Attention to the wound characteristics are vital to create the right environment for the wound to heal. Attention to debridement and systemic infection are described above but the role of bio-burden, exudates management and healing need to be considered.
Increase in bioburden
Terms used to describe the ’bacterial bio burden’, or different levels of bacteria on the surface of an ulcer, include ’contaminated’, ’colonised’ or ’infected’, and obtaining a degree of bacterial balance have been cited as a key objective in successful wound care10. It is established that increase in bacterial load may delay healing, cause failure of healing, and even cause wound deterioration11.
Increase in bio burden can be managed locally with debridement and antimicrobial dressings. The major benefits of antimicrobial dressings are that they can reduce bioburden, decrease the risk of infection, and create an environment that readily supports the normal sequence of wound healing12. The main rationale for using antimicrobials on DFUs is the prevention and treatment of bio-burden and a subsequent increased rate of the healing process.