If you work in wound management, the word “biofilm” is something you will come across a lot. What are biofilms? What are they made of? Why are they significant to wound healing? This blog post will explore everything you need to know about biofilms.
What are Biofilms?
Biofilms consist of a variety of species of bacteria, fungi, yeasts, algae and other microbes. It comes about when certain types of microorganisms attach themselves to the wound surface by secreting a certain gummy substance.
According to studies, biofilms are present in 60% to 80% of chronic wounds and 6% of acute wounds. They are tolerant to some of today’s common antibiotics. Antiseptics, and disinfectants. They also reform quickly and may delay wound healing unless they are properly managed.
What are Biofilms Made Of?
As mentioned, biofilms are made of bacteria, fungi, and other microorganisms. While these organisms are considered microscopic, they often form a protective matrix that attaches the community to the surface once the biofilm matures.
As such, underdeveloped biofilms can be difficult to identify but they become more visible as they grow larger, often taking the appearance of a shiny film which protects the microorganisms living inside and keeps antibodies from reaching them.
Effects on Wound Care
Biofilms can prolong the wound healing process and thus, increase the risk of infection among patients. This is due to the fact that the film protects the microorganisms from the body's natural immune response, which can make it difficult for wounds to heal on their own.
While the body tries to fight the biofilm through its inflammatory response, the body may end up helping the biofilm by giving it nutrition in the form of exudate. What this does is create a situation where the body is ineffectively fighting biofilms while damaging healing tissue and delaying wound healing at the same time.
How to Manage Biofilms
Given the effects mentioned, that’s not to say that something can’t be done. By managing biofilms properly, speeding up the wound healing process is still possible by doing the following.
Sharp debridement that will help disrupt the biofilm. Just make sure to consult your doctor before attempting to remove the biofilm.
Effective cleansing which will help keep the biofilm from reforming. Some good examples are wound cleansers with surfactants and hypochlorous acid soaks. Just make sure the gauze is moistened and allow it to sit in or on the wound for about 15 minutes prior to dressing application.
Application of topical microbials is also an alternative. Antimicrobials such as cadexomer iodine, honey, Hydrofera Blue, and silver are highly recommended.
To keep biofilms from reforming, it’s important to always inspect the wounds for biofilms, regularly cleanse and debride the wound area, and increase debridement frequency for mature formations.
It’s important to keep in mind that standard swab wound cultures are of little use in identifying the bacteria in biofilms since they do not measure the bacteria. Molecular analysis, the study of tissues, cells, and fluids using DNA/RNA analysis techniques, is still the most effective way to identify the bacteria that make up the biofilms.