Biofilms in Wounds and Surgical Sites
Acute infections caused by pathogenic bacteria have been combated effectively by the development of antibiotics and infection control measures. Most research into bacterial pathogenesis has focused on acute infections, but these diseases have now been supplemented by a new category of chronic infections caused by bacteria growing in slime-enclosed aggregates known as biofilms.
While microbial biofilms have been recognized as being ubiquitous in nature for the past 40 years, it has only been within the past 20 years that clinical practitioners have realized that biofilm play a significant role in both device-related and tissue-based infections. The global impact of surgical site infections (SSIs) is monumental and as many as 80% of these infections may involve a microbial biofilm.
The impact of bacterial biofilms on the pathogenesis and maintenance of chronic, no healing wounds has been established within the scientific literature. Biofilm has been identified in up to 60% of chronically open wounds (i.e., open for >30 days) versus 6% of acute wounds. Biofilm reduction, eradication, and repopulation inhibition are essential considerations in the treatment of chronic diabetic foot wounds. Biofilm control and hence prevention of adherence of bacteria to the biofilm is a better approach to manage the non-healing wounds.