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Biofilm Intervention Pathway: An Idealized Algorithm

Hess, Cathy Thomas BSN, RN, CWOCN

Advances in Skin & Wound Care: October 2012 - Volume 25 - Issue 10 - p 480
doi: 10.1097/01.ASW.0000421458.76031.bc
Departments: Practice Points

Cathy Thomas Hess, BSN, RN, CWOCN, is Vice President and Chief Clinical Officer, Net Health Systems, Inc.

Please address correspondence to: Cathy Thomas Hess, BSN, RN, CWOCN, via e-mail:

As clinicians, we like algorithmic thinking that leads to interventions, such as wound-healing pathways. Although the wound care community has written, researched, and reviewed the etiology of a chronic wound, we have a lot more work to do to understand how biofilms affect chronic wounds and appropriate interventions to eradicate them from the wound. To that end, an idealized “Biofilm Intervention Pathway” is shared for your consideration. This pathway has been created as a clinical tool to assist the clinician in understanding the ideal steps necessary to remove and prevent biofilms from occurring. This idealized algorithm shares the following fundamental thoughts:

  • Clinical characteristics of wounds that have biofilm have not been validated, and routine testing to confirm the presence of a biofilm does not currently exist.
  • Removal of biofilm by surgery is theoretically possible, but the depth needed for debridement is not currently known.
  • Without adequate prevention, reformation of biofilm is likely to occur after removal.
Source: Hess CT, Kirsner RS

Source: Hess CT, Kirsner RS

© 2012 Lippincott Williams & Wilkins, Inc.