Laser-Generated Shockwaves as a Treatment to Reduce Bacterial Load and Disrupt Biofilm

Objective: The goal of this paper is to demonstrate and evaluate the potential efficacy of laser-generated shockwave (LGS) therapy on biofilm infected tissue. Methods: To demonstrate proof of concept, Staphylococcus epidermidis was allowed to proliferate on ex vivo pigskin, until mature biofilm formation was achieved, and then subjected to LGS. Bacterial load between control and treated samples was compared using the swab technique and colony counting. Scanning electron microscopy (SEM) was then used to visualize the biofilm growth and resulting reduction in biofilm coverage from treatment. Images were false colored to improve contrast of biofilm, and percent biofilm coverage was computed, along with biofilm cluster size. Results: LGS reduced bacterial load by 69% (p = 0.008). Imaging showed biofilm coverage reduced by 52% and significantly reduced average cluster size (p<; 0.001). Conclusion: LGS therapy reduced the burden of bacterial biofilm on ex vivo pigskin and can be visualized using SEM imaging. Significance: LGS therapy is a new treatment for infected wounds, allowing rapid disruption of biofilm to 1) remove bacteria and 2) increase susceptibility of remaining biofilm to topical antibiotics. This can lead to improved wound healing times, reduced patient morbidity, and decreased healthcare costs.