadd5ad4f33", "mtime": 1418536641149, "tags": [], "relations": {}, "dateAdded": "2014-12-18T08:36:17Z", "dateModified": "2014-12-18T08:36:17Z" } }, { "key": "U9H7VV8V", "version": 462, "library": { "type": "group", "id": 299845, "name": "Business of Bioscience Biofilms", "links": { "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299845/items/U9H7VV8V", "type": "application/json" }, "alternate": { "href": 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"contentType": "", "charset": "", "tags": [], "relations": {}, "dateAdded": "2014-12-18T08:35:54Z", "dateModified": "2014-12-18T08:35:54Z" } }, { "key": "HMHXH86X", "version": 461, "library": { "type": "group", "id": 299845, "name": "Business of Bioscience Biofilms", "links": { "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299845/items/HMHXH86X", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms/items/HMHXH86X", "type": "text/html" } }, "meta": { "createdByUser": { "id": 2096426, "username": "ckwhiteside", "name": "Claire Whiteside", "links": { "alternate": { "href": "https://www.zotero.org/ckwhiteside", "type": "text/html" } } }, "creatorSummary": "Sen et al.", "parsedDate": "2009", "numChildren": 2 }, "data": { "key": "HMHXH86X", "version": 461, "itemType": "journalArticle", "title": "Human Skin Wounds: A Major and Snowballing Threat to Public Health and the Economy", "creators": [ { "creatorType": "author", "firstName": "Chandan K.", "lastName": "Sen" }, { "creatorType": "author", "firstName": "Gayle M.", "lastName": "Gordillo" }, { "creatorType": "author", "firstName": "Sashwati", "lastName": "Roy" }, { "creatorType": "author", "firstName": "Robert", "lastName": "Kirsner" }, { "creatorType": "author", "firstName": "Lynn", "lastName": "Lambert" }, { "creatorType": "author", "firstName": "Thomas K.", "lastName": "Hunt" }, { "creatorType": "author", "firstName": "Finn", "lastName": "Gottrup" }, { "creatorType": "author", "firstName": "Geoffrey C", "lastName": "Gurtner" }, { "creatorType": "author", "firstName": "Michael T.", "lastName": "Longaker" } ], "abstractNote": "In the United States, chronic wounds affect around 6.5 million patients. It is claimed that an excess of US$25 billion is spent annually on treatment of chronic wounds and the burden is growing rapidly due to increasing health care costs, an aging population and a sharp rise in the incidence of diabetes and obesity worldwide. The annual wound care products market is projected to reach $15.3 billion by 2010. Chronic wounds are rarely seen in individuals who are otherwise healthy. In fact, chronic wound patients frequently suffer from “highly branded” diseases such as diabetes and obesity. This seems to have overshadowed the significance of wounds per se as a major health problem. For example, NIH’s Research Portfolio Online Reporting Tool (RePORT; http://report.nih.gov/), directed at providing access to estimates of funding for various disease conditions do list several rare diseases but does not list wounds. According to the latest data from the National Center for Health Statistics, 40 million inpatient surgical procedures were performed in the United States in 2000, followed closely by 31.5 million outpatient surgeries. The need for post-surgical wound care is sharply on the rise. Emergency wound care in an acute setting has major significance not only in a war setting but also in homeland preparedness against natural disasters as well as against terrorism attacks. An additional burden of wound healing is the problem of skin scarring, a $12 billion annual market. Current research advances in the field have led to solutions that have been effective in improving patient care. The immense economic and social impact of wounds in our society calls for allocation of a higher level of attention and resources to understand biological mechanisms underlying cutaneous wound complications. Investment in the detailed scrutiny of wounds presented clinically as well as in pre-clinical models seems prudent.", "publicationTitle": "Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society", "publisher": "", "place": "", "date": "2009", "volume": "17", "issue": "6", "section": "", "partNumber": "", "partTitle": "", "pages": "763-771", "series": "", "seriesTitle": "", "seriesText": "", "journalAbbreviation": "Wound Repair Regen", "DOI": "10.1111/j.1524-475X.2009.00543.x", "citationKey": "", "url": "http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2810192/", "accessDate": "2014-12-13T18:18:09Z", "PMID": "", "PMCID": "", "ISSN": "1067-1927", "archive": "", "archiveLocation": "", "shortTitle": "Human Skin Wounds", "language": "", "libraryCatalog": "PubMed Central", "callNumber": "", "rights": "", "extra": "PMID: 19903300\nPMCID: PMC2810192", "tags": [], "collections": [ "66S93C8S" ], "relations": {}, "dateAdded": "2014-12-18T08:35:54Z", "dateModified": "2014-12-18T08:35:54Z" } }, { "key": "ZT6KVI89", "version": 462, "library": { "type": "group", "id": 299845, "name": "Business of Bioscience Biofilms", "links": { "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms", "type": "text/html" } } }, "links": { "self": { "href": "https://api.zotero.org/groups/299845/items/ZT6KVI89", "type": "application/json" }, "alternate": { "href": "https://www.zotero.org/groups/business_of_bioscience_biofilms/items/ZT6KVI89", "type": "text/html" }, "up": { "href": "https://api.zotero.org/groups/299845/items/I6M7HCE8", "type": "application/json" } }, "meta": { "createdByUser": { "id": 2096426, "username": "ckwhiteside", "name": "Claire Whiteside", "links": { "alternate": { "href": "https://www.zotero.org/ckwhiteside", "type": "text/html" } } } }, "data": { "key": "ZT6KVI89", "version": 462, "parentItem": "I6M7HCE8", "itemType": "attachment", "linkMode": "imported_url", "title": "Snapshot", "accessDate": "2014-12-13T21:04:33Z", "url": "http://onlinelibrary.wiley.com/doi/10.1111/wrr.12016/abstract", "note": "", "contentType": "text/html", "charset": "utf-8", "filename": "abstract.html", "md5": "973ce87dc504e44a9c5a032d7f562ffe", "mtime": 1418504673735, "tags": [], "relations": {}, "dateAdded": "2014-12-18T08:35:32Z", "dateModified": "2014-12-18T08:35:32Z" } } ]