Biofilm Inhibition and Destabilisation through Optimized Phage Therapy as a Novel Wound Healing Therapy

Background: Chronic wounds, such as diabetic foot ulcers (DFUs), present major clinical and societal challenges, to which leading nations have been slow to give sufficient research funding priority, e.g. there are 4.5 million people with diabetes in the UK, 34% of these will develop a DFU at some point in their lives. Our inability to successfully manage these wounds with antibiotics due to poor tissue penetration and the presence of antibiotic tolerant microbial biofilms has created an impossible situation. Hypothesis: We believe that biologic (bacteriophage) based novel therapies could be used as an alternative to manage DFUs. Methods and approaches: We will use a mixed methods approach to generate data that will demonstrate the need for bacteriophage, demonstrate the effectiveness at treating complex wound biofilm infections, and explore the barriers and perceptions of using bacteriophage as an augmentative therapy in this patient group. Critical to the project will be the academic understanding of which bacteriophage are the most effective in a complex biofilm environment, and how they target changes in biofilm stability and composition within a “real life” ex vivo wound biofilm, and whether these optimised phage can then be stabilised and functionalised for delivery into a wound environment. In parallel, we will gather an evidence base for the need for alternative therapeutic approaches for wound care, and provide insights into how to effectively engage with this technology in a clinical environment.