Biofilm is tough. It is recalcitrant. It sets up in 24 hours, and the experts in the field say your window to treat it is gone within 3 days.
NOT ALL WOUNDS NEED THIS. If you fall off your bike and get a scrape, you do not need to rush out and diagnose your wound bacteria and go on special antibiotic gels and treatments. This is for wounds or issues that don’t heal and go on for months.
You can create a window to treat it by debriding the wound. In English, debriding means getting rid of the top layer, that waxy exudate on your skin, the dead cells and tissue. As they say on TV shows, YOU SHOULD NOT TRY THIS AT HOME. Other physicians refer to us plastic surgeons to do this. Why? Because there is a fine line between removing what should be removed and removing too much. If you remove too much you will get scar, contour deformities, and ickiness.
So how to treat biofilm?
- Debride. Frequently. You will be seeing your doctor to do this every couple days.
- Selective biocide. In English, that means you can use a treatment which helps get rid of bacteria, but not the normal good cells. An example of a nonselective biocide is peroxide- it kills bacteria, but it also kills your normal healthy cells.
- Antiobiofilm. These are enzymes and gels which help break down the biofilm
- Antibiotics. These are personalized antibiotics tailored directly to what they found on your test. What bugs you have and what they are susceptible to cannot be gotten from a culture. This is done by PCR. You have to treat usually “long and strong,” and you have to reassess and potentially rotate agents if resistance is growing.
So if you have a nonhealing wound, that has gone on for months, you should look into diagnosing the biofilm. Some of the results they showed for diabetic foot ulcers and other what seemed to be “impossible to heal wounds” was amazing.