Eradication of Wound Biofilms by Electrical Stimulation

Chronic wounds are a major clinical health problem, costing billions of dollars and plaguing millions of people worldwide with increased morbidity and mortality. Treatment of these wound infections is complex and can take months to years. The length and difficulty of treating these wounds are largely attributed to the presence of biofilms created by common microbiological contaminants in the wounded area. Since multidrug-resistant bacterial biofilms persist in these wounds, the biofilms are able to dodge the “magic” antibiotic bullet. Without the aid of antimicrobials to fight off these infections, novel antimicrobials are essential. Recently, the physical sciences have been mined for alternatives to antibiotics. One such promising alternative therapy is the use of electrical stimulation devices to speed the wound healing process. There are three forms of electrical stimulation predominately utilized to treat chronic wound infections: low-intensity direct current, high-voltage pulsed current, and alternating current. The use of these various forms of electrical stimulation is proposed to enhance wound healing via the stimulation of host cells and by inhibiting bacterial biofilm growth. This chapter focuses on studies examining electrical stimulation in conjunction with host and bacterial cells, along with relevant clinical trial studies.