title: Antiseptics for treating infected wounds: Efficacy on biofilms and effect of pH.
abstract: Biofilm recalcitrance is a persistent problem when managing difficult to heal and infected chronic wounds. The wound biofilm is a fundamental factor in the re-occurrence and delayed healing commonly observed in non-healing and infected chronic wounds. However, there is presently no single antimicrobial agent that is completely efficacious against both the planktonic and sessile polymicrobial communities evident in at risk or infected wounds. We will review currently available antimicrobials, with particular emphasis on silver and iodine, employed to help suppress biofilms in wounds. In addition, we will also review the effect of pH on antimicrobial efficacy. Available evidence suggests that it is best to take a multifactorial approach towards controlling biofilm in chronic, "at risk" and infected wounds. This highlights the growing importance of avoiding indiscriminate or inappropriate use of antimicrobials in the treatment of chronic wounds.
authors.affiliation: a Institute of Ageing and Chronic Disease and Surface Science Research Centre, University of Liverpool , Liverpool , UK .
authors.forename: Steven L
authors.initials: SL
authors.lastname: Percival
authors.affiliation: b Department of Chemistry , University of Sheffield , Sheffield , UK .
authors.forename: Simon
authors.initials: S
authors.lastname: Finnegan
authors.affiliation: c Microbial Biofilm Laboratory , IRCCS Fondazione Santa Lucia , Rome , Italy , and.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Donelli
authors.affiliation: c Microbial Biofilm Laboratory , IRCCS Fondazione Santa Lucia , Rome , Italy , and.
authors.forename: Claudia
authors.initials: C
authors.lastname: Vuotto
authors.affiliation: b Department of Chemistry , University of Sheffield , Sheffield , UK .
authors.forename: Steve
authors.initials: S
authors.lastname: Rimmer
authors.affiliation: d Medical School , University of Oxford , Oxford , UK.
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Lipsky
mesh_terms: D000818:Animals; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000145:classification / Q000627:therapeutic use*; D018441:Biofilms / Q000187:drug effects; D001684:Biological Dressings; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007455:Iodine / Q000737:chemistry / Q000494:pharmacology; D012834:Silver / Q000737:chemistry / Q000494:pharmacology; D016896:Treatment Outcome; D014946:Wound Infection / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000891:Anti-Infective Agents, Local; D012834:Silver; D007455:Iodine
keywords: Antiseptics; biofilms; iodine; pH; silver