Defying hard-to-heal wounds with an early antibiofilm intervention strategy: ‘wound hygiene’

Author:

Murphy Christine1,Atkin Leanne2,Dissemond Joachim3,Hurlow Jennifer4,Tan Yih Kai5,Apelqvist Jan6,James Garth7,Salles Nathalie8,Wu Jun9,Tachi Masahiro10,Wolcott Randall11

Affiliation:

1. Vascular Nurse Specialist; The Ottawa Hospital Limb Preservation Centre, Canada

2. Lecturer Practitioner; University of Huddersfield and Vascular Nurse Consultant at Mid Yorks NHS Trust, UK

3. Professor, Consultant of Dermatology and Venerology; University of Essen, Germany

4. Consultant Wound Specialised Nurse Practitioner; Memphis, US

5. Director of Vascular Services, Consultant Vascular and Endovascular Surgeon; Changi General Hospital, Singapore

6. Associate Professor; Department of Endocrinology University Hospital of Malmö, Sweden

7. Associate Research Professor; Department of Chemical and Biological Engineering and Center for Biofilm Engineering at Montana State University, US

8. Professor, Head of Geriatric Medicine; University Hospital Center, Bordeaux, France

9. Professor, Doctoral Tutor and Chief Scientist of Burn Department; The First Affiliated Hospital, Sun Yat-Sen University, China

10. Professor; Department of Plastic and Reconstructive Surgery, Tohoku University, Japan

11. Founder; Southwest Regional Wound Care Centre, Lubbock, TX. US

Abstract

Biofilm has been implicated as a barrier to wound healing and it is widely accepted that the majority of wounds not following a normal healing trajectory contain biofilm. Therefore, strategies that inform and engage clinicians to reduce biofilm and optimise the wound tissue environment to enable wound progression are of interest to wound care providers. In March 2019, an advisory board was convened where experts considered the barriers and opportunities to drive a broader adoption of a biofilm-based approach to wound care. Poor clarity and articulation of wound terminology were identified as likely barriers to clinical adoption of rigorous and proactive microbial decontamination that is supportive of wound healing advancement. A transition to an intuitive term such as ‘wound hygiene’ was proposed to communicate a comprehensive wound decontamination plan with an associated message of expected habitual routine. ‘Wound hygiene’, is a relatable concept that supports meticulous wound practice that addresses barriers to wound healing, such as biofilm, while aligning with antimicrobial stewardship programmes.

Publisher

Mark Allen Group

Subject

Nursing (miscellaneous),Fundamentals and skills

Reference16 articles.

1. World Union of Wound Healing Societies (WUWHS), Florence Congress, Position Document. Management of biofilm. Wounds International, 2016

2. Wounds UK. Best practice statement: making day-to-day management of biofilm simple. Wounds UK, 2017

3. A chronic case of confusion

4. The prevalence of biofilms in chronic wounds: a systematic review and meta-analysis of published data

5. Consensus guidelines for the identification and treatment of biofilms in chronic nonhealing wounds

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