Understanding the efficacy of Cadexomer Iodine in managing Wound Biofilms: Review
Biofilms are aggregates of bacteria growing together in a community surrounded by a protective and adhesive extracellular matrix (ECM) of exopolysaccharides (EPS), extracellular DNA (eDNA), and proteins (1-3). It helps in the long-term survival of the bacteria due to the resistance to hostile conditions, antibiotic treatment, and immune evasion (4,5). Biofilms are known to be more than 1000fold resistant to treatment with conventional antibiotics used normally for treating planktonic cells. Biofilms are often associated with human disease and are responsible for the majority of bacterial infections (7).
Previous studies have shown biofilm to be prevalent in up to 60% of chronic non-healing wounds (8,9). However, in a recent meta-analysis of various studies examining biofilm presence, this number has shown to be closer to 80% (10). Biofilms have been linked to many chronic clinical diseases including middle ear infections, implant-related infections, and chronic lung infections (11). European Society of Clinical Microbiology and Infectious Diseases (ESCMID) has highlighted this clinical impact of biofilms with the conclusion that biofilms cause chronic infections (12). Animal studies have clearly shown a significant impact of bacterial biofilms on wound healing in mice, rabbit, and porcine models (13-15)