title: Microbial Biofilms and Chronic Wounds.
abstract: Background is provided on biofilms, including their formation, tolerance mechanisms, structure, and morphology within the context of chronic wounds. The features of biofilms in chronic wounds are discussed in detail, as is the impact of biofilm on wound chronicity. Difficulties associated with the use of standard susceptibility tests (minimum inhibitory concentrations or MICs) to determine appropriate treatment regimens for, or develop new treatments for use in, chronic wounds are discussed, with alternate test methods specific to biofilms being recommended. Animal models appropriate for evaluating biofilm treatments are also described. Current and potential future therapies for treatment of biofilm-containing chronic wounds, including probiotic therapy, virulence attenuation, biofilm phenotype expression attenuation, immune response suppression, and aggressive debridement combined with antimicrobial dressings, are described.
authors.affiliation: Innovotech Inc., Suite 101, 2011 94 Street, Edmonton, Alberta T6N 1H1, Canada. amin.omar@innovotech.ca.
authors.forename: Amin
authors.initials: A
authors.lastname: Omar
authors.affiliation: Harkynn Consulting, P.O. Box 104, Albertville, Saskatchewan S0J 0A0, Canada. jbarry.wright@gmail.com.
authors.forename: J Barry
authors.initials: JB
authors.lastname: Wright
authors.affiliation: Department of Obstetrics and Gynecology, Institute for Wound Research, University of Florida, 1600 South West Archer Road, Room M337F, Gainesville, FL 32610-0294, USA. schultzg@ufl.edu.
authors.forename: Gregory
authors.initials: G
authors.lastname: Schultz
authors.affiliation: Department of Biomedical Engineering, Faculties of Engineering and Medicine & Dentistry, 1101 Research Transition Facility, University of Alberta, Edmonton, Alberta T6G 2G6, Canada. rburrell@ualberta.ca.
authors.forename: Robert
authors.initials: R
authors.lastname: Burrell
authors.affiliation: Innovotech Inc., Suite 101, 2011 94 Street, Edmonton, Alberta T6N 1H1, Canada. patricia.nadworny@innovotech.ca.
authors.forename: Patricia
authors.initials: P
authors.lastname: Nadworny
keywords: MBEC (minimum biofilm eradication concentration); antibiotic resistance; antibiotic tolerance; exopolymer; inflammation; quorum sensing; wound healing