Biofilms in chronic wounds and the potential role of negative pressure wound therapy: an integrative review.

Biofilms are communities of microbes that exist in a variety of environments. The extracellular substances secreted by biofilms make them difficult to eradicate, giving the bacterial community in the biofilm a resistance advantage over freefloating (planktonic) microbes. Biofilms are particularly problematic in chronic wounds because of their resistance to conventional therapies and tendency to delay healing. Multimodal strategies to combat wound biofilms are necessary, including wound debridement, antimicrobial treatment, and continued disruption of biofilms. Negative pressure wound therapy with irrigation or instillation may lower the bacterial burden in chronic wounds and prevent the biofilm formation. This article provides an overview of biofilms and evolving strategies to counteract them.