Biofilm is an increasingly important topic of discussion in the care of the chronic diabetic foot wound. Treatment modalities have focused on biofilm reduction or eradication through debridement techniques, topical therapies, negative pressure therapy, and ultrasound. In addition, advanced wound healing modalities, such as bioengineered alternative tissues, require optimal wound bed preparation with specific consideration of biofilm reduction before their application. Although fundamental principles of diabetic wound care still apply, critical thought must be given to biofilm before implementing a treatment plan for the closure of these complex wounds.

Kim, Steinberg, , , , , , , (2012). Wound care: biofilm and its impact on the latest treatment modalities for ulcerations of the diabetic foot. Seminars in vascular surgery, 2012 Jun;25(2):70-4. https://www.ncbi.nlm.nih.gov/pubmed/22817855