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Geesey GG Sessile bacteria: an important component of the microbial population in small mountain streams. Limnol Oceanography. 1978; 23:(6)1214-1223

Marsh PD, Bradshaw DJ. Dental plaque as a biofilm. J Industr Microbiol. 1995; 15:(3)169-175

Costerton JW. Cystic fibrosis pathogenesis and the role of biofilms in persistent infection. Trends Microbiol. 2001; 9:(2)50-52

Bjarnsholt T Pseudomonas aeruginosa biofilms in the respiratory tract of cystic fibrosis patients. Pediatric Pulmonology. 2009; 44:(6)547-558

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Hall-Stoodley L Direct detection of bacterial biofilms on the middle-ear mucosa of children with chronic otitis media. J Am Med Assoc. 2006; 296:(2)202-211

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Biofilms
Hard-to-heal wounds

Biofilm-based wound care: the importance of debridement in biofilm treatment strategies

02 February 2019
Practice
02 February 2019
Volume 3 · Issue 1

Abstract

The concept of biofilms in human health and disease is now universally accepted. Unlike planktonic counterparts, microorganisms in biofilm phenotypes demonstrate a remarkable tolerance to many forms of treatments. This presents a challenge to wound care clinicians dealing with chronic wounds complicated by biofilm. This article will focus on the treatment of wound biofilm that is supported by evidence-based practice.

Emerging evidence from the last century on the behaviour of microorganisms in their natural environments (i.e. exploration of aquatic/marine environments) identified that microorganisms have a natural tendency to associate with surfaces, with each other, and prefer a sessile (stationary, slow growth) lifestyle.1 A significant proportion of this work was conducted on environmental samples and has provided a platform for the contemporary medical models that we have come to understand as microbial biofilms. The concept of biofilms in human health and disease is now universally accepted in periodontal disease and dental caries,2 cystic fibrosis3,4 and indwelling medical device infections,5 otitis media and other upper respiratory infections6 and chronic wounds.7,8,9 Unlike planktonic counterparts, microorganisms in biofilm phenotypes demonstrate a remarkable tolerance to many forms of treatments. This presents a challenge to wound care clinicians dealing with chronic wounds complicated by biofilm. This article will focus on the treatment of wound biofilm that is supported by evidence-based practice.

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biofilm
debridement
treatment strategies
wound care