The diabetic foot: the importance of biofilms and wound bed preparation.
The diabetic foot: the importance of biofilms and wound bed preparation.
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DOI：
10.1007/s11892-006-0076-x
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发表时间：
2006-12-01
影响因子：
4.2
通讯作者：
Kirsner, Robert
中科院分区：
文献类型：
--
作者：
Davis, Stephen C;Martinez, Lisa;Kirsner, Robert
生物膜无处不在，在医学上具有重要意义，是一种复杂的结构，由嵌入自身产生的水合胞外聚合物基质中的微生物相关细胞组成，这些细胞不可逆地附着在生物或非生物表面。以生物膜形式存在的细菌对传统治疗有抵抗力。微生物存在的这种特殊群落最近作为慢性伤口不愈合的一个潜在原因引起了人们的关注。这对于糖尿病足溃疡可能尤为重要，糖尿病足溃疡通常具有难治性、易发生相关潜在感染以及通过清创可改善的特点。为了更好地研究生物膜，已经开发了动物模型和体外模型，这将为治疗干预提供途径。存在一些潜在的机会，包括防止细菌附着、防止生物膜形成、破坏生物膜以使局部抗菌药物能够渗透、干扰群体感应以及促进细菌从生物膜分散到更易被破坏的浮游状态。
Biofilms are ubiquitous and medically important complex structures consisting of microbial-associated cells embedded in self-produced extracellular matrix of hydrated extrapolymeric substances, which are irreversibly attached to a biological or nonbiological surface. Bacteria that reside as biofilms are resistant to traditional therapy. This alternative community in which microbes exist has recently attracted interest as a potential reason why chronic wounds do not heal. This may be especially important for diabetic foot ulcers, which are often characterized by their refractory nature, their predisposition to have associated underlying infection, and their improvement with debridement. Animal and in vitro models have been developed to better study biofilms, which will allow a venue for therapeutic intervention. Potential opportunities exist that include prevention of bacterial attachment, prevention of biofilm formation, disruption of the biofilm to allow penetration of topical antimicrobial agents, interference with quorum sensing, and enhancement of bacteria dispersion from biofilms to a more easily destroyed planktonic state.