BIOMES℠: A mnemonic device that stands for Blood Flow, Infection/Bioburden, Offloading/Overloading, Metabolic/Morbidities, Exudate/Edema, and Social/Economic Barriers. This assessment tool helps health care providers make proactive decisions that may help prevent wounds from becoming chronic.

Chronic wound: A wound that has failed to progress toward healing in a predetermined, evidence-based amount of time, when treated with standard of care. Varying factors can cause a wound to stall, such as infection or a prolonged inflammatory phase. 

Evidence-based care: Making decisions about patient care based on literature evidence regarding a particular topic. This practice involves combining clinical expertise, patient preferences, and best available evidence from high-quality research.

Exudate: Fluid drainage originating from tissue in the wound bed in response to injury or inflammation. Exudate types are serous or clear, sanguineous or bloody, purulent or seropurulent. Exudate quantity may be described as none, scant, small or minimal, moderate, large, or copious.

Infection: The invasion and multiplication of pathogenic microorganisms in host tissues, leading to an immune response that may cause localized or systemic disease.

Offloading: The mechanical process of distributing weight and dynamic forces evenly.

Protease: Proteases are enzymes that break down protein. Excess protease activity in a wound can damage healthy tissues and lead to inflammation and wound chronicity.

Wound balance: A concept placing the patient at the center of care, integrating continuity, individualized, tailored plans, and clinical decision-making. A concept placing the patient at the center of care, integrating continuity, individualized, tailored plans, and clinical decision-making.

_{BIOMES^SM was created by Trent Brookshier, DPM, and is a service mark of HARTMANN USA, Inc, © 2024 HARTMANN USA, Inc.}