부산대학교 도서관

Simple Summary: Chronic wounds consist of those injuries that have failed to complete the healing process. This type of wound is frequently infected by pathogens and represents a challenging medical situation, a substantial cause of health problems, and a financial burden for the healthcare system. Indeed, the ability of some pathogens to produce multicellular structures enclosed in a matrix, called biofilms, considerably hampers the efficacy of the treatments. Hence, this work aims to strengthen the knowledge of the pathophysiology and treatment of infected chronic wounds. With this purpose, this work gives a comprehensive overview of the wound healing process, the pathogenesis of chronic wounds, with a special focus on chronic wounds infected by biofilm-forming pathogens, and on anti-biofilm therapeutic strategies. The strategies currently used in the clinical setting to remove biofilms from chronic wounds are described alongside several approaches currently under development. These novel strategies have the potential to counteract the ability of pathogens to produce biofilms, kill the pathogens within the biofilm, target biofilm molecules, or activate the immune system against the infection. These strategies used in combination could result in the better management of patients, avoiding the development of serious healthcare outcomes. Wound repair and skin regeneration is a very complex orchestrated process that is generally composed of four phases: hemostasis, inflammation, proliferation, and remodeling. Each phase involves the activation of different cells and the production of various cytokines, chemokines, and other inflammatory mediators affecting the immune response. The microbial skin composition plays an important role in wound healing. Indeed, skin commensals are essential in the maintenance of the epidermal barrier function, regulation of the host immune response, and protection from invading pathogenic microorganisms. Chronic wounds are common and are considered a major public health problem due to their difficult-to-treat features and their frequent association with challenging chronic infections. These infections can be very tough to manage due to the ability of some bacteria to produce multicellular structures encapsulated into a matrix called biofilms. The bacterial species contained in the biofilm are often different, as is their capability to influence the healing of chronic wounds. Biofilms are, in fact, often tolerant and resistant to antibiotics and antiseptics, leading to the failure of treatment. For these reasons, biofilms impede appropriate treatment and, consequently, prolong the wound healing period. Hence, there is an urgent necessity to deepen the knowledge of the pathophysiology of delayed wound healing and to develop more effective therapeutic approaches able to restore tissue damage. This work covers the wound-healing process and the pathogenesis of chronic wounds infected by biofilm-forming pathogens. An overview of the strategies to counteract biofilm formation or to destroy existing biofilms is also provided. [ABSTRACT FROM AUTHOR]