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inFectiOn and biOFilM
An infection is the presence of replicating microorganisms
invading wound tissue and causing damage to the tissue
and the host. Biofilms, created in the presence of a bacteria,
are complex polymicrobial communities attached
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to
a substrate, covered with an extracellular polymeric
substance (EPS). Biofilms and their causative organisms
are not visible to the naked eye, and conventional
swabbing is often inconclusive in identifying them. Biofilms
repopulate in toxic wound environments in which cells
break down and chronic inflammation occurs. This is
exacerbated by the release of planktonic bacteria from
the biofilm, which stimulates an inflammatory response.
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Persister cells can repopulate the biofilm despite antibiotic
susceptibility and therapy.
FOreign bOdieS
Finally, external factors such as foreign bodies can
complicate wound management. Debris (projectiles,
splinters, glass and shrapnel), and even fragments of
dressing and suture material, must be removed as they
can interfere with healing.
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