J Bone Jt Infect 2018; 3(2):50-67. doi:10.7150/jbji.23423

Review

Current therapies in treatment and prevention of fracture wound biofilms: why a multifaceted approach is essential for resolving persistent infections

Krystle A. Blanchette, Joseph C. Wenke

US Army Institute of Surgical Research, Ft Sam Houston, TX

Abstract

Traumatic orthopedic injuries, particularly extremity wounds, are a significant cause of morbidity. Despite prophylactic antibiotic treatment and surgical intervention, persistent infectious complications can and do occur. Persistent bacterial infections are often caused by biofilms, communities of antibiotic tolerant bacteria encased within a matrix. The structural and metabolic differences in this mode of growth make treatment difficult. Herein, we describe both established and novel, experimental treatments targeted at various stages of wound healing that are specifically aimed at reducing and eliminating biofilm bacteria. Importantly, the highly tolerant nature of these bacterial communities suggests that most singular approaches could be circumvented and a multifaceted, combinatorial approach will be the most effective strategy for treating these complicated infections.

Keywords: Biofilm, wound care, chronic infection, persistent infection, antimicrobial treatment

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How to cite this article:
Blanchette KA, Wenke JC. Current therapies in treatment and prevention of fracture wound biofilms: why a multifaceted approach is essential for resolving persistent infections. J Bone Jt Infect 2018; 3(2):50-67. doi:10.7150/jbji.23423. Available from http://www.jbji.net/v03p0050.htm