Biofilms are communities of microorganisms that attach to surfaces and produce extracellular polymeric substances that can embed the microbes. Biofilms are prevalent in nature and hospital settings. Microbes in biofilms are more resistant to antibiotics and host defenses than individual planktonic cells. About 90% of chronic wounds contain bacteria and fungi living within biofilms, which delays wound healing and causes chronic inflammation. Treating biofilm infections is challenging as high concentrations of antibiotics are needed to penetrate the protective biofilm matrix. Thorough debridement and use of anti-biofilm agents like honey or silver are needed to manage biofilm-related wounds.

1. BIOFILMS & WOUNDS
DR.S.KARTHICK KUMAR
PG Mch Plastic surgery

2. INTRODUCTION
• The term biofilm was coined by Bill
costerton in 1978
• Microbes attach together and forms
colonies and function as groups and that
individuals within the group could respond
to the group as a whole
• This phenomenon is known as QUORUM
SENSING and results in formation biofilm
with unique characteristics & structure

3. DEFINITION
• A community of micro organisms
either as mono species or mixed
species stick to each and often
to surface within a matrix of
extracellular polymeric
substances(EPS)

4. • Biofims may form on living or non-living
surfaces & prevalent in nature,industrial
and hospital settings
• When there is mostuire
biofilms will form like in
Pipeline, kitchen, contact lens
etc…

5. • The microbial cells growing in biofilms
are physiologically distinct from
planknotic cells of same
organisms,which by contrast,these cells
may float or swim in liquid medium
• These cells are embedded in a self
produced matrix of extracellular
polymeric substances (EPS)
• Biofilm EPS is also referred to as
SLIME

6. STRUCTURE
• Extracellular polymeric substances (EPS)
-Composed of DNA,proteins and
polysaccharides
-EPS is highly hydrated & has water
channels which allows transport of nutrients
and oxygen to biofilms
• Microbial cells
- Mono microbial aggregation
. - Polymicrobial aggregation

7. Characteristics
• Protection : Resistance to antimicrobial
agents
• Plasmid : they may allow exchange of
resistance plasmids
• Persistent source of infection
• Pathogenic organism may be harbored

8. • Evade the host defences like phagocytosis
• Obtain a high density of microorganisms
• Exchange of genes results in more virulent
strains
• Produce large concentration of toxins
• Detachment of microbial aggregates
transmits microbes to other sites

9. • Planktonic : free floating form in which
cells float or swim in liquid medium
• Sessile : attached state in which cells are
closely packed and firmly attached to each
other on solid surface

10. Formation

12. Bacteria forming biofilm
• E.coli
• Pseudomonas aeruginosa
• Staph aureus
• Staph epidermidis
• K.pneuomoniae
• Actinomycosis
• H. influenza
• Bacillus
• Pneumococcus

15. Methods of detection
• Electron microscope
• Tissue & culture plate method
• Congo red agar method

16. Antibiotic resistance
Biofilms exhibits multiple defence
mechanisms results in antibiotic resistance

18. • Planktonic bacteria can attaches to a
surface within minutes
• And resistance to antibiotics and
antiseptics within 6 to 12 hrs
• Mature biofilm can develop within 2 to 4
days
• Even after thorough debridement biofilm
can reform within 24 hrs

19. • Chronic inflammatory process is not
successful in removing biofilm
• Chronic ineffective inflammatory process
will form exudate Which contain nutrition
will help the Biofilm

20. Biofims and wounds
• Biofilms play a significant role
in inability of wound to heal
• ~90% of chronic wounds
contain bacteria & fungi living
within biofilm
• Biofilms delay the wound
healing without causing
Obvious Clinical infection
• Evades host defence and from
antibiotics and neutrophils

21. • Biofilm has more virulence than planktonic
bacteria so difficult to treat with antibiotics
• 4000x more resistant
• The presence of biofilm ensures chronic
inflammatory state which results in
chronicity of wound

22. Difficulties in treatment with
antibiotics
• High concentration of antibiotics is
required to penetrate through matrix
• The Cells are base exhibits low metabolic
activity and Sessile which reduce the
effectiveness of antibiotics

23. Manegement
• Topical agents
• Broad spectrum antibiotics
• debridement

24. Anti biofilm agents
• Honey which Block lectin pseudomonas
• Silver destabilize biofilm matrix
• Iodine cadexomer Which soaks up staph
aureus Can destroy biofilm matrix and kill
staph aureus

25. Debridement
• Partial removal of biofilms will results in
more virulence & biofilm will adapt and
become more active
• So Thorough and serial debridements
required
• Rapid removal of exudate Will prevent
Biofims to Use nutrients

26. Wound cleaning
Antiseptics used
Alcohol
Aldehydes
Oxidatives
Phenols
Quaternary ammonium components

27. • Most widely used
• Guanidine
• Octenidine dihydrochloride
• Chlorhexidine , cetrimide

28. • THANK YOU