Current concepts regarding the effect of wound microbial ecology and biofilms on wound healing.

Biofilms are a collection of microbes that adhere to surfaces by manufacturing a matrix that shields them from environmental elements. Wound biofilms are difficult to evaluate clinically, and standard culture methods are inadequate for capturing the true bioburden present in the biofilm. New molecular techniques provide the means for rapid detection and evaluation of wound biofilms, and may prove to be useful in the clinical setting. Studies have shown that many commercial topical agents and wound dressings in use are ineffective against the biofilm matrix. At this stage, mechanical debridement appears to be essential in the eradication of a wound biofilm. Topical antimicrobial agents and antibiotics may be effective in the treatment of the wound bed after debridement in the prevention of biofilm reformation.