{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:56:05Z","timestamp":1792702565200,"version":"4.5.0"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,8,10]],"date-time":"2025-08-10T00:00:00Z","timestamp":1754784000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal Orthopaedic Research"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Percutaneous osseointegrated implants offer significant benefits to amputees, including improved mechanical feedback and reduced skin irritation. However, their percutaneous nature increases susceptibility to biofilm\u2010associated infections. This study evaluated the potential efficacy of antimicrobial blue light (aBL) as a preventive strategy to manage biofilm burden in a 12\u2010week ovine model wherein two treatment cycles were implemented. In this study, aBL was applied proactively to reduce surface colonization and prevent infection progression, rather than to treat confirmed or deep infections. Sheep were inoculated with <jats:italic>Staphylococcus aureus<\/jats:italic> biofilm and treated with aBL or systemic antibiotics, with or without a washing protocol. aBL with washing achieved the greatest bacterial reduction, lowering CFU levels to 3.0\u2009\u00b1\u20090.3 log<jats:sub>10<\/jats:sub> during the second treatment period, significantly outperforming washing alone, which resulted in 5.6\u2009\u00b1\u20090.4 log<jats:sub>10<\/jats:sub> (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). The study also showed a lower observed infection rate (14% vs. 43%), when comparing aBL with washing to washing only based on histologic, microCT, and gross assessments, though no statistical comparison was performed. Despite these benefits, the aBL treatments induced notable tissue changes, including increased epithelial thickening, rete ridge elongation, and accelerated skin\/tissue downgrowth. Systemic antibiotics were effective during the initial treatment period but failed to reduce biofilm burden during the second treatment cycle. Altogether, while aBL combined with washing shows promise as a localized preventive therapy for reducing biofilm burden and implant\u2010related infection, the observed tissue remodeling and accelerated downgrowth highlight the need for further investigation to ensure long\u2010term safety.<\/jats:p>","DOI":"10.1002\/jor.70039","type":"journal-article","created":{"date-parts":[[2025,8,10]],"date-time":"2025-08-10T10:00:01Z","timestamp":1754820001000},"page":"2043-2054","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessing the Potential of Antimicrobial Blue Light (aBL) to Manage Biofilm Burden at the Skin\u2010Implant Interface of Percutaneous Osseointegrated Implants"],"prefix":"10.1002","volume":"43","author":[{"given":"Jemi","family":"Ong Watts","sequence":"first","affiliation":[{"name":"Department of Orthopaedics University of Utah Salt Lake City Utah USA"},{"name":"Bone and Biofilm Research Lab University of Utah Salt Lake City Utah USA"},{"name":"Department of Biomedical Engineering University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6736-8641","authenticated-orcid":false,"given":"Richard Tyler","family":"Epperson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics University of Utah Salt Lake City Utah USA"},{"name":"Bone and Biofilm Research Lab University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooke","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics University of Utah Salt Lake City Utah USA"},{"name":"Bone and Biofilm Research Lab University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Olsen","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine Utah State University Logan Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josh","family":"Tam","sequence":"additional","affiliation":[{"name":"Wellman Center for Photomedicine Massachusetts General Hospital Boston Massachusetts USA"},{"name":"Department of Dermatology Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Pasquina","sequence":"additional","affiliation":[{"name":"Musculoskeletal Injury Rehabilitation Research for Operational Readiness (MIRROR) Uniformed Services University of the Health Sciences Bethesda Maryland USA"},{"name":"Department of Rehabilitation Walter Reed National Military Medical Center Bethesda Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad","family":"Isaacson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics University of Utah Salt Lake City Utah USA"},{"name":"Musculoskeletal Injury Rehabilitation Research for Operational Readiness (MIRROR) Uniformed Services University of the Health Sciences Bethesda Maryland USA"},{"name":"The Geneva Foundation Tacoma Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Gililland","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dustin","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics University of Utah Salt Lake City Utah USA"},{"name":"Bone and Biofilm Research Lab University of Utah Salt Lake City Utah USA"},{"name":"Department of Biomedical Engineering University of Utah Salt Lake City Utah USA"},{"name":"Musculoskeletal Injury Rehabilitation Research for Operational Readiness (MIRROR) Uniformed Services University of the Health Sciences Bethesda Maryland USA"},{"name":"Department of Pathology University of Utah Salt Lake City Utah USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e31815b35aa"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.5812\/traumamon.11693"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000001031"},{"issue":"1","key":"e_1_2_8_5_1","first-page":"57","article-title":"Evaluation of Problems and Needs of Veteran Lower\u2010Limb Amputees in the San Francisco Bay Area During the Period 1977\u20131980","volume":"20","author":"Hoaglund F. T.","year":"1983","journal-title":"Journal of Rehabilitation R&D"},{"issue":"1","key":"e_1_2_8_6_1","first-page":"106","article-title":"A Novel Osseointegrated Percutaneous Prosthetic System for the Treatment of Patients With Transfemoral Amputation: A Prospective Study of 51 Patients","volume":"96","author":"Br\u00e5nemark R.","year":"2014","journal-title":"Bone & Joint Journal"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-19-00016"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biomaterials.2005.11.044"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biomaterials.2009.01.004"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.actbio.2009.12.016"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.3390\/life12081110"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/pj.2012.130"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/jor.25535"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2011.08.020"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/8756-3282(95)00026-A"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/jbm.a.30038"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0290347"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1017\/S143192760999136X"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajpath.2020.02.007"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms10112133"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medmal.2012.07.018"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01163-08"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.biomaterials.2006.03.041"}],"container-title":["Journal of Orthopaedic Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jor.70039","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T10:29:07Z","timestamp":1760005747000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jor.70039"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,10]]},"references-count":22,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/jor.70039"],"URL":"https:\/\/doi.org\/10.1002\/jor.70039","archive":["Portico"],"relation":{},"ISSN":["0736-0266","1554-527X"],"issn-type":[{"value":"0736-0266","type":"print"},{"value":"1554-527X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,10]]},"assertion":[{"value":"2025-03-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}