Evidence for biofilm treatment in chronic wounds: narrative review

Authors

  • Miriam Viviane Baron Pontifícia Universidade Católica do Rio Grande do Sul
  • Julia Braga-da-Silveira Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil.
  • Sandra de Oliveira Thomé Clínica de Fisioterapia Sandra Thomé, Rio de Janeiro, Rio de Janeiro, Brasil
  • Carolina Gonçalves Pinheiro Universidade Estadual do Ceará, Fortaleza, Ceará, Brasil
  • Andrielle Dias Pinheiro Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brasil
  • Ryana Karla Ferreira Paulino Universidade Estadual do Ceará, Iguatu, Ceará, Brasil
  • Raissa Gabriella Mota Vieira de Carvalho Universidade Paulista, São Paulo, São Paulo, Brasil
  • Maria Edmeia Lopes de Oliveira Hospital Regional do Vale do Salgado, Icó, Ceará, Brasil
  • Paulline Paiva Mendes de Souza Universidade Federal do Piauí, Teresina, Piauí, Brasil

DOI:

https://doi.org/10.17058/reci.v16i.20139

Keywords:

Wounds and Injuries, Gram-Positive Bacteria, Gram-Negative Bacteria, Bacterial Adhesion, Wound Healing

Abstract

Background and Objectives: Microbial load predicts failures in chronic wound treatment. The objective was to investigate the available evidence on biofilm treatment in chronic wounds in adults. Content: Narrative review using descriptors such as “Treatment” and “Biofilm” in searches across major databases from February to July 2024, including articles from the last 10 years, excluding preclinical studies, and ensuring quality with the SANRA checklist. The initial search identified 1,323 articles, of which 780 were excluded. After screening, 21 articles were read in full, resulting in the inclusion of 11 in the review. Conclusion: The study demonstrates the effectiveness of therapeutic approaches for treating biofilms in chronic wounds. Surfactant-based dressings with silver sulfadiazine proved effective, especially when applied early. The AQUACEL™ Ag+ dressing showed promising results in chronic venous ulcers, and olive oil extract of C. oestroides emerged as an alternative for refractory patients. Microbial load was identified as a predictor of treatment failures, while fluorescence imaging and antibiofilmogram technology improved antimicrobial management. Surfactant-based gel shows contradictory results in bacterial community and cadexomer iodine reduces microbial load although without statistical significance in healing. Limitations such as sample sizes and lack of methodological rigor indicate the need for further research.

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Author Biography

  • Miriam Viviane Baron, Pontifícia Universidade Católica do Rio Grande do Sul

    PhD in Health Sciences from the Pontifical Catholic University of Rio Grande do Sul - PUCRS (CAPES 6 - Medicine 1) 2022/1 (Doctorate Title with Commendation Vote). Thesis selected by PPGMCS / PUCRS to compete for the CAPES Thesis Award at the national level in 2023. During her Doctorate, she was a full CAPES scholarship holder (2017/2 - 2022/1). Master in Health Promotion from the University of Santa Cruz do Sul - UNISC (2015). Post-graduate in Public Health with an Emphasis on Family Health from the Uninter International University Center (2013) and in Physiotherapy in ICU from Faculdade Inspirar (2015). Bachelor in Physiotherapy from UNISC (2009). She is currently an undergraduate student in Biomedicine at UNINTER and a postgraduate student in Dermatofunctional Physiotherapy at INSPIRAR. She has experience as a Physiotherapist and Nursing Technician. She worked for 18 years in a hospital institution. During her undergraduate studies, she worked in research in areas such as prevention and treatment of pressure injuries and other chronic wounds with the use of laser and therapeutic ultrasound, urinary incontinence, therapy dogs, actions for aging with quality of life and comprehensive attention and care for amputees and people with special needs. She organized and launched the book "Pressure Ulcers: a multidisciplinary approach" (2012) in partnership with researchers from the Federal University of Ceará. She participated in the organization and publication of the book "Paths to protagonism in their spaces of education and health" (2021), in partnership with researchers from the State University of Ceará, and in the writing of 17 chapters of books with national and international authors. During her master's research, she developed a prototype called "Pressure Ulcer (PU) preventive boot in the heel region" with a patent application and filing with INPI/BR. He conducted the first Controlled and Randomized Clinical Trial in the world that evaluated and demonstrated the efficacy and safety of the neuromuscular electrostimulation protocol in the prevention of pressure injuries in patients admitted to ICUs, published in the Annals of Intensive Care. Participating member of the following research groups: M.A.C (Healing Acceleration Method) research group, of the Instituto Celulare - Center for Clinical Phototherapy and Functional Diagnosis, Petrópolis/RJ; of the Educational Practices, Memories and Oralities - PEMO research group of the Postgraduate Program in Education of the State University of Ceará (UECE), Fortaleza/CE. She is currently part of the research group that studies "The precariousness of teaching work asserted in the Covid-19 pandemic: public policies to reduce professional burnout, at UECE together with researchers from different universities in Brazil and internationally (France, Canada, Spain and Chile), funded by CNPq n. 420121/2022-6. In addition, she participates in a research network with national and international scientific production (Denmark, Colombia, Mexico, Chile and Italy). She is currently CEO and scientific coordinator of the Interdisciplinary Institute of Education, Science and Health IIECS, and coordinates interdisciplinary study groups at IIECS with an emphasis on tissue repair of chronic wounds (diabetic, venous, arterial ulcers and pressure ulcers), photodynamic therapy, infrared thermography, artificial intelligence applied to scientific research, technological innovations, scientific methodologies and education. Leader of the IIECS/CNPq research group and member of the Stomatherapy Group of GREST at Hospital Moinhos de Vento - POA. Full member of the Brazilian Association of Scientific Editors - ABEC and the National Association of Injectable Physiotherapy - ANAFIN.

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Published

2026-03-13

Issue

Vol. 16 (2026)

Section

REVIEW ARTICLE

License

Copyright (c) 2026 Miriam Viviane Baron, Julia Braga-da-Silveira, Sandra de Oliveira Thomé, Carolina Gonçalves Pinheiro, Andrielle Dias Pinheiro, Ryana Karla Ferreira Paulino, Raissa Gabriella Mota Vieira de Carvalho, Maria Edmeia Lopes de Oliveira, Paulline Paiva Mendes de Souza

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How to Cite

Baron, M. V. ., Braga-da-Silveira, J., de Oliveira Thomé, S., Gonçalves Pinheiro, C., Dias Pinheiro, A., Ferreira Paulino, R. K., Mota Vieira de Carvalho, R. G. ., Lopes de Oliveira, M. E. ., & Paiva Mendes de Souza, P. (2026). Evidence for biofilm treatment in chronic wounds: narrative review. Revista De Epidemiologia E Controle De Infecção, 16. https://doi.org/10.17058/reci.v16i.20139