Evidence map›Paper›PMID 42566190›Full record

ReviewJournal of internal medicine2026

An update on biofilms in acute and chronic wounds: Incidence, clinical evidence, diagnosis, prevention, and treatment.

Steven L Percival, Marcus J Swann, Kristian Daly, Dieter O Mayer, Prashini Moodley, Rui Chen

Abstract readReview
In one paragraph

Review in Journal of internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

6 authors.

Steven L Percival5D Health Protection Group Ltd, Liverpool, UK.ORCID https://orcid.org/0000-0002-7752-5935
Marcus J Swann5D Health Protection Group Ltd, Liverpool, UK.ORCID https://orcid.org/0000-0001-6288-7135
Kristian Daly5D Health Protection Group Ltd, Liverpool, UK.ORCID https://orcid.org/0000-0002-1075-1831
Dieter O MayerDepartment of Dermatology, University Hospital of Zurich, Zurich, Switzerland.ORCID https://orcid.org/0000-0001-5933-7749
Prashini MoodleyNelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.ORCID https://orcid.org/0009-0009-8882-6723
Rui Chen5D Health Protection Group Ltd, Liverpool, UK.ORCID https://orcid.org/0000-0001-8384-4353

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Pathogenic biofilms are a critical barrier to wound healing, driving infection persistence, delayed tissue repair, and antimicrobial resistance (AMR) and tolerance. This recognition has driven a paradigm shift from a traditional planktonic model of infection to a biofilm-mediated framework, where structured microbial communities are encased within a protective extracellular polymeric substance (EPS) matrix. These communities are highly prevalent in chronic wounds, with reported detection rates of 60%-100% across diabetic foot ulcers, venous leg ulcers, and pressure injuries. The establishment of biofilms fundamentally alters host-microbe interactions, promotes antimicrobial tolerance, and triggers therapeutic failure, prolonged inflammation, and wound chronicity. Despite their clinical relevance, management strategies remain limited. Crucially, a lack of rapid point-of-care diagnostics and standardized clinical endpoints hampers timely intervention. Conventional culture based methods frequently fail to detect sessile microbial populations, necessitating advanced techniques such as next-generation sequencing or confocal microscopy, which are largely unavailable in routine practice. A detailed understanding of the molecular and cellular mechanisms underpinning biofilm persistence is essential to translate knowledge into targeted clinical interventions. Effective management requires a biofilm centric, multimodal strategy that prioritizes regular mechanical debridement to disrupt the EPS matrix, supported by proactive exudate control and appropriate topical therapies. Looking forward, advances in diagnostic technologies, artificial intelligence (AI)-assisted analysis, and matrix disrupting or permeating agents offer significant potential. Furthermore, emerging biological therapies, including bacteriophages, promise to help transform wound management, reduce the burden of AMR, and potentially improve patient outcomes globally.

Indexed as

BiofilmsWound InfectionWounds and InjuriesChronic DiseaseDiabetic FootHumansIncidenceWound Healingantimicrobial resistancebiofilmschronic woundsdiagnostic methodsinfection managementwound healing

Identifiers

PMID42566190
PMCPMC13569318

What OpenQuestion holds

Textmetadata
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.