Biofilm delays wound healing: A review of the evidence

Metcalf, Daniel; Bowler, Philip G

doi:10.4103/2321-3868.113329

Cited by 240 publications

(162 citation statements)

References 55 publications

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“…Both enzymatic and mechanical debridement play a role in this pathway, with mechanical debridement especially important in the presence of biofilms. [41][42][43] Moisture balance is the assessment and management of wound exudate, of which mismanagement results in either desiccation, which slows epithelial cell migration, or excessive fluid, which causes maceration of wound margins. 27,28,[37][38][39] Finally, Edge of wound assesses the non-advancing or undermined wound edges.…”

Section: Introductionmentioning

confidence: 99%

Optimizing Wound Bed Preparation With Collagenase Enzymatic Debridement

McCallon

Weir

Lantis

2014

Journal of the American College of Clinical Wound Specialists

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Difficult-to-heal and chronic wounds affect tens of millions of people worldwide. In the U.S. alone, the direct cost for their treatment exceeds $25 billion. Yet despite advances in wound research and treatment that have markedly improved patient care, wound healing is often delayed for weeks or months. For venous and diabetic ulcers, complete wound closure is achieved in as few as 25%-50% of chronic or hard-to-heal wounds. Wound bed preparation and the consistent application of appropriate and effective debridement techniques are recommended for the optimized treatment of chronic wounds. The TIME paradigm (Tissue, Inflammation/infection, Moisture balance and Edge of wound) provides a model to remove barriers to healing and optimize the healing process. While we often think of debridement as an episodic event that occurs in specific care giver/patient interface. There is the possibility of a maintenance debridement in which the chronic application of a medication can assist in both the macroscopic and microscopic debridement of a wound. We review the various debridement therapies available to clinicians in the United States, and explore the characteristics and capabilities of clostridial collagenase ointment (CCO), a type of enzymatic debridement, that potentially allows for epithelialization while debriding. It appears that in the case of CCO it may exert this influences by removal of the necrotic plug while promoting granulation and sustaining epithelialization. It is also easily combined with other methods of debridement, is selective to necrotic tissue, and has been safely used in various populations. We review the body of evidence has indicated that this concept of maintenance debridement, especially when combined episodic debridement may add a cost an efficacious, safe and cost-effective choice for debridement of cutaneous ulcers and burn wounds and it will likely play an expanding role in all phases of wound bed preparation.

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Section: Introductionmentioning

confidence: 99%

Optimizing Wound Bed Preparation With Collagenase Enzymatic Debridement

McCallon

Weir

Lantis

2014

Journal of the American College of Clinical Wound Specialists

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“…Bakterie tworzące biofilm wydzielają do macierzy biopolimery białkowo-cukrowe chroniące je przed atakiem ze strony układu odpornościowego oraz stosowanymi antybiotykami [10][11][12]. Biofilm jest złożony z wielu ściśle współpracujących gatunków bakterii, które współdziałają podobnie jak organizm wielokomór-kowy [13].…”

Section: Wpływ Biofilmu Bakteryjnego Na Gojenie Ran Przewlekłychunclassified

Innovative methods of biofilm treatment in chronic wounds

Mehrholz¹,

Domagała²,

Zielińska³

et al. 2016

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“…Translational research [4][5][6] has shown that when biofilm is deliberately introduced into controlled wound models in vivo, infection may ensue, healing is delayed, and interventions to remove wound biofilm reverse this delay. 7 In subjects with comorbidities, wound healing has been observed to be delayed more so than in wild-type subjects, [8][9][10] suggesting interactions between host factors and microbial bioburden.…”

Section: Translational Relevancementioning

confidence: 99%