Background and aims: Pressure ulcers (PUs) are common in physical trauma patients who require prolonged stays in the intensive care unit (ICU).Despite standard preventive and therapeutic measures, healing is often a slow process.Conventional systemic antibiotics offer limited therapeutic benefits due to inadequate tissue penetration and the associated risk of driving antimicrobial resistance.Bacteriophage therapy, with its ability to target resistant and biofilm-associated bacteria, offers a potential "alternative." We aimed to evaluate the efficacy and safety of topical bacteriophage therapy for the management of PUs in critically ill ICU patients and its comparison to conventional therapy.Patients and methods: This prospective, randomized, double-blind controlled trial was conducted in the ICU of a tertiary care center between April 2024 and May 2025.Seventy-six adult patients with grade II-IV PUs were screened, and 68 were enrolled (34 in each group).Group C received conventional therapy, while group B received conventional plus customized topical bacteriophage therapy.Healing was assessed using the Pressure Ulcer Scale for Healing (PUSH) tool; tissue type, exudate amount, and ulcer dimensions were assessed at baseline and on days 5, 7, 14, 21, and 28.The primary objective was to evaluate the efficacy of bacteriophage therapy for the management of PUs.The secondary objective was to observe the safety profile of bacteriophage therapy.Results: Both groups demonstrated healing over time, but group B demonstrated significantly greater improvement as compared to group C. The reduction in the mean PUSH score was higher in group B (p < 0.05).Group B also showed faster epithelialization, an earlier decrease in exudate, and more closed ulcers.These differences became statistically significant from day 7 onward.No adverse events were reported.Conclusion: Topical bacteriophage therapy is a safe and effective adjunct to conventional care in the management of PUs among ICU patients.
Meena et al. (Wed,) studied this question.