The association between pressure injury microbiome and wound healing: a systematic review
Abstract
Introduction: Pressure injuries (PIs) are a significant clinical problem, particularly in elderly, bedridden, and spinal cord injury patients. Bacterial infections are a primary complication that often delays or prevents wound healing. This systematic review analysed the current evidence on the role of the PI microbiome in wound healing outcomes.
Methods: A systematic search was conducted in three online databases, namely Embase, Medline, and Web of Science (latest search October 2024). In total, 20 studies met the inclusion criteria, of which three were interventional (randomised controlled trials (RCTs), n=2; pre-post study, n=1), and 17 were observational study designs (retrospective, n=6; prospective, n=8; and case-control, n=3) comprising 1'015 study participants (with 1'034 PIs). These studies examined the PI microbiome, mostly at PI grades III and IV, using culture-based and next-generation sequencing (NGS) techniques. Data extraction focused on microbial diversity, predominant species, and their association with wound healing. The risk of bias was categorised as moderate, mostly due to the absence of sample size justification, as assessed by the NHLBI tool.
Results: The findings confirmed that Staphylococcus aureus, Pseudomonas aeruginosa, Proteus mirabilis, Klebsiella pneumoniae, Enterococcus spp., and Escherichia coli dominated the PI microbiomes. Microbiome composition varied according to PI severity and anatomical location. Molecular techniques have identified a…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 15 participants or records.
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