Are wound biofilms visible? An interesting controversy

Two letters published in the Journal of Wound Care discuss clinical practice in wound biofilm identification


A letter by Richard White (University of Worcester) and Keith Cutting (Perfectus Medical) published in the March 2012 issue of the Journal of Wound Care* stated that while the use of experimental models and circumstantial evidence has established the existence of wound biofilms, as yet there is no conclusive clinical/in vivo proof to support this. In particular, they observe that there is no evidence of visual biofilm identification which is supported by microscopic confirmation. They argue that clinical understanding of wounds and wound biofilms must be based on firm science.

In a response published in the April 2012 issue of the Journal of Wound Care*, Jennifer Hurlow (Plastic Surgery Group) argues that, with a trained eye and clinical experience, wound biofilms can likely be differentiated from slough without the need for in vitro validation. She notes that an increasing number of practices and studies are using clinical cues to identify biofilm presence, and points out that awaiting microscopic confirmation of biofilm presence before taking appropriate action might not be in the best interests of the patient.

*Letters reproduced with permission of the Journal of Wound Care: