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Bioburden in wounds
Take control of bioburden
Wound healing is a biological process involving a series of precisely programmed phases. Elevated microbe levels will impair the process, resulting in an increased risk of wound infection and delayed wound healing.
Wound management – the importance of control
Once the skin is damaged, microbes normally present on the skin surface gain access to the underlying tissue. An important part of effective wound healing is to optimize the wound environment. The main task is to control both the moisture balance and the microbial load. The effectiveness of the patient’s defense system, together with the quantity and virulence of microbes, influences the development of wound infections.1, 2
Increased microbial load – associated with delayed wound healing
A wound may be locally infected, with delayed wound healing as a result, even if there are no or only subtle signs of infection. It is therefore important to reduce the microbial load and treat infections before there are distinct signs that an infection has developed.
Presence of fungi in the wound may also affect wound healing
Clinical experience and published studies show that presence of fungi is associated with delayed wound healing.
In a study of 915 clinical specimens from mixed chronic wounds* almost 25% were positive for fungal species.3 In another recent published study, 80% of non-healing diabetic foot ulcers contained fungi.4
* Decubitus ulcers, diabetic foot ulcers, non-healing surgical wound and venous leg ulcers
At least 30% of antibiotics prescribed in the out patient setting are unnecessary5
While antibiotics have saved countless lives worldwide, their overuse in unsuitable cases has led to increasing antimicrobial resistance. By the year 2050, it is predicted that antimicrobial resistance will be responsible for 10 million annual deaths worldwide.5
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References
1.Australian Wound Management Association Inc. 2011. Bacterial impact on wound healing: From contamination to infection. Australian Wound Management Association Inc. Version 1.5.
2.International Wound Infection Institute (IWII). 2016. Wound infection in clinical practice. Wounds Int.
3.Dowd SE, Delton Hanson J, et al. 2011. Survey of fungi and yeast in polymicrobial infections in chronic wounds. J Wound Care. 20(1):40-47.
4.Kalan L, Loesche M, et al. 2016. Redefining the Chronic-Wound Microbiome: Fungal Communities Are Prevalent, Dynamic, and Associated with Delayed Healing. mBio. 7(5):e01058-16.
5.O’Neill J. 2016. Tackling drug-resistant infections globally: Final report and recommendations. Review on Antimicrobial Resistance.