Wound Care

Temple University School of Podiatric Medicine's picture

By Temple University School of Podiatric Medicine Journal Review Club

An appropriate timeline to initiate biofilm-based wound care (BBWC) has been a topic of question since the incorporation of biofilm therapy was introduced. In hard-to-heal delayed wounds, it is largely agreed upon that biofilms are a significant barrier to healing, and that removal is essential. By definition, hard-to-heal wounds are wounds that have failed to respond to evidence-based standard of care and contain biofilm. Biofilms are polymicrobial communities residing in an extracellular matrix produced by bacteria, which is well-hydrated and resistant against antimicrobial agents and host defenses. Biofilm can form within hours, can reach maturity within 48-72 hours, and has the ability to regrow within 24-48 hours. A first critical step to BBWC is debridement, though it requires additional suppression methods, as well as considerations of a patient’s risk factors. Risk factors include peripheral vascular disease, infection, diabetes, and pressure off-loading, which encourage biofilm development by delaying wound healing. Risks and costs with early BBWC are most likely less than those associated with biofilm-related wound complications. Thus, in March 2019, a panel of nine experts met in London for an Advisory Board Meeting, where they developed solutions to barriers preventing early BBWC and methods of appropriate “wound hygiene” for all health professionals. They reconvened in the summer of 2019 to create a clinical consensus document published in the Journal of Wound Care supported by ConvaTec Limited.

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By Miranda Henry, Editorial Director of WoundSource

Whether meeting with patients via telehealth at your home-based office or doing rounds at the clinic, WoundSource is still there to provide you with the most trusted and up-to-date wound care education and product information.

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Heidi Cross's picture

By Heidi Cross, MSN, RN, FNP-BC, CWON

Pressure injury risk and development are multifactorial, individualized processes. Each patient presents with a unique set of circumstances and needs. In looking at charts for attorneys to determine whether standards of care related to pressure injuries have been met, key elements include turning and positioning measures, support surfaces, mobility, proper and timely assessment of risk factors and wounds, physician communication and notifications, communication with family, proper wound treatments, and nutrition assessment and measures.