Clinical and Antibiofilm Efficacy of Antimicrobial Hydrogels.

Significance: Hydrogels have been shown to have a significant role to play in wound healing. Hydrogels are used to assist in the management of dry, sloughy, or necrotic wounds. However, recent scientific evidence has shown that biofilms delay wound healing and increase a wound propensity to infection. It is therefore essential that hydrogels incorporating antimicrobials demonstrate efficacy on biofilms. Consequently, it is the aim of this article to review the efficacy of hydrogels, incorporating antimicrobials, on wounds with specific reference to their efficacy on biofilms. Recent Advances: Technologies being developed for the management of wounds are rapidly expanding. In particularly next-generation hydrogels, incorporating copolymers, have been reported to enable the smart release of antimicrobials. This has led to the development of a more tailored patient-specific antimicrobial hydrogel therapy. Critical Issues: Evidence relating to the efficacy of hydrogels, incorporating antimicrobials, on biofilms within both the in vitro and in vivo environments is lacking. Future Direction: Studies that investigate the efficacy of antimicrobial hydrogel wound dressings on both in vivo and in vitro biofilms are important. However, there is a significant need for better and more reproducible in vivo biofilm models. Until this is possible, data generated from appropriate and representative in vitro models will help to assist researchers and clinicians in evaluating antimicrobial and antibiofilm hydrogel technology for the extrapolation of efficacy data relevant to biofilms present in the in vivo environment.