Scapa Healthcare Plc, Manchester, UK.
Wound Repair Regen. 2012 Sep-Oct;20(5):647-57. doi: 10.1111/j.1524-475X.2012.00836.x.
Both chronic and acute dermal wounds are susceptible to infection due to sterile loss of the innate barrier function of the skin and dermal appendages, facilitating the development of microbial communities, referred to as biofilms, within the wound environment. Microbial biofilms are implicated in both the infection of wounds and failure of those wounds to heal. The aim of this review is to provide a summary of published papers detailing biofilms in wounds, the effect they have on infection and wound healing, and detailing methods employed for their detection. The studies highlighted within this paper provide evidence that biofilms reside within the chronic wound and represent an important mechanism underlying the observed, delayed healing and infection. The reasons for this include both protease activity and immunological suppression. Furthermore, a lack of responsiveness to an array of antimicrobial agents has been due to the biofilms' ability to inherently resist antimicrobial agents. It is imperative that effective strategies are developed, tested prospectively, and employed in chronic wounds to support the healing process and to reduce infection rates. It is increasingly apparent that adoption of a biofilm-based management approach to wound care, utilizing the "antibiofilm tool box" of therapies, to kill and prevent reattachment of microorganisms in the biofilm is producing the most positive clinical outcomes and prevention of infection.
慢性和急性皮肤创面都容易受到感染，这是由于皮肤和皮肤附属物的固有屏障功能丧失，导致微生物群落（称为生物膜）在创面环境中发展。微生物生物膜与创面感染和创面愈合失败都有关。本综述的目的是总结已发表的详细描述创面生物膜的文献，它们对感染和创面愈合的影响，并详细介绍用于检测生物膜的方法。本文强调的研究提供了证据，证明生物膜存在于慢性创面中，是观察到的延迟愈合和感染的重要机制。这包括蛋白酶活性和免疫抑制的原因。此外，生物膜固有地抵抗抗菌药物的能力导致其对多种抗菌药物缺乏反应性。至关重要的是，必须开发、前瞻性测试并在慢性创面中采用有效的策略，以支持愈合过程并降低感染率。越来越明显的是，采用基于生物膜的创面护理管理方法，利用“抗生物膜工具包”的治疗方法，杀死和防止生物膜中微生物的重新附着，正在产生最积极的临床结果和预防感染。
