Biofilm in wound care

Abstract

A biofilm can be described as a microbial colony encased in a polysaccharide matrix which can become attached to a wound surface. This can affect the healing potential of chronic wounds due to the production of destructive enzymes and toxins which can promote a chronic inflammatory state within the wound. Biofilms can be polymicrobial and can result in delayed wound healing and chronic wound infection resistant to antibiotics, leading to prolonged hospitalisation for some patients. There appears to be a correlation between biofilms and non-healing in chronic wounds. It is suggested that biofilms are a major player in the chronicity of wounds. They are a complex concept to diagnose and management needs to be multifactorial.

In vitro microbicidal, anti‐biofilm and cytotoxic effects of different commercial antiseptics

“…• biochemically, antiseptic stable substances are highly toxic for microorganisms as well as for eukaryotic cells because of their permanence in the environment • unstable molecules, such as halogens, can control early microorganism growth, with very limited eukaryotic damage • nevertheless, biofilm impairment or its elimination becomes a higher challenge, where antiseptic treatment frequency and toxicity must be considered A biofilm offers physical (10) and metabolic barriers (11) that make microorganisms in biofilms much more resistant to antimicrobials compared with microorganisms that grow independently or as plankton. Bacteriostatic, bactericidal and fungicidal strategies that are effective under simple conditions (i.e.…”

“…A biofilm offers physical and metabolic barriers that make microorganisms in biofilms much more resistant to antimicrobials compared with microorganisms that grow independently or as plankton. Bacteriostatic, bactericidal and fungicidal strategies that are effective under simple conditions (i.e.…”

Wound Repair and Experimental Wound Models

“…Yaranın bulunduğu bölge ile bu bölgedeki kan akımı, sitokinler ve büyüme faktörleri, genetik ve immünolojik bozukluklar, diyabet, radyoterapi, kemoterapi, uygun olmayan beslenme, steroid ilaç kullanımı gibi faktörler yara iyileşmesini etkiler. Sağlıklı yara iyileşmesi yeterli doku perfüzyonu, oksijenizasyonu ve epitelizasyonu yanında, dokunun iyi beslenmesi ve nemlenmesi ile sağlanır (3). Yara iyileşmesi sırasında gerçekleşen bu süreçlerin başlıca amacı yara gerilim kuvvetinin normal düzeyine getirilmesidir.…”

“…Yara içinde kronik enflamatuvar bir duruma sebep olan enzim ve toksinler üretmeleri, antibiyotiklere dirençli kronik yara enfeksiyonuna sebep olmaları, hastalar için hastanede uzun yatış süreleri, sağlık sistemi için ise yüksek maliyet demektir. Yara biyofilmlerine yönelik yeni tedavilerin geliştirilmesi, kronik yaraların tedavi edilebilme umudunu artırarak birçok hastanın hayatını kurtaracaktır (3). Diğer taraftan son yıllarda yara iyileşmesini hızlandırmak ve hastanın yaşam kalitesini artırmak amacıyla elektrik akımı, lazer ışını, radyo dalgaları ve ultrason uygulamasını da kapsayan yeni teknolojiler üzerinde de yoğun olarak çalışılmaktadır (3,4).…”

Antimicrobial peptides and wound healing: biological and therapeutic considerations

“…This makes the eradication of bacteria difficult, mainly due to the weak penetration of antibiotics or host clearance mechanisms, that is antibodies and phagocytes through the microbial biofilm . Furthermore, toxins released from bacteria contribute to recruitment of immune cells resulting in an excessive, damaging inflammatory response . Wound infections have become an increasing cause of death in severely ill hospitalized patients (especially in long‐term care facilities), and their treatment has put a significant burden on the healthcare system and on the economy as a whole .…”