Evidências no tratamento de biofilme em feridas crônicas: revisão narrativa

Background and Objectives: Microbial load predicts failures in chronic wound treatment. The objective was to investigate the available evidence on biofilm treatment in chronic wounds in adults. Content: Narrative review using descriptors such as “Treatment” and “Biofilm” in searches across major databases from February to July 2024, including articles from the last 10 years, excluding preclinical studies, and ensuring quality with the SANRA checklist. The initial search identified 1,323 articles, of which 780 were excluded. After screening, 21 articles were read in full, resulting in the inclusion of 11 in the review. Conclusion: The study demonstrates the effectiveness of therapeutic approaches for treating biofilms in chronic wounds. Surfactant-based dressings with silver sulfadiazine proved effective, especially when applied early. The AQUACEL™ Ag+ dressing showed promising results in chronic venous ulcers, and olive oil extract of C. oestroides emerged as an alternative for refractory patients. Microbial load was identified as a predictor of treatment failures, while fluorescence imaging and antibiofilmogram technology improved antimicrobial management. Surfactant-based gel shows contradictory results in bacterial community and cadexomer iodine reduces microbial load although without statistical significance in healing. Limitations such as sample sizes and lack of methodological rigor indicate the need for further research.