Recommendations for the management of biofilm: a consensus document

T. Bianchi, R D Wolcott, Angela Peghetti, David J. Leaper, K Cutting, R Polignano, Z Rosa Rita, A Moscatelli, A Greco, M. Romanelli, Simone Pancani, A Bellingeri, V. Ruggeri, Laura Postacchini, Serena Tedesco, L. Manfredi, Maria Camerlingo, Sheldon Rowan, A. Gabrielli, Giovanni Pomponio

Research output: Contribution to journalArticle

Abstract

The potential impact of biofilm on healing in acute and chronic wounds is one of the most controversial current issues in wound care. A significant amount of laboratory-based research has been carried out on this topic, however, in 2013 the European Wound Management Association (EWMA) pointed out the lack of guidance for managing biofilms in clinical practice and solicited the need for guidelines and further clinical research. In response to this challenge, the Italian Nursing Wound Healing Society (AISLeC) initiated a project which aimed to achieve consensus among a multidisciplinary and multiprofessional international panel of experts to identify what could be considered part of 'good clinical practice' with respect to the recognition and management of biofilms in acute and chronic wounds. The group followed a systematic approach, developed by the GRADE working group, to define relevant questions and clinical recommendations raised in clinical practice. An independent librarian retrieved and screened approximately 2000 pertinent published papers to produce tables of levels of evidence. After a smaller focus group had a multistep structured discussion, and a formal voting process had been completed, ten therapeutic interventions were identified as being strongly recommendable for clinical practice, while another four recommendations were graded as being 'weak'. The panel subsequently formulated a preliminary statement (although with a weak grade of agreement): 'provided that other causes that prevent optimal wound healing have been ruled out, chronic wounds are chronically infected'. All members of the panel agreed that there is a paucity of reliable, well-conducted clinical trials which have produced clear evidence related to the effects of biofilm presence. In the meantime it was agreed that expert-based guidelines were needed to be developed for the recognition and management of biofilms in wounds and for the best design of future clinical trials. This is a fundamental and urgent task for both laboratory-based scientists and clinicians.

Original languageEnglish
Pages (from-to)305-17
Number of pages13
JournalJournal of wound care
Volume25
Issue number6
DOIs
Publication statusPublished - Jun 2016

Fingerprint

Biofilms
Wounds and Injuries
Clinical Trials
Guidelines
Librarians
Laboratory Personnel
Politics
Focus Groups
Research
Wound Healing
Nursing

Keywords

  • Anti-Infective Agents
  • Anti-Infective Agents, Local
  • Bandages
  • Biofilms
  • Burns
  • Debridement
  • Diabetic Foot
  • Disease Management
  • Humans
  • Pressure Ulcer
  • Surgical Wound Dehiscence
  • Surgical Wound Infection
  • Varicose Ulcer
  • Wound Infection
  • Wounds and Injuries
  • Consensus Development Conference
  • Journal Article
  • Research Support, Non-U.S. Gov't
  • Review

Cite this

Bianchi, T., Wolcott, R. D., Peghetti, A., Leaper, D. J., Cutting, K., Polignano, R., ... Pomponio, G. (2016). Recommendations for the management of biofilm: a consensus document. Journal of wound care, 25(6), 305-17. https://doi.org/10.12968/jowc.2016.25.6.305

Recommendations for the management of biofilm : a consensus document. / Bianchi, T.; Wolcott, R D; Peghetti, Angela; Leaper, David J.; Cutting, K; Polignano, R; Rosa Rita, Z; Moscatelli, A; Greco, A; Romanelli, M.; Pancani, Simone; Bellingeri, A; Ruggeri, V.; Postacchini, Laura; Tedesco, Serena; Manfredi, L.; Camerlingo, Maria; Rowan, Sheldon; Gabrielli, A.; Pomponio, Giovanni.

In: Journal of wound care, Vol. 25, No. 6, 06.2016, p. 305-17.

Research output: Contribution to journalArticle

Bianchi, T, Wolcott, RD, Peghetti, A, Leaper, DJ, Cutting, K, Polignano, R, Rosa Rita, Z, Moscatelli, A, Greco, A, Romanelli, M, Pancani, S, Bellingeri, A, Ruggeri, V, Postacchini, L, Tedesco, S, Manfredi, L, Camerlingo, M, Rowan, S, Gabrielli, A & Pomponio, G 2016, 'Recommendations for the management of biofilm: a consensus document', Journal of wound care, vol. 25, no. 6, pp. 305-17. https://doi.org/10.12968/jowc.2016.25.6.305
Bianchi T, Wolcott RD, Peghetti A, Leaper DJ, Cutting K, Polignano R et al. Recommendations for the management of biofilm: a consensus document. Journal of wound care. 2016 Jun;25(6):305-17. https://doi.org/10.12968/jowc.2016.25.6.305
Bianchi, T. ; Wolcott, R D ; Peghetti, Angela ; Leaper, David J. ; Cutting, K ; Polignano, R ; Rosa Rita, Z ; Moscatelli, A ; Greco, A ; Romanelli, M. ; Pancani, Simone ; Bellingeri, A ; Ruggeri, V. ; Postacchini, Laura ; Tedesco, Serena ; Manfredi, L. ; Camerlingo, Maria ; Rowan, Sheldon ; Gabrielli, A. ; Pomponio, Giovanni. / Recommendations for the management of biofilm : a consensus document. In: Journal of wound care. 2016 ; Vol. 25, No. 6. pp. 305-17.
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