28 responses to “Chronic ulcers and biofilms”

  1. I have found this information very useful.

  2. So is the biofilm usually contamibnated as well, i.e. the ocassional positive, deep wound culture(and I ussually do not culture wounds routinely) that is obtained, is that not the reason for the biofilm occurring?

  3. Interesting article. I like it. How often do you have to debride before the biofilm gives up?

  4. I have often wondered about this situation before and appreciate this help.

  5. Interesting makes me think back to the use of ELase[hyluronidase] or maggots to clean up sloughy wounds i will try it

  6. Useful info and worth a try.

  7. Makes sense

  8. I have often been tempted to debride this more aggressively. Now I have more reason to do so.

  9. Very good article

  10. I remember this talk at the last derm conference as it had some nasty photos.

  11. good reminder -problem getting equipment at nursing homes
    What dressing after the curetting?

  12. Does hyperbaric oxygen treatment slow or prevent the formation of the biofilm?

  13. Good article. I’ll give it a try.

  14. Very basic but clever.

  15. Interesting. I previously was familiar with biofilms that occur in water distribution systems and are suspected when non-coliform bacteria counts are elevated. They cause comsumption of the chlorine or bromine disinfectants. This is the slime that you might find in your charcoal filters when you replace them. Chemicals don’t remove them, you must physically do so.

  16. Good comparison to plaque formation.

  17. Does the 2% xyloc. gel penetrate the biofilm to be truly efficacious? Otherwise an interesting approach worth trying.

  18. Fantastic information. I am part owner of a Personal Care Home and we deal with this issue occasionally.

  19. Great to see this – now I can debride properly and enhance wound healing

  20. I can concur with the rationale of debridgement in treating chronic ulcer,but wonder how practical it is in a busy family practice.

  21. This is what I normally do, but I also do biopsies of non healing ulcers to understand nature of ulcer and rule out wound cancers.

  22. Curreting as suggested is tedious and too time consuming for the busy office. Is there still something in the pharmaceutical market (like ? “Debrisand” beads) that the patient can do/apply/assist in debridement at home ?

  23. 1. To Leslie Sank:
    Biofilm is actually a structure that is composed of the multiple species of bacteria housed in an exo-polysaccharide matrix. It occurs whenever there is a solid-fluid interface (ie your mouth, the bathroom sink, the toilet, and even stainless steel sinks). Biofilm is bacteria!

    2. To William Wu:
    I usually debride BF with a curette or the blunt end of a cotton tip applicator once a week. Studies have shown that more often is better (but less practical!)

    3. To John Taylor:
    I am glad you found this interesting. BF represents about 90% of the biomass of bacteria on this planet. It is about time we humans began to understand them. I believe they are the biggest reason for multi-drug resistant bacteria. We docs just can’t seem to stop prescribing antibiotics for non-infections resulting in toys for these bugs to play with.

    4. To all who found this interesting: Go forth and DEBRIDE!!!

    5. To Dr. Surkan:
    An absorbent dressing such as Allevyn or Mepilex or ETE could be used because these wounds are usually quite exudative

    6. To T. Pickett:
    There is no evidence that Hyperbaric Oxygen inhibits biofilms.

  24. After debridement what kind of dressing is best

  25. very good article. I will try it

  26. thank you, I see chronic wounds all the time in the hospital

  27. Very interesting post i liked it a lot. Great work.

  28. I am studying Podiatry at the moment and have an assignment on wound healing. I was going to do diabetic ulcers using biofilm. Is there any other healing treatment that can be used to heal diabetic ulcers? and what other healing methods are good for treating diabetic ulcers? thankyou.

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