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J Bone Jt Infect. 2018 Apr 12;3(2):50-67. doi: 10.7150/jbji.23423. eCollection 2018.

Current therapies in treatment and prevention of fracture wound biofilms: why a multifaceted approach is essential for resolving persistent infections.

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US Army Institute of Surgical Research, Ft Sam Houston, TX.


Traumatic orthopedic injuries, particularly extremity wounds, are a significant cause of morbidity. Despite prophylactic antibiotic treatment and surgical intervention, persistent infectious complications can and do occur. Persistent bacterial infections are often caused by biofilms, communities of antibiotic tolerant bacteria encased within a matrix. The structural and metabolic differences in this mode of growth make treatment difficult. Herein, we describe both established and novel, experimental treatments targeted at various stages of wound healing that are specifically aimed at reducing and eliminating biofilm bacteria. Importantly, the highly tolerant nature of these bacterial communities suggests that most singular approaches could be circumvented and a multifaceted, combinatorial approach will be the most effective strategy for treating these complicated infections.


Biofilm; antimicrobial treatment; chronic infection; persistent infection; wound care

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Competing Interests: The authors have declared that no competing interest exists.

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