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Does the Application of a Semiocclusive Dressing Alter the Microflora of Healthy Intact Skin on the Foot?
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Background
The skin on human feet presents unique environments for the proliferation of potentially pathogenic commensals. This study examined microflora changes on healthy intact skin under a semiocclusive dressing on the medial longitudinal arch of the foot to determine changes in growth, distribution, and frequency of microflora under the dressing.
Methods
Nine human participants wore a low-adherent, absorbent, semiocclusive dressing on the medial longitudinal arch of the left foot for 2 weeks. An identical location on the right foot was swabbed and used as a control. Each foot was swabbed at baseline, week 1, and week 2. The swabs were cultured for 48 hours. Visual identification, Gram staining, DNase test agar, and a latex slide agglutination test were used to identify genera and species.
Results
Microflora growth was categorized as scant (0–10 colony-forming units [CFU]), light (11–50 CFU), moderate (51–100 CFU), or heavy (>100 CFU). Scant and light growth decreased and moderate and heavy growth increased under the dressing compared with the control. Seven different genera of bacteria were identified. Coagulase-negative Staphylococcus spp appeared most frequently, followed by
Conclusions
Changes in microflora distribution, frequency, and growth were found under the dressing, supporting historical studies. Microflora changes were identified as an increase in bioburden and reduction in diversity. The application of similar methods, using more sophisticated identification and analysis techniques and a variety of dressings, could lead to a better understanding of bacterial and fungal growth under dressings, informing better dressing selection to assist the healing process of wounds and prevent infection.
Department of Podiatry, University of Brighton, Eastbourne, England. Mrs. Forss is also with Centre of Regenerative Medicine and Devices, University of Brighton, Eastbourne, England.
Senior Biomedical Scientist Microbiology, East Sussex Healthcare NHS Trust, Eastbourne, England.
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