A diabetic patient develops a chronic non-healing lower limb wound with a peri-wound biofilm. Which of the following wound care strategies directly targets biofilm disruption in chronic wounds?

• A Sharp wound debridement combined with topical antimicrobial dressings (e.g., silver or iodine-based dressings) ✓
• B Hydrocolloid dressings maintained for 7 days to maintain moisture balance
• C Systemic oral antibiotics alone for 2 weeks targeting the most likely biofilm organisms
• D Negative pressure wound therapy (NPWT) as the sole intervention

Explanation

Biofilm in chronic wounds consists of organised microbial communities embedded in a polysaccharide matrix, rendering them resistant to systemic antibiotics (which penetrate poorly) and standard host defences. The primary strategy for biofilm disruption is sharp wound debridement (mechanical disruption of the biofilm matrix) combined with topical antimicrobial dressings containing silver ions or cadexomer iodine, which have activity against biofilm-forming organisms. NPWT is an adjunct for wound preparation and granulation tissue formation but does not primarily address biofilm. Systemic antibiotics alone without debridement are ineffective against biofilm.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.