The Effects of Biofilm and Prolonged Inflammation on the Wound Bed

Acute healing wounds progress through four well defined phases of healing: hemostasis (~15 minutes), inflammation (~ 5 to 7 days), repair/proliferation (~14 days) and remodeling (several months). In contrast, chronic skin wounds usually become stalled in a persistent and elevated state of inflammation that leads to highly elevated levels of proteases (matrix metalloproteinases, MMPS, and neutrophil elastase, NE) that degrade proteins that are essential for healing, which converts an acute healing wound into a chronic wound. Objctives:

• Review the four phases of normal acute wound healing and compare to the chronic inflammation that occurs in most chronic wounds
• Contrast important differences between planktonic and biofilm bacteria
• Describe how biofilm bacteria promote a state of prolonged inflammation in chronic wounds
• Explore new point-of-care technologies to detect planktonic and biofilm bacteria
• Assess the effectiveness of topical treatments to eliminate biofilms
• Recognize how to effectively incorporate advanced wound treatments in the “step-down then step-up” concept of optimized biofilm-based wound care

Optimizing treatments to rapidly heal individual chronic wounds requires assessing multiple factors and implementing effective treatments to correct the problems that impair healing as described in the TIMERS guidelines, which emphasizes reducing the wound biofilm bioburden.

Presented by: Gregory S. Schultz, PhD






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