Clinical investigation of biofilm in non-healing wounds by high resolution microscopy techniques.
J Hurlow, E Blanz, J A Gaddy
PMID 27608736WHAT IT FOUND
Microscopy confirmed biofilm in 75% of chronic wound samples despite antiseptic dressings.
Biofilms persisted during systemic antibiotics and reformed quickly. Regular sharp debridement every 2-3 days is critical, but often hindered by nursing scope of practice and dressing intervals.
Key findings
01Biofilm was identified in 75% of the chronic non-healing wound samples evaluated, even in wounds treated with antiseptic dressings.
02Biofilms were found in wounds where patients were receiving or had recently completed guided systemic antibiotics, suggesting the biofilm matrix protects bacteria from treatment.
03The study notes that effective biofilm management requires sharp debridement every 2-3 days, but this is often not performed due to nursing scope of practice restrictions and weekly dressing change schedules.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study included only 11 patients and 16 samples, with some samples taken from the same patient on different days, which limits the ability to generalize prevalence. The clinical algorithm used to select samples for biofilm presence was not validated prior to this study. There was no mechanism to ensure adequate sampling across the entire wound bed, so biofilm might have been missed in other locations. The study was observational and did not test whether changing debridement frequency or dressing type improved healing outcomes.
Declared interests
The authors declare no conflicts of interest. Funding sources are not explicitly detailed in the provided text but the study was approved by Institutional Review Boards at the University of Tennessee Health Science Center and Vanderbilt University Medical Center.
The easy way to misread this
Do not interpret the 75% biofilm rate as evidence that all chronic wounds have biofilm, as the sample selection used a non-validated algorithm specifically targeting suspicious films. Additionally, this small case series does not prove that more frequent debridement improves healing outcomes, only that biofilm persists under current standard care.