The chronic wounds challenge
Biofilm-growing bacteria cause chronic infections and impede wound healing. *1,5,6
There are an estimated 40 million chronic wounds worldwide *26. These represent a silent epidemic affecting a large share of the world population and pose a major threat to public health and economy. In developed countries, it is estimated that 1–2% of the population will experience a chronic wound during their lifetime. *9, 10 Chronic wounds affect 6.5 million patients in the United States alone. *11 In the Scandinavian countries, costs associated with chronic wounds account for 2–4% of the total healthcare expenses.*12 The burden of treating chronic wounds is rapidly increasing due to rising healthcare costs, an ageing population and a sharp rise in the prevalence of diabetes and obesity in both the United States and the rest of the world. It is claimed that an excess of USD 25 billion is spent annually on the treatment of chronic wounds. *9
Major types of chronic wounds include venous leg ulcers, diabetic foot ulcers, and pressure ulcers. Chronic wounds fail to proceed through the normal phases of wound healing in a timely and orderly manner. Chronic wounds affect a large share of the population, particularly in Western communities, and post a significant socioeconomic burden, including hospitalisation, patient suffering, loss of employment, reduced quality of life, and early death. The average duration of chronic leg and foot ulcers is 12–13 months. These recur in up to 60% to 70% of patients and can lead to loss of function and decreased quality of life. They are also a signiﬁcant cause of morbidity. *8
Biofilm infections are common in chronic wounds and increase disease severity by stimulating chronic inflammation at the wound site *1, 5. Current treatments with antibiotics are ineffective against biofilms and contribute to the development and spread of antibiotic resistant microorganisms. Novel antimicrobial agents targeting biofilms in wounds are acutely needed to eliminate wound infections and restore normal wound healing *1, 8.