Through trial and error, laboratory and clinical studies, multiple tools have been developed to treat wound biofilm. In treating wounds as if biofilm is a major barrier to wound healing, it is important that the treatments suppress biofilm but not damage host defenses and/or host healing mechanisms. Also, since biofilm is so resilient and robust, it has become apparent that multiple concurrent strategies are most effective.
Wounds versus other biofilm based human infections are unique in that the surface of biofilm is accessible, which allows physical management. Tissue surfaces, which touch each other sequester the biofilm and give it the advantage. Therefore, by altering the anatomy, that is opening all undermining, opening all tunneling, sculpting the wound bed to remove crevices and redundant tissue takes the advantage from the biofilm and gives it to the host.
What is biofilm?
When bacteria attach to the surface of the wound and evade the host’s defenses, they can quickly develop into a film, which covers the surface. This film, biofilm, is truly a multicellular organism with several well recognized defenses, synergies between different types of bacteria and the ability to reconstitute itself very quickly. The bacteria in the biofilm arrangement are quite different than those in the planktonic form with only 30% of the proteins in the outer membrane being homologous between the two. These phenotype differences along with metabolic differences in the different regions of the biofilm make biofilm very difficult, if not impossible, to eradicate. The best that can be hoped for is suppression of the biofilm to allow for host healing.
Biofilm Based Wound Care is trademark of Southwest Regional Wound Care Center.