The question: “Is there a biofilm in the wound?” reveals it is still hard to understand biofilms for wound care professionals.
To ask this simple question is uncovering a knowledge gap.
There is no such thing as A biofilm. Her are two thoughts which may enlighten you.
- most microbes are able to produce biofilms.
- If a biofilm will increase their chance of survival they will produce one, if it does not they will not.
This immediately implies that every imaginable combination of species and numbers of each species will have an influence on the biofilm.
This also implies no two biofilms are the same, stay the same or that there is only one biofilm in the wound. There will be deep tissue biofilms and superficial biofilms. The whole combination of microbes and biofilms may be more comparable to a city than a glass house. Its appearance will depend on the size of the city and the number of different inhabitants and their needs.
Luckily even biofilms will have to follow some natural or mathematical rules and therefore the number of clinical relevant biofilms may be not infinite.
Not all biofilms are bad either. As we know, every nine out of ten cells in your body are not really you. There are biofilms in the intestine which are essential for a proper functioning body. They are so important the appendix functions as a special reservoir for spare biofilms in the case something goes wrong.
In the wound it is very well imaginable that a biofilm has a ECM like function. So presumably not all biofilms are bad.
So in the end, the question is not if there is a biofilm in the wound, the question is if there is a (good or bad) clinical relevant microbiome in the wound.
For more information: Elisabeth Bik has a nice blog on biofilms and the microbiome. Here you may find this nice example of biofilm dynamics.