title: Biofilms and Inflammation in Chronic Wounds.
abstract: CONCLUSIONS
  The incidence, cost, morbidity, and mortality associated with non-healing of chronic skin wounds are dramatic. With the increasing numbers of people with obesity, chronic medical conditions, and an increasing life expectancy, the healthcare cost of non-healing ulcers has recently been estimated at $25 billion annually in the United States. The role played by bacterial biofilm in chronic wounds has been emphasized in recent years, particularly in the context of the prolongation of the inflammatory phase of repair.
  
  
  BACKGROUND
  Rapid high-throughput genomic approaches have revolutionized the ability to identify and quantify microbial organisms from wounds. Defining bacterial genomes and using genetic approaches to knock out specific bacterial functions, then studying bacterial survival on cutaneous wounds is a promising strategy for understanding which genes are essential for pathogenicity.
  
  
  RESULTS
  When an animal sustains a cutaneous wound, understanding mechanisms involved in adaptations by bacteria and adaptations by the host in the struggle for survival is central to development of interventions that favor the host.
  
  
  CONCLUSIONS
  Characterization of microbiomes of clinically well characterized chronic human wounds is now under way. The use ofin vivomodels of biofilm-infected cutaneous wounds will permit the study of the mechanisms needed for biofilm formation, persistence, and potential synergistic interactions among bacteria. A more complete understanding of bacterial survival mechanisms and how microbes influence host repair mechanisms are likely to provide targets for chronic wound therapy.
authors: Division of Dermatology, University of Washington , Seattle, Washington.
authors: Ge
authors: G
authors: Zhao
authors: Division of Dermatology, University of Washington , Seattle, Washington.
authors: Marcia L
authors: ML
authors: Usui
authors: Department of Genome Sciences, University of Washington , Seattle, Washington.
authors: Soyeon I
authors: SI
authors: Lippman
authors: Center for Biofilm Engineering, Montana State University , Bozeman, Montana.
authors: Garth A
authors: GA
authors: James
authors: Center for Biofilm Engineering, Montana State University , Bozeman, Montana.
authors: Philip S
authors: PS
authors: Stewart
authors: Division of Dermatology, University of Washington , Seattle, Washington.
authors: Philip
authors: P
authors: Fleckman
authors: Division of Dermatology, University of Washington , Seattle, Washington.
authors: John E
authors: JE
authors: Olerud