title: Disrupting the biofilm matrix improves wound healing outcomes.
abstract: OBJECTIVE
  The most unyielding molecular component of biofilm communities is the matrix structure that it can create around the individual microbes that constitute the biofilm. The type of polymeric substances (polymeric sugars, bacterial proteins, bacterial DNA and even co-opted host substances) are dependent on the microbial species present within the biofilm. The extracellular polymeric substances that make up the matrix give the wound biofilm incredible colony defences against host immunity, host healing and wound care treatments. This polymeric slime layer, which is secreted by bacteria, encases the population of microbes, creating a physical barrier that limits the ingress of treatment agents to the bacteria. The aim of this study was to determine if degrading the wound biofilm matrix would improve wound healing outcomes and if so, if there was a synergy between treating agents that disrupted biofilm defenses with Next Science Wound Gel (wound gel) and cidal agents (topical antibiotics).
  
  
  METHODS
  A three-armed randomised controlled trial was designed to determine if standard of care (SOC) was superior to SOC plus wound gel (SOC + gel) and wound gel alone. The wound gel used in this study contains components that directly attack the biofilm extracellular polymeric substance. The gel was applied directly to the wound bed on a Monday-Wednesday-Friday interval, either alone or with SOC topical antibiotics.
  
  
  RESULTS
  Using a surrogate endpoint of 50% reduction in wound volume, the results showed that SOC healed at 53%, wound gel healed at 80%, while SOC plus wound gel showed 93% of wounds being successfully treated.
  
  
  CONCLUSIONS
  By directly targeting the wound biofilm matrix, wound healing outcomes are improved.
authors.affiliation: Medical Director of Southwest Regional Wound Care Center; Southwest Regional Wound Care Center, Lubbock, Texas.
authors.forename: R
authors.initials: R
authors.lastname: Wolcott
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D018441:Biofilms / Q000187:drug effects*; D005109:Extracellular Matrix / Q000187:drug effects*; D005260:Female; D005782:Gels / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009779:Occlusive Dressings; D059039:Standard of Care; D014647:Varicose Ulcer / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology*; D014945:Wound Healing; D014946:Wound Infection / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D005782:Gels
keywords: Next Science Wound Gel; biofilm; chronic infection; chronic wound; extracellular matrix; ulcer