PMID- 28540567
OWN - NLM
STAT- MEDLINE
DCOM- 20180319
LR  - 20181113
IS  - 1433-044X (Electronic)
IS  - 0177-5537 (Linking)
VI  - 120
IP  - 6
DP  - 2017 Jun
TI  - [The significance of biofilm for the treatment of infections in orthopedic 
      surgery : 2017 Update].
PG  - 461-471
LID - 10.1007/s00113-017-0361-y [doi]
AB  - BACKGROUND: The increase in endoprosthetic and osteosynthetic surgical treatment 
      is associated with a simultaneous increase in implant-associated infections 
      (surgical site infections, SSI). Biofilms appear to play a significant role in 
      the diagnosis and treatment of these infections and heavily contaminated wounds. 
      This article aims to provide a current overview of biofilm and its relevance in 
      orthopedic surgery. MATERIALS AND METHODS: A computer-assisted literature search 
      of MedLine (PubMed) was performed using key word combinations with "biofilm" (as 
      of March 2017). RESULTS: Biofilm, a polymicrobial organization and life form 
      surrounded by a polysaccharide matrix, refers to an adaptation strategy of 
      bacteria in unfavorable living conditions (e. g. under antibiotic therapy). 
      Biofilms can develop after 6 h in highly contaminated wounds. In acute and 
      chronic infections, biofilms can occur in 30-80 % of the cases. Only planktonic 
      bacteria (high metabolic activity, cultivable) can be detected in standard 
      microbiological cultures, biofilms, however, cannot. Molecular microscopic 
      methods, such as fluorescence in situ hybridization (FISH), enable the detection 
      of bacteria in biofilms. The core concepts of anti-biofilm therapy include the 
      prevention of biofilm and early surgical debridement, followed by the local 
      and/or systemic administration of antibiotics as well as the local application of 
      antiseptics. CONCLUSIONS: The development of biofilm should be anticipated in 
      strongly contaminated wounds as well as in acute and chronic infection sites. The 
      best strategy to combat biofilms is to prevent their development. Standard 
      microbiological culture methods do not enable the detection of biofilm. 
      Therefore, the implementation of molecular biological detection methods (z. B. 
      FISH) is important. Further anti-biofilm strategies are being investigated 
      experimentally, but there are no real options for clinical use as of yet.
FAU - Scheuermann-Poley, C
AU  - Scheuermann-Poley C
AD  - Abteilung fur Unfallchirurgie, Orthopadie, septische und plastische Chirurgie, 
      Bundeswehrkrankenhaus Berlin, Scharnhorststr. 13, 10115, Berlin, Deutschland.
FAU - Wagner, C
AU  - Wagner C
AD  - Zentrum fur Orthopadie und Unfallchirurgie, Klinikum Ingolstadt, 
      Krumenauerstr. 25, 85049, Ingolstadt, Deutschland.
FAU - Hoffmann, J
AU  - Hoffmann J
AD  - Biofilmzentrum, Deutsches Herzzentrum Berlin, Hindenburgdamm 30, 12203, Berlin, 
      Deutschland.
FAU - Moter, A
AU  - Moter A
AD  - Biofilmzentrum, Deutsches Herzzentrum Berlin, Hindenburgdamm 30, 12203, Berlin, 
      Deutschland.
FAU - Willy, C
AU  - Willy C
AD  - Klinik fur Unfallchirurgie, Orthopadie, septisch-rekonstruktive Chirurgie, 
      Forschungs- und Behandlungszentrum Septische Defektwunden, Bundeswehrkrankenhaus 
      Berlin, Scharnhorststr. 13, 10115, Berlin, Deutschland. 
      christianwilly@bundeswehr.org.
LA  - ger
PT  - Journal Article
PT  - Review
TT  - Bedeutung des Biofilms fur die Infektbehandlung in der Unfallchirurgie : Update 
      2017.
PL  - Germany
TA  - Unfallchirurg
JT  - Der Unfallchirurg
JID - 8502736
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Anti-Bacterial Agents/*administration & dosage
MH  - Bacterial Infections/*therapy
MH  - Biofilms/*drug effects
MH  - Combined Modality Therapy/methods
MH  - Debridement/*methods
MH  - Evidence-Based Medicine
MH  - Humans
MH  - Negative-Pressure Wound Therapy/*methods
MH  - Orthopedic Procedures/*adverse effects
MH  - Surgical Wound Infection/etiology/*therapy
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Antiseptic agents
OT  - Debridement
OT  - Fluorescence in situ hybridization
OT  - Implant-associated infections
OT  - Negative pressure wound therapy instillation
EDAT- 2017/05/26 06:00
MHDA- 2018/03/20 06:00
CRDT- 2017/05/26 06:00
PHST- 2017/05/26 06:00 [pubmed]
PHST- 2018/03/20 06:00 [medline]
PHST- 2017/05/26 06:00 [entrez]
AID - 10.1007/s00113-017-0361-y [pii]
AID - 10.1007/s00113-017-0361-y [doi]
PST - ppublish
SO  - Unfallchirurg. 2017 Jun;120(6):461-471. doi: 10.1007/s00113-017-0361-y.