Using Empirical Biofilm-Directed Care for Patients Who Fail to Heal Using Standard Wound Care Treatment

Untreated biofilm in nonhealing wounds often progresses to infection, especially among poor and disadvantaged patients. In the U.S. annually, 8.2 million Medicare beneficiaries have a chronic nonhealing wound at a cost of over $31 billion annually. More than 7 million elderly people live below the poverty level. Biofilms, surface attached bacterial communities, have high levels of antibiotic tolerance, are resistant to typical topical wound care treatments as well, and represent the potential progression to life-threatening infection.

Bacteria exist in two different lifestyles: planktonic or free floating, which are easily treated with antibiotics, antiseptics, or disinfectants; or bacteria that live in their preferred environment, encased within a protective biological matrix or structure that is made by the bacteria themselves. While planktonic bacteria can be identified through regular swab culture methods, bacteria with biofilm matrixes require amplification via a more expensive complex testing methodology.

Among poor and disadvantaged people, and absent testing access, can empirical biofilm-directed care restore wound healing trajectories?

These antibiofilm compounds can reach bacteria within the biofilm, eradicate biofilm’s impact, and decrease the potential progression to infection.

For this work, literature supports that patients who failed to reach a trajectory of wound closure after four weeks of good standard of care may have biofilm attached to the surface of their wounds. Patients were identified who had failed to heal using a benchmark healing trajectory of 40–50% healing in four weeks or less. The empirical antibiofilm treatment was applied as directed to patient wounds to determine if healing would be resumed.

Treating patients using empirical biofilm-directed care can have a positive impact on wound healing and infection modulation. Using antibiofilm compounds that impact both planktonic bacteria and the biofilm, protective matrix can restore patients to a healing state and decrease the potential progression to infection.