How to remove biofilm from wounds

The presence of biofilm is reportedly present in 60-100% of non-healing wounds (WUWHS Biofilm Position Paper, 2016). While the role that biofilm plays in the chronicity of wounds is still not fully investigated, it is becoming widely accepted that hard-to-heal wounds contain biofilm - and somehow its presence delays or prevents healing. 

Therefore the management of biofilm in chronic wounds is rapidly becoming a primary object of wound care. 

The concept of  ”Wound bed preparation“ was first described by Falanga et al (2000) and can be defined as the global wound management procedure to accelerate endogenous healing and enhance the effectiveness of advanced wound care products. The ultimate aim is to ensure healthy granulation tissue formation resulting in complete wound closure.

Correct Chronic "Wound bed preparation" is achieved by:

• Reducing bacterial bioburden e.g. biofilm in the wound bed
• Removing necrotic tissue and slough
• Controling exudates
• Managing cellular dysfunctions and biochemical imbalances

With Prontosan®  we provide a leading concept for wound bed preparation based on an unique combination of Polihexanide and Betaine. Several clinical studies prove faster wound closure, less complications and better quality of life. Prontosan® helps manage infection prevention, cleansing/debridement as well as wound bed moistening. Prontosan®  is your partner in preventing and treating the formation of biofilms.

Wound irrigation with Prontosan® removes debris, slough, bioburden and biofilm*

Traditional irrigation solutions are likely to glide over the biofilm without removing it.*

The latest addition to the Prontosan® product family is the Prontosan® Debridement Pad. It has been designed to support the Wound Bed Preparation by providing rapid, effective and safe debridement of the wound. 

Chronic wounds generally require repeated debridement. The Prontosan® Debridement Pad has been designed to support the Wound Bed Preparation with Prontosan® Wound Irrigation Solution. The Pad consists of a front layer with microfibers that debride and an absorbent backing layer for rapid, effective and safe debridement. Prontosan® Debridement Pad frees the wound from coatings and dead cell residues (debris) and absorbs excess exu­dates and slough. Intact tissue is spared. Prontosan® Debridement Pad produces good results even with scaly and necrotic coatings, if they are subject to prior autolytic treatment.

The unmarked side of the pad has to bee moistured with 15 – 20 ml of Prontosan® wound irrigation solution*. If local guidelines exist, they have to be followed. Apply gentle pressure, wipe the moiste­ned side over the wound and / or adjacent skin in a circular motion.

Following debridement, it is advisable to irrigate the wound thoroughly for a second time with Prontosan® Wound Irrigation Solution and to continue with standard treatment.

Microfibers are able to attach themselves to even the smallest, most microscopic particles—ones that normal monofilament fibers (positively giant in comparison) crudely brush past. If forces were visible, you‘d be able to see that there are adhesive forces between microfibers and the particles. There are millions of microfibers in a pad, so the overall sticking effect is magnified dramatically. That‘s why cell residues (debris), exudate and slough can be «hoovered up» by microfiber cloths. 

In this '5minutes, 5 questions' series of talking heads, Professor Keith Harding, Professor Marco Romanelli and Dr Bjorn Behr answer key questions about the concept of wound bed preparation. 

• How does wound bed preparation facilitate the use of advanced therapies?

• How does wound bed preparation help to accelerate healing?

• What are the key components of wound bed preparation?

• When was WBP introduced and how does it differ from good wound care?

• What factors contribute to a wound’s chronicity?

• How do topical antimicrobials assist wound bed preparation?

• How do you select the preferred method of debridement?

• What procedures do you use to reduce the bacterial bioburden/biofilms in a wound?

• How can you tell when the wound has a biofilm and what role do biofilms play in delaying wound healing?

• Prevention and management of infection is an integral part of wound bed preparation. How does it help early recognition of the signs and symptoms of infection?

*Seipp HM et al. Efficacy of various wound rinsing solutions against biofilms. ZfW 2005; 4(5):160-163 / Perez R et al. Effect of different wound rinsing solutions on MRSA biofilm in a porcine model. WoundM 2010; 4(2):44-48

1) Attinger, Christopher and Randy Wolcott. “Clinically Addressing Biofilm In Chronic Wounds”. Advances in Wound Care 1.3 (2012): 127-132. Web.

2) Bjarnsholt, T et al. “Biofilm Management”. 2016. Lecture.

3) International Wound Infection Institute (IWII): Wound infection in clinical practice. Wounds International;2016.

4) Bradbury, S and J Fletcher. “Prontosan Made Easy”. Wounds International 2.2 (2016): 1-6. Web. 23 Sept. 2016.

5) Kaehn, K Polihexanide: A Safe and Highly Effective Biocide, Skin Pharmacol Physiol 2010;23(suppl1);7-16