Need a Biofilm Disrupter? Consider Application of a Concentrated Surfactant Technology: A Case Series

Aim: Bacterial biofilms have been noted to be in many chronic wounds and are probably the most important single cause of persistent delayed healing.  The current clinical evidence suggests that bacterial biofilms are best treated by sharp debridement alongside an antibacterial agent.  In many practice arenas clinicians are unable to perform sharp debridement and thus autolytic debridement has been incorporated to assist with removal of devitalized tissue. Recent research is evolving regarding the use of a surfactant to aid in stimulating autolytic debridement. Data is emerging that a non-ionic surfactant can interfere with aggregations of bacteria such as biofilm and in fact it may turn the biofilm-associated bacteria in a more susceptible planktonic-like phenotype.

Method: Four patients, two with chronic wounds of greater than 24 months were included in this case series that included application of a concentrated surfactant based gel.  The wound etiologies included two venous leg ulcers, one pressure injury and one delayed surgical wound. Other variables such as offloading and compression were incorporated to the wound care regimen.  

Results/Discussion: In three out of four cases the wounds closed in less than 5 months, and the fourth case proceeded to surgical intervention as the wound bed appearance had improved.  Application of the surfactant gel to all individuals was deemed to be virtually “pain-free”.

Conclusion: Wound care clinicians need to consider incorporating surfactant based technology to disrupt biofilm in chronic wounds, and thus move them to the proliferative stage in the wound healing cascade.