Testosterone receptor is tied to healing

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					 NEWS | Wound Care

                   Ask                                   Chronic wound bacteria talk
                                                         to each other, scientists find
                   The Treatment Expert
                   Donna Sardina, RN,
                   MHA, WCC
                   President, Wound Care
                   Education Institute
                                                         By John O’Connor                                                                            autoinducer-2 (AI-2). About
                                                         Listening in on bacterial “con-                                                             1 in 5 produce a different type
 Do you have any tips for treating                       versations” might help improve                                                              of communication molecules
 denuded skin around a flush stoma?                       wound care, according to                                                                    that are called acyl-homoserine-

                                                                                                                                Photo: iStockphoto
                                                         researchers at Binghamton                                                                   lactones (AHLs).
 The first thing I would check for is a prop-             University in New York.                                                                        “Based on our findings,
 er and secure fit of the ostomy appliance                   “Bacteria, often viewed as                                                               we think that most resident
 (pouch). Because a flush stoma is flat                    simplistic creatures, are in fact    Bacteria in chronic wounds send                        species–the ‘good’ bacteria
 and even with the skin level, effluent                   very sociable units of life,” said   specific signals to each other.                         that live on us and don’t cause
 (stool and urine) can become caught                     Alex Rickard, assistant profes-                                                             disease–produce AI-2 while
 under the wafer, causing persistent leak-               sor of biological sciences. “They    chronic wound bacteria and to                          the pathogenic species typically
 age, erosion of the skin barrier, short-                can physically and chemically        test their ability to produce cell-                    produce AHLs,” said Katelynn
 ened wear time and skin breakdown.                      interact with one another and        to-cell signaling molecules.                           Manton, who was part of the
    Flush stomas and stomas recessed                     are quite selective about who           Partial gene sequencing                             undergraduate team.
 below the skin level require a special                  they hang out with. How bac-         allowed the team to identify 46                           The type of wound didn’t
 pouch with a curved back, called convex-                teria might communicate in           chronic wound strains belong-                          seem to matter, she added. All
 ity. Pouches can come with convexity                    chronic wounds, however, was         ing to nine genera. Further                            indicated a presence of possible
 built into them or you can buy the convex               somewhat of a mystery.”              research implied that close to                         AHLs or A1-2s, she said.
 inserts separately. These convex inserts                   Rickard and a team of under-      70% of those chronic wound                                Findings appear in the
 help the stoma protrude a little more and               graduate researchers were able       strains produce a specific type                         Dec. 22 issue of the Journal of
 thus direct the flow of stool or urine into              to identify specific types of        of communication molecule-                             Applied Microbiology. ■
 the bag rather than under the wafer.

    Some other ideas:
    • Dust peristomal skin with skin bar-
                                                         Testosterone receptor is tied to healing
 rier powder prior to application of the                 By John O’Connor                     end of health—the elderly, or                        
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