SynthesisInternational wound journal2026
Clinical Signs and Symptoms of Biofilm-Associated Infection in Chronic Wounds: A Systematic Review of Diagnostic Accuracy Studies.
Synthesis in International wound journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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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.
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Authors and funding
7 authors.
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Abstract
The presence of biofilm in chronic wounds represents a major diagnostic challenge, as clinical manifestations are often subtle and laboratory confirmation remains limited. To identify clinical signs and symptoms (CSS) evaluated in validated tools or scales related to wound infection and biofilm, and to assess their diagnostic accuracy. A systematic review of diagnostic accuracy studies was conducted in accordance with PRISMA-DTA guidelines, searching six databases from inception to May 2025. Of 2064 records identified, four studies met inclusion criteria. All were focused on infection-related CSS; none were specifically designed to diagnose biofilm. Sensitivity and specificity varied substantially across CSS and study designs, and no validated, non-invasive diagnostic scale for biofilm was identified. The available evidence base is limited and heterogeneous. A preliminary list of candidate CSS is proposed to guide future validation studies and support earlier clinical recognition of biofilm-associated infection.
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