You know that fuzzy film you sometimes feel on your teeth first thing in the morning? That’s biofilm. Dentists refer to it as plaque and have long understood its negative effects on the health of your teeth. They encourage daily brushing and flossing to effectively manage biofilm growth.1
But what about biofilm in wounds?
Biofilm has only been a buzzword in wound care for the past two decades or so, but it has taken on vital importance in the war against challenging wounds.2
How does biofilm impact wound healing?
The frustrating part for your work on wounds is that biofilms are notoriously tolerant to antibiotics and seemingly protected from the patient’s natural immunities, which contributes to the wound’s chronic character.
In fact, studies show that biofilm bacteria can be up to a 1,000 times more resistant to antibiotics than free-floating bacteria of the same species.6
“We are just now seeing more and more research into how biofilm can affect a body’s ability to heal wounds and what treatments can most effectively create an optimal wound healing environment,” says Medline Clinician Katie James BA, RN, CWCN
When to suspect biofilm
Biofilm is sneaky because routine lab tests can not differentiate between floating bacteria and attached biofilm even exist to detect it, and it’s often growing under the surface of the wound.10
What you see: stalled wound healing. The unique structure and EPS barrier of biofilm kills tissue in a slow, steady process that, if gone unchecked, can have devastating consequences. “The end result is typically some type of surgical removal of degraded tissues,” explains Dr. Kennedy. “In wound care, too often, that could mean amputation.” Before biofilm gets the upper hand, look out for qualities in the wound that might signal its existence.
Tools to treat biofilm
Standardizing a treatment protocol may help manage biofilm on a wound to help wound healing. “Since biofilm is found in such a high population of chronic wounds, it has to be a part of any discussion regarding wound healing and treatment practices today,” James says. In addition to the negative effects for the patient, James notes, “The longer it takes to heal a wound, the increased cost to heal that wound.” The right treatment can speed your patient’s healing time and reduce expenses for your patients and the healthcare facility.
Treating biofilm can be situational. The three tactics below are not a linear timetable, but rather offer an interactive approach.
The strength of iodine as an antibacterial
Iodine has been used in wound care since the American Civil War. Scientists believe that its value is related to its ability to penetrate the cell wall of micro-organisms.13 While silver has been a standard in hard-to-heal wound care, numerous in-vitro studies show that iodine is better at controlling biofilm than other antibacterial agents.14
“There are only a few true antibacterials on the market, and silver has been the number one go-to, even though iodine actually has a broader spectrum of effectiveness than silver,” James explains. “The problem with iodine is that, alone, it is also cytotoxic, meaning that it kills the good with the bad. Now, with the ability to have a controlled release platform, IoPlex has become an effective agent in managing the biofilm activity.”
Biofilm may be to blame for hard-to-heal wounds—and one of the reasons why your job is so important. Although treating biofilm is tricky because of its tolerance to typical antibiotics, if you know the signs to look for and the right products to use, you can help improve healing outcomes for your patients. Product innovations to manage biofilm, such as the effective use of iodine, could be your secret weapon.