Optimisation of treatment of chronic wounds in bullous epidermolysis and the influence of microflora: A literature review
The study was conducted to find the most effective approaches to the treatment of chronic wounds in bullous epidermolysis, addressing the influence of the wound microbiome on the healing process. The study reviewed relevant scientific sources in dermatology, pharmacology, genetics, immunology, and microbiology, established the role of the wound microbiome in the healing of chronic wounds in bullous epidermolysis and analysed modern treatment strategies to accelerate the healing of these wounds. The results of the study showed that the wound microflora has a significant impact on the healing process. Epidermolysis bullosa provokes constant skin trauma, contributing to the creation of conditions for the growth of pathogenic bacteria in wounds, which leads to the development of dysbiosis and complicates the healing process. The wound microbiome in bullous epidermolysis is significantly affected by the patient’s immune status, antibiotic use, location, depth, and duration of the wound. Weakened immunity provokes the development of multidrug-resistant bacteria, an enhanced immune response and autoimmune processes create conditions for the development of microorganisms that can multiply in conditions characteristic of an inflamed wound. The use of antibiotics is a highly effective method of treating infections, but prolonged or irrational antibiotic therapy can provoke the emergence of resistant bacterial strains. Depending on its location, the wound microbiome is influenced by skin characteristics in different parts of the body, such as the level of moisture, the presence of sweat and sebaceous glands, and hair. The influence of the wound depth on the microbiome is realised by creating conditions for the reproduction of the relevant microorganisms at the appropriate depth. The duration of the wound increases dysbiosis in the wound, complicating healing. Modern treatment strategies to accelerate the healing of chronic wounds in bullous epidermolysis include personalised medicine, an integrated approach and the use of modern dressings. The results obtained indicate the need to research and develop new effective methods of eliminating wound dysbiosis to normalise its microbiome and accelerate the healing process
healing; pathogenic bacteria; dysbiosis; antibiotics; resistance; personalised medicine
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