More effective cell-based therapy through biofilm suppression

Objective: To determine if targeted biofilm suppression of a specific wound improves the efficacy of cell-based therapy (CBT). Method: A retrospective study designed to compare a cohort of patients who received CBT in conjunction with biofilm-based wound management with published outcomes from randomised controlled trials in the literature, utilising standard care and CBT. Biofilm-based wound management is the use of multiple simultaneous strategies to suppress wound biofilm, specifically targeting the individual wound's bioburden with agents and methods to suppress the wound biofilm and improve wound-bed preparation. Results: A Kaplan-Meier analysis shows that all wound aetiologies receiving biofilm-based wound care and CBT showed better healing than published outcomes at 3 months and 6 months. Overall wound closure for all wound types combined was 79% at 3 months (versus 56% for the literature) and 92% at 6 months (compared with 63–78% in the literature). All wounds that failed to heal showed some improvement with therapy. Conclusion: With adequate biofilm suppression, the entire graft material was observed to remain intact on the surface of the wound and wounds healed faster than reported in the literature. The relationship between improvement of wound biofilm suppression and less degradation of the graft suggests that the wound microbiota plays a significant role in the degradation of applied bioengineered skin. Declaration of interest: There were no external sources of funding for this study. The author has no financial or commercial conflicts of interest to declare.