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Review
. 2015 May 1;4(5):295-301.
doi: 10.1089/wound.2014.0567.

Clinical Biofilms: A Challenging Frontier in Wound Care

Jennifer Hurlow  1 , Kara Couch  2 , Karen Laforet  3 , Laura Bolton  4 , Daniel Metcalf  5 , Phil Bowler  6
Affiliations
Review

Clinical Biofilms: A Challenging Frontier in Wound Care

Jennifer Hurlow et al. Adv Wound Care (New Rochelle). .

Abstract

Significance: Biofilms have been implicated in a variety of wound complications. Recent Advances: Research has confirmed that biofilms form in wounds of patients experiencing delayed healing and may be a precursor to infection. Critical Issues: Research into the strength of this association is still in its infancy. Is biofilm formation a cause of these complications, a step toward them, or a signal that unresolved factors injuring tissue or delaying healing are setting the stage for biofilm formation, infection, and healing delay? To qualify biofilms for use in informing clinical practice decisions, biofilm characteristics supporting those decisions need standardized definitions and valid evidence that they predict or diagnose healing or infection outcomes. Literature searches of relevant terms reviewed biofilm definitions and validation of their role in predicting and diagnosing delayed wound healing or infection. Future Directions: Further research is needed to provide a rapid accurate technique to identify and characterize biofilms in ways that optimize their validity in diagnosing or screening patient risk of infection or delayed healing and to inform clinical decisions. This research will help validate biofilm's capacity to support wound care clinical practice decisions and establish their importance in guiding clinical practice.

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Figures

None
Jennifer Hurlow, GNP, CWOCN
<b>Figure 1.</b>
Figure 1.
Biofilm in perspective of factors involved in delayed wound healing.
<b>Figure 2.</b>
Figure 2.
CONSORT diagram of MEDLINE, CINAHL, and Scopus biofilm search results (number of citations found).
<b>Figure 3.</b>
Figure 3.
Diagnostic validity of wound biofilm.,, Biofilm currently lacks the positive and negative predictive validity to support clinical screening decisions needed to improve wound healing or infection outcomes. To see this illustration in color, the reader is referred to the web version of this article at www.liebertpub.com/wound
<b>Figure 4.</b>
Figure 4.
Mind map exploring the links between wound biofilm and factors that lead to its development and the effects it has on the wound and ultimately, the patient quality of life. *See references and . To see this illustration in color, the reader is referred to the web version of this article at www.liebertpub.com/wound
See this image and copyright information in PMC

References

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    1. AAWC Wound Infection Control Guidelines: Under Development. AAWC Annual Report Summer. 2013.
    1. Metcalf DG, Bowler PG. Biofilm delays wound healing: a review of the evidence. Burns Trauma 2013;1:5–12 - PMC - PubMed
    1. Seth AK, Geringer MR, Hong SJ, Leung KP, Mustoe TA, Galiano RD. In vivo modeling of biofilm-infected wounds: a review. J Surg Res 2012;178:330–338 - PubMed