Chronic wounds are a large burden to patients and healthcare systems. Biofilm infections in chronic wounds are crucial factors leading to non-healing of wounds. It is important to study biofilm in wounds and to develop effective interventions against wound biofilm. This study presents a novel in vitro biofilm model mimicking infected chronic wounds. The novel layered chronic wound biofilm model uses woundlike media and includes both Pseudomonas aeruginosa and Staphylococcus aureus, which have been identified as the most important pathogens in wounds. The model sustains their coexistence for at least 96 h. Microscopy of the model revealed microbial growth in non-surface attached microcolonies as previously observed in vivo. The model was used to determine log 10 -reduction for the use of an antimicrobial solution and antimicrobial dressings (containing silver or honey) showing moderate-to-low antibiofilm effect, which indicates better concordance with the observed clinical performance of this type of treatment than other widely used standard tests. K E Y W O R D S biofilm, coexistence of Pseudomonas aeruginosa and Staphylococcus aureus, model, test of antibiofilm effect
| INTRODUCTIONChronic wounds constitute a large burden on patients, society and healthcare systems, affecting 2% of the population in the developed countries with an estimated 2%-3% of the healthcare budgets related to chronic wounds globally, equalling US $13-15 billion annually. [1][2][3] Bacteria inflict on the healing of chronic wounds, 4 with Pseudomonas aeruginosa being identified as a major pathogen 5 together with Staphylococcus aureus, but the underlying mechanisms on the pathogenicity of wound biofilm are not well understood. 6 Furthermore, the Chen and Lorenzen served as co-first authors.