Clinical trials are the mainstay for evidence-based medicine. These trials allow the evaluation of medical treatments in such as way that they can be statistically analyzed with all other variables controlled. This evaluation will allow us to understand the efficacy of different treatments. Medicine is scientifically based. First, we diagnose, and then we treat. Furthermore, our treatments have to be based on scientific evidence. Clinical trials are the best pathway to obtaining information on which different treatments work best.
Analysis of the chronic wound microbiota of 2,963 patients by 16S rDNA pyrosequencing
The extent to which microorganisms impair wound healing is an ongoing
controversy in the management of chronic wounds.
Biofilms cause chronic infections
A very impressive group of scientists and clinicians representing the European Society of Clinical Microbiology and Infectious Diseases (ESMID) recently concluded that: ‘Biofilms cause chronic infections…’
Clinically Addressing Biofilm in Chronic Wounds
A chronic wound is a wound that is arrested in the inflammatory phase of wound healing and cannot progress further. Over 90% of chronic wounds contain bacteria and fungi living within a biofilm construct.
Consensus guidelines for the identification and treatment of biofilms in chronic nonhealing wounds
A wound that is not healing in a timely fashion, despite holistic investigation and optimal intervention, can be considered as being chronic. Interventions may include treatment of infection, maintenance debridement, adequate compression (venous leg ulcers), restoration of arterial inflow (ischemic ulcers), adequate attention and intervention with respect to pressure injury (PI), offloading in diabetes-related foot ulcers (DRFUs), and management of other factors or underlying systemic diseases.
After controlling for these factors, biofilms are probably by the Wound Healing Society the most important single cause of persistent, delayed healing.