Evidence map›Paper›PMID 41185925›Full record

ArticleInternational wound journal2025

Clinical Signs and Symptoms of Biofilm in Chronic Wounds. What Do Practitioners Think? Consensus Through an Electronic Delphi Survey.

John D Ivory, Duygu Sezgin, Patricia M Coutts, Davood Roshan, Chloe M Hobbs, José Verdú Soriano, James P O'Gara, David Gallagher, Georgina Gethin

Abstract readConsensus Statement
In one paragraph

Article in International wound journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

John D IvorySchool of Nursing and Midwifery, University of Galway, Galway, Ireland.ORCID https://orcid.org/0000-0002-8445-4602
Duygu SezginSchool of Nursing and Midwifery, University of Galway, Galway, Ireland.ORCID https://orcid.org/0000-0001-8378-6835
Patricia M CouttsWounds Canada, North York, Ontario, Canada.
Davood RoshanSchool of Mathematical and Statistical Sciences, University of Galway, Galway, Ireland.
Chloe M HobbsMicrobiology, School of Biological and Chemical Sciences, University of Galway, Galway, Ireland.
José Verdú SorianoDepartamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia, Universidad de Alicante, Alicante, Spain.
James P O'GaraAlliance for Research and Innovation in Wounds (ARIW), University of Galway, Galway, Ireland.
David GallagherAlliance for Research and Innovation in Wounds (ARIW), University of Galway, Galway, Ireland.
Georgina GethinSchool of Nursing and Midwifery, University of Galway, Galway, Ireland.

Funding

Health Research Board CDA-2019-007Irish Research Council GOIPG/2020/535
6 · The paper itself

Abstract

This study aimed to gain clinician consensus on which signs/symptoms reported to be indicative of biofilm in chronic wounds are likely to be so. An international, two-round eDelphi process including wound care clinicians ran from December 2023 to February 2024. Participants rated 26 items on a 9-point Likert scale. Consensus to include: ≥ 70% of respondents rate an item 7-9, ≤ 15% rate it 1-3. Consensus to exclude: ≥ 70% of respondents rate an item 1-3, ≤ 15% rate it 7-9. Eleven items (visual indicators [a shiny, slimy, persistent layer, easily removed, returns quickly without frequent intervention]; failure to respond to antimicrobials; infection > 30 days duration; poor quality granulation tissue; stalled wound despite optimal management; persistent/prolonged inflammation; wound > 6 weeks duration; soft tissue deterioration despite antimicrobials/debridement; signs of local infection; tunnelling/undermining; presence of slough) achieved consensus to include status. To our knowledge, consensus work on this topic has not previously been performed on such a wide scale. When examined alongside similar work, clinical opinion on the matter lacks coherence. We hope that these findings will help direct us toward greater cohesiveness. The work supports a need for research to quantify the predictive abilities of signs and symptoms reported to be indicative of biofilm in chronic wounds.

Indexed as

BiofilmsWound HealingWound InfectionWounds and InjuriesAdultChronic DiseaseDelphi TechniqueFemaleHumansMaleMiddle AgedSurveys and Questionnairesbiofilmschronic woundsconsensuselectronic Delphisigns and symptoms

Identifiers

PMID41185925
PMCPMC12583926

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.