Infection Control and Wound Management

Strategies for Early Biofilm Interventions

Randall Wolcott, MD
Biofilm is present in chronic wounds anywhere from 60% to 100% of the time. Biofilm has multiple colony defenses that must be overcome to manage chronic wounds effectively. Identifying the microbiota producing a chronic infection requires molecular methods such as polymerase chain reaction and sequencing. Since wound biofilm is polymicrobial, where one-and-done strategies work for the planktonic bacteria phenotype, biofilm management requires patience, persistence, and multiple concurrent therapies. Therefore, there can be no half measures in treating wound biofilm. Participants in this webinar will be able to:

• Describe how chronic wounds are chronic infections caused by biofilm.
• Understand how biofilm infection causes exudate, accumulation of material on the wound bed (slough), abnormal wound beds, and non-healing of wounds.
• Describe how the characteristics of wounds support identification of the presence of biofilm in a chronic wound.
• Understand how early intervention and aggressive management with multiple simultaneous treatment strategies are most successful.

Biofilm-based wound management consists of aggressive initial treatment with inclusion of many strategies such as debridement, antibiofilm agents, antiseptics, antibiotics, and management of comorbidities. This webinar will discuss the role of treatment modalities in the effective management of biofilm, as well as clinical presentation of wounds in discontinuing intervention as control of the wound (less exudate, less slough, etc.) is obtained.

Biofilm Management Using a Wound Hygiene Protocol

Wound care professionals whose patients have hard-to-heal wounds work to prevent or treat biofilm formation and infection, for optimal clinical outcomes. Utilizing the wound hygiene protocol encourages consistent implementation of wound cleansing, debridement, refashioning of wound edges, and appropriate wound dressing selection. This strategy can reduce antibiotic prescriptions, lower overall wound-related costs, and improve quality of care for patients with chronic wounds. This white paper des...

Quick Facts - Infection Control and Wound Management

Chronic wounds, more recently also referred to as "hard-to-heal wounds," are common, costly, and debilitating. Factors that delay healing of these wounds include wound etiology and comorbidities, wound size and depth, anatomic location of the wound, wound duration, and the presence of a biofilm. Biofilms are identified in more than 80% of chronic wounds. To support wound healing progress, biofilms must be removed. As part of a wound hygiene protocol, debridement disrupts biofilm and promotes wou...

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Infection Control and Wound Management: Important Terms to Know

Bioburden: Bioburden is the number of microorganisms in a wound, and a high bioburden can cause delayed wound healing. Biofilm: Biofilms are usually composed of mixed strains of bacteria, fungi, yeasts, algae, microbes, and other cellular debris that adhere to the wound surface. Epibole: Epibole refers to rolled or curled-under closed wound edges. These rolled edges are thickened epidermis that may be callused, dry, scaly, and/or hyperkeratotic. When epibole is present in a wound, it signals to the body that the wound has healed, even though the wound remains open. Epibole must be resolved to allow the wound to close.