The effects of pH on wound healing, biofilms, and antimicrobial efficacy.

It is known that pH has a role to play in wound healing. In particular, pH has been shown to affect matrix metalloproteinase activity, tissue inhibitors of matrix metalloproteinases activity, fibroblast activity, keratinocyte proliferation, microbial proliferation, and also immunological responses in a wound; the patient's defense mechanisms change the local pH of a wound to effect microorganism invasion and proliferation; this pH change has been found to affect the performance of antimicrobials, and therefore the efficacy in biological environments directly relevant to wound healing. Based on the available body of scientific evidence to date, it is clear that pH has a role to play in both the healing of and treatment of chronic and acute wounds. It is the purpose of this review to evaluate the published knowledge base that concerns the effect of pH changes, the role it plays in wound healing and biofilm formation, and how it can affect treatment efficacy and wound management strategies.