Bioburden can be defined as microbial cells adherent to a living or non-living surface, which are embedded within a self-produced matrix of extra-cellular polymeric substances (EPS). Bioburden provides tolerance to antimicrobial agents and can result in persistent inflammation and infection.1,2
Bioburden is a huge problem:
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1. Gurjala AN et al. Development of a novel, highly quantitative in-vivo model for the study of biofilm-impaired cutaneous wound healing. Wound Rep Reg (2011) 19 400-410.
2. Hall-Stoodley LI et al. Towards diagnostic guidelines for biofilm-associated infections. FEMS Immunol Med Microbiol. 2012; 65:127-145.
3. Malone M et al. 2017. The prevalence of biofilm in chronic wounds: a systematic review and meta-analysis of published data. JWC; 20-25.
4. Hurlow, J., Couch, K., Laforet, K., Bolton, L., Metcalf, D. et al. (2015). Clinical Biofilms: A Challenging Frontier in Wound Care. Advances in Wound Care, 4(5). 295-301.
5. Metcalf, Bowler. Biofilm delays would healing: a review of the evidence. Burns Trauma 2013; 1: 5-12.
6. Wolcott RD et al. Biofilm maturity studies indicate sharp debridement opens a time dependent therapeutic window. J Wound Care. 2010; 19: 320-328.
7. Costerton JW, Stewart PS, Greenberg EP. Bacterial Biofilms: A Common Cause of Persistent Infections. 1999: 284 Science.