Normal healing of acute skin wounds proceeds through the four sequential phases of hemostasis, inflammation, repair, and remodeling. Neutrophils and macrophages in normal inflammation engulf and kill contaminating bacteria and release proteases that enzymatically debride the extracellular matrix proteins like collagen that were damaged by the injury.
However, if contaminating planktonic bacteria are able to proliferate and generate biofilm communities, it leads to chronic inflammation that produces persistently elevated levels of proteases and reactive oxygen species that destroy proteins that are essential for healing (extracellular matrix, growth factors, receptors) eventually leading to a stalled, chronic wound.
Bacteria in biofilm communities that are tightly attached to wound bed matrix develop high tolerance to patients’ immune cells, antibodies, and even exogenous antibiotics and antiseptics that normally rapidly kill planktonic bacteria.
This program will review:
- The prevalence of biofilms in chronic skin wounds
- The mechanism of action of biofilm in the wound bed and how this impairs wound healing
- The concept of Biofilm-Based Wound Care
- Using effective local antimicrobial treatments to prevent biofilm reformation
- The STEP-DOWN-THEN-STEP-UP approach for effective therapies for chronic wounds
