Biofilm: Control, Prevent and Manage Biofilm Formation

Biofilms are communities of bacteria covered in a polysaccharide matrix, which translates to a slimy barrier of sugars and proteins. Interestingly enough, almost all hard-to-heal wounds have some amount of Biofilm. Management of biofilm is quickly becoming a major objective of wound care. However, as much essential as it is to manage biofilm, treatment and management of biofilm is a complex process

How does Biofilm impact wound healing?

Biofilms are tolerant to antibiotics, and they are attributed to have a connection with impaired epithelialization and granulation tissue formation. Biofilms promote a sub standardized inflammatory response that perturbs wound healing. Additionally, the polymicrobial biofilms found in chronic wounds are considered a great hindrance in wound healing.

Stages of Biofilm Development

  1. Attachment: The free-floating bacteria or the planktonic attach themselves to the wound.
  2. Colonies: With adequate time and opportunity, bacteria form a community that succors their development and survival.
  3. Slimy Covering: The third stage marks the beginning of the secretion of slimy covering known as the extracellular polymeric substance (EPS). This covering serves as a strong protective shield against the immune system and regular antimicrobial wound products.

Experts opine that attempting to see biofilms with naked eyes is like trying to catch the wind. One can only see the consequences of biofilms.

What are the consequences of Biofilm?

There is very meager information available about biofilms and their consequences. However, it is ascertained that apart from causing delayed wound healing; biofilms may result in the development of -

  • Diabetes Mellitus
  • Venous Insufficienc
  • Malnutrition
  • Malignancy
  • Oedema
  • Repetitive trauma to the tissue
  • Impaired Host Response

How to Manage Biofilm?

If the biofilm is proven to have been established, it is about time an appropriate treatment strategy is determined, considering the stages of biofilm formation. There is no one-step approach to treating biofilms. Hence, the targeted process must involve various stages of treatment while keeping in mind the aim of the treatment, which is the reduction of bioburden and prevention of rebuilding of biofilm. Biofilm-based wound care is based on multiple treatment strategies, including antibiotics, anti-biofilm agents, and frequent debridement.

Management of Biofilm

The three major steps for the management of Biofilm are

1. Soaking: A liquid solution is poured onto the open wound site. The Nurse Assist USP Normal Sterile Saline For Irrigation is ideal for wound irrigation, feeding tube flush, foley catheter inflation, and device irrigation. It is meant to remove cellular debris and surface pathogens contained in wound exudates or residue. The wound cleanser does not only cleanse the wound bed, but the six-stage water purification process, which includes reverse osmosis, deionization, and ion exchange, also aid in the moistening of wound dressings.

2. Removing: Debridement is the process of removing the dead cells and debris from the wound bed. The Lohmann and Rauscher Debridement Agent Debrisoft Pad is a quick, fast, simple, effective, and virtually painless debridement method producing rapidly visible results in 2 to 4 minutes. It can be relied on to remove debris and exudate from wounds and skin flakes and keratosis from the surrounding skin. New granulation tissue and epithelial cells are spared. The angled fibre tips loosen debris effectively from the wound and protect intact tissue. Moreover, the fiber composite also absorbs dead skin flakes and keratosis the skin surrounding the wound.

3. Covering: Covering an open wound keeps the wound away from re-developing biofilm again. The Medline Skintegrity Hydrogel Wound Dressing is a clear grease-less hydrogel ideal for dry-to-moist clean wounds. It helps create a moist wound environment and balanced formulation. Donates moisture and rinses easily from the wound. The Skintegrity bellows bottle reduces waste and eases application. This hydrogel dressing is effectively used with a combination of Stratasorb Composite, Bordered gauze, and Suresite 123+Pad to treat the distinctive wounds.

When to Treat a Biofilm?

Identification of biofilm is difficult and requires sophisticated lab equipment. The standard culture microbiology procedures are only relevant in the detection of planktonic bacteria. Thus, a different technique must be deployed to detect bacteria in biofilms. In general, samples are treated initially to kill all planktonic bacteria. Later on, the biofilm is physically dispersed with ultrasonic energy, further cultured on nutrient agar plates to determine the extent of biofilm presence. In certain cases, it becomes crucial to treat a biofilm, and these situations maybe -

  1. Antibiotic failure
  2. Infection that is existent for 30 or more days
  3. Friable granulation tissue
  4. The presence of gelatinous material is accorded, which removes and quickly rebuilds

At Shop Wound Care, we have a great range of wound care supplies that can help you in successfully managing wound biofilm and ensuring that wound healing takes place swiftly and efficiently.


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