title: Clinical Biofilms: A Challenging Frontier in Wound Care.
abstract: Significance:Biofilms have been implicated in a variety of wound complications.Recent Advances:Research has confirmed that biofilms form in wounds of patients experiencing delayed healing and may be a precursor to infection.Critical Issues:Research into the strength of this association is still in its infancy. Is biofilm formation a cause of these complications, a step toward them, or a signal that unresolved factors injuring tissue or delaying healing are setting the stage for biofilm formation, infection, and healing delay? To qualify biofilms for use in informing clinical practice decisions, biofilm characteristics supporting those decisions need standardized definitions and valid evidence that they predict or diagnose healing or infection outcomes. Literature searches of relevant terms reviewed biofilm definitions and validation of their role in predicting and diagnosing delayed wound healing or infection.Future Directions:Further research is needed to provide a rapid accurate technique to identify and characterize biofilms in ways that optimize their validity in diagnosing or screening patient risk of infection or delayed healing and to inform clinical decisions. This research will help validate biofilm's capacity to support wound care clinical practice decisions and establish their importance in guiding clinical practice.
authors.affiliation: Wound Practitioner LLC , Memphis, Tennessee.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hurlow
authors.affiliation: George Washington University Hospital Wound Healing Center , Washington, District of Columbia.
authors.forename: Kara
authors.initials: K
authors.lastname: Couch
authors.affiliation: Calea Home Care , Mississauga, Ontario, Canada .
authors.forename: Karen
authors.initials: K
authors.lastname: Laforet
authors.affiliation: Department of Surgery, Rutgers Robert Wood Johnson University Medical School , New Brunswick, New Jersey.
authors.forename: Laura
authors.initials: L
authors.lastname: Bolton
authors.affiliation: Infection Prevention R&D, ConvaTec Global Development Centre , Flintshire, United Kingdom .
authors.forename: Daniel
authors.initials: D
authors.lastname: Metcalf
authors.affiliation: Science & Technology, ConvaTec Global Development Centre , Flintshire, United Kingdom .
authors.forename: Phil
authors.initials: P
authors.lastname: Bowler