From: Biofilm delays wound healing: A review of the evidence
Wound type | No. | Clinical observations | Biofilm management | Reference |
---|---|---|---|---|
Non-healing surgical ulcer | 1 | Cloudy, shiny, thin film of slime, after lavage, enzymatic ointment and a silver alginate dressing | Curettage gently scraped away film; managed underlying pathophysiology | Hurlow & Bowler (2009)[13] |
Venous leg ulcer (VLU) | 1 | Thick, visible film, after lavage, collagenase debridement and a silver alginate dressing | Continual debridement plus negative pressure wound therapy and split-thickness graft | Hurlow & Bowler (2009)[13] |
VLU | 1 | Persistent, cloudy, translucent film, after a silver alginate dressing | Sodium hypochlorite wound cleanser between dressing changes | Hurlow & Bowler (2009)[13] |
Diabetic with cellulitis | 2 | Visible, opaque, pale yellow films | Antibiotics, debridement and a silver carboxymethyl cellulose dressing | Hurlow & Bowler (2012)[23] |
Highly exuding | 3 | Thick, green-tinted or translucent film, after inappropriate dressings (polyurethane, hydrogel or foam dressings) | Two wounds healed using antibiotics, debridement and a silver carboxymethyl cellulose dressing | Hurlow & Bowler (2012)[23] |
Peripheral arterial disease (PAD) | 3 | Cloudy and translucent film / opaque film / red/green film | Sharp debridement and a silver carboxylmethyl cellulose dressing | Hurlow & Bowler (2012)[23] |
Critically ischemic lower limb wounds | 190 | 77% (146) wounds healed | Combinations of sharp and ultrasonic debridement, lactoferrin/xylitol, cadexomer iodine and silver dressings | Wolcott & Rhoads (2008)[12] |
Dehisced | 4 | Healing | Sharp debridement | Wolcott et al. (2010)[24] |
Lower limb traumatic in a PAD patient | 1 | Wound had become chronic with suspected biofilm | Healed over 6 months using BBWC | Wolcott et al. (2010)[25] |
Traumatic chemical burn in a diabetic | 1 | Infection developed and patient was declared an amputation case | Healed in 12 weeks using debridement, systemic and topical antibiotics and silver dressings | Wolcott & Dowd (2011)[26] |
Mixed etiologies undergoing cell-based therapy | 97 | Entire graft material remained intact with biofilm suppression | Debridement and personalised topical gels containing anti-biofilm agents and antibiotics | Wolcott & Cox (2013)[27] |