Hurlow Jennifer, Bowler Philip G
ConvaTec, Wound Therapeutics Global Development Centre, Deeside, Flintshire, UK.
Ostomy Wound Manage. 2009 Apr;55(4):38-49.
Biofilm is a relatively new concept in the fields of infectious disease, wound infection, and healing. Although scientific research and "noise" regarding wound biofilm is increasing, little is known about the presentation, diagnosis, potential implications, and management strategies regarding wound biofilms. A series of four clinical cases is utilized to demonstrate the existence of wound biofilm. All patients presented with or developed a film on the wound bed that appeared to be distinct from slough; wounds also were failing to progress. Although the slough in some of the wounds was easily removed with traditional debridement methods, removal of the film required physical disruption with a curette or dry gauze. All wounds eventually progressed to healing. Considering the biofilm concept and available preclinical research, it is evident from this small case series that the appearance of biofilm in wounds is quite different from slough and requires different management strategies for its control. The evolving biofilm paradigm could profoundly change approaches to wound management. Additional research is needed in this evolving aspect of wound management.
生物膜在传染病、伤口感染及愈合领域是一个相对较新的概念。尽管关于伤口生物膜的科学研究及相关“讨论”日益增多,但对于伤口生物膜的表现、诊断、潜在影响及管理策略仍知之甚少。现通过一系列四个临床病例来证明伤口生物膜的存在。所有患者的伤口床均出现或形成了一层看似与腐肉不同的薄膜;伤口也未出现愈合进展。尽管部分伤口的腐肉可通过传统清创方法轻松去除,但去除该薄膜则需要用刮匙或干纱布进行物理剥离。所有伤口最终均实现愈合。结合生物膜概念及现有的临床前研究,从这个小病例系列中可以明显看出,伤口中生物膜的外观与腐肉截然不同,需要采用不同的管理策略来控制。不断发展的生物膜模式可能会深刻改变伤口管理方法。在伤口管理的这一不断发展的方面,还需要进一步研究。