A Biofilm is a surface-associated community that is composed of various types of microbes, which encases itself in a 3-dimensional matrix of extracellular polymeric substances (EPS) (e.g. polysaccharides, nucleic acids and proteins) and demonstrates increased resistance to cellular and chemical attack.
Microorganisms may exist in at least two distinct phenotypes – planktonic (free floating) and sessile (attached). A biofilm refers to a group or community of planktonic bacteria that may be incased in part of the extracellular matrix. The fragments have the ability to attach to another suitable surface and reform a biofilm community in the new area.
AAWC, (2008). Advancing your practice: Understanding wound infection and the role of biofilms. UKCT-A0021
Consider biofilm if the wound signs and symptoms includes:
Thick tenacious slough non-responsive (in the form of fast returning slough) to sharps debridement
Bright pink hypergranular tissue that bleeds easily
Wound bed has a slimy appearance
A biofilm may explain the delayed healing seen in some chronic wounds
Tx:
Serial Debridement
Alternate Silver (Acticoat) with Iodine based (Iodosorb)
Dakin’s solution 0.025 BID (for uncomplicated wounds)
Antibiotics
For more information connect to the center for biofilm engineering at Montana State University www.erc.montana.edu/
Matthew Livingston R.N. C.W.S.