In Vivo Wound Healing Effects of Antimicrobial Peptide-Based Dressings for S. aureus-Infected Wounds-A Systematic Review and Meta-Analysis.

The purpose of this systematic review was to determine whether the addition of antimicrobial peptides (AMPs) to dressing materials enhances their wound healing capabilities when applied to S. aureus-infected wounds in rodent models. The primary objective was not to derive definitive efficacy conclusions, but to systematically assess the quality, consistency, and translational readiness of existing in vivo evidence for AMP-based dressings in excisional wound models to inform future in vivo experimental design. The systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two authors independently completed the literature search using three electronic databases and two databases for grey literature. Studies were included if they met pre-established inclusion criteria. Rate of wound healing was considered as the primary outcome; the secondary outcome involved histological analyses of tissue samples of the wounds. Risk of bias was assessed using the SYRCLE risk of bias tool for animal studies and meta-analysis was performed with pooled data from three or more studies reporting the same outcome, employing a random effects model. By the final timepoint, the meta-analyses identified a significant increase in wound healing rate in both rats (mean difference = 2.79%, 95% CI [1.52%, 4.06%], p < 0.0001) and mice (mean difference = 32.30%, 95% CI [18.06%, 46.54%], p < 0.00001) exposed to AMP-based dressing materials compared to AMP-free carrier materials. The significantly improved wound healing rates provide promising evidence that these materials are suitable for promoting the wound healing of S. aureus-infected wounds that may be investigated further in clinical studies.