In fostering fibronectin production, UVC stimulates cell migration and the production of growth factors, which further augment the healing cascade.īased on our earlier studies in vitro and in vivo, here we hypothesized that exposure of far-UVC light onto the surgical wound area during surgery is a suitable approach to killing bacteria both in the air and as they lay down onto the wound area or settle on the surgeon's hands and instruments, without adverse health hazards for patient or staff. Another advantage of the ability of far-UVC light to selectively inactivate microorganisms while preserving the viability of mammalian host cells and tissues, is promotion of wound healing and skin homeostasis. Previously we have shown that far-UVC light in the range of 207–222 nm kills bacteria efficiently, but without the skin damaging effects associated with conventional germicidal UV exposure. This necessitates the use of cumbersome personal protective equipment for patient and hospital staff, which has prevented widespread adoption of germicidal UV lamps during surgical procedures. However, the major downside of using conventional germicidal UV lamps during surgery is that exposure to germicidal 254-nm light is a health hazard, causing skin cancer and cataracts.
These results, which are also consistent with direct measurement of bacterial loads in wounds with and without in-surgery UV exposure suggest that continuous UV exposure during surgery might reduce SSI rates significantly. Surgical wound irradiation with conventional germicidal UV lamps typically emitting 254-nm light have shown great promise for infection control : over a nineteen-year period following 5,980 joint replacements, the SSI rate using UV exposure decreased by three-fold (p< 0.0001), compared to unirradiated controls. While significant resources have been applied to reduce their rates in the clinical setting, effective prevention remains elusive. SSI infections from drug-resistant bacteria such as methicillin resistant Staphylococcus aureus (MRSA) currently present a major health care burden. In fact there have been multiple clinical studies, starting as far back as 1940, demonstrating that UV exposure of the wound during surgery results in markedly decreased SSI rates. īecause of the prevalence of the airborne bacteria route, UV exposure during surgery has long been considered as a potential modality for reducing SSI.
Evidence for the dominance of the airborne route comes from correlations between the density of airborne bacteria and postoperative sepsis rates proof for the impact of airborne bacteria alighting directly on the surgical wound comes, for example, from studies of conventional ultraviolet (UV) lamps specifically directed over the surgical site, and also from wound-directed filtered airflow studies. The majority of surgical site infection (SSI) are believed to be caused by airborne transmission of bacteria alighting onto the wound. This does not alter our adherence to PLOS ONE policies on sharing data and materials. (Tokyo, Japan) pursuant to exclusive license and research agreements with Columbia University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: I have read the journal's policy and the author of this manuscript Gerhard Randers-Pehrson has the following competing interests: GR-P receives royalty payments from Ushio Inc. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the paper and in Open Science Framework at the following DOI: 10.17605/OSF.IO/BGQSW.įunding: This work was supported by Shostack Foundation and USHIO Inc., grant number PG006603-02-USHIO CU15-1452 to DJB. Received: NovemAccepted: JanuPublished: February 21, 2018Ĭopyright: © 2018 Ponnaiya et al. Fornace Jr, Georgetown University, UNITED STATES Citation: Ponnaiya B, Buonanno M, Welch D, Shuryak I, Randers-Pehrson G, Brenner DJ (2018) Far-UVC light prevents MRSA infection of superficial wounds in vivo.
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