Prevalence of biofilm in chronic wounds: systematic review with meta-analysis.

Background: To estimate the prevalence of biofilms in chronic wounds.

Methods: The authors performed a systematic review of prevalence studies and meta-analysis, structured according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Articles were searched in Scopus (Elsevier), Web of Science (Clarivate), MEDLINE/PubMed (National Institutes of Health), and Embase (Elsevier) databases. Data collected included the author and year of publication, total number of lesions evaluated, number of lesions with biofilm, detected bacteria, biofilm levels, country where the research was conducted, and the methodological quality of the studies. The meta-analysis was performed using a random effects model in R software (The R Foundation for Statistical Computing).

Results: A total of 281 articles were retrieved; after applying the reading and exclusion criteria, 24 studies were included. The meta-analysis incorporated 24 studies from 12 countries, evaluating 2666 lesions with a biofilm prevalence of 68% (95% CI, 58%-79%; I² = 92%). A high prevalence was observed in Asian publications (73%; 95% CI, 62%-84%; I² = 98%), with of Staphylococcus aureus (71%; 95% CI, 51%-90%; I² = 98%) and Pseudomonas aeruginosa (65%; 95% CI, 47%-82%; I² = 98%) being the most common found in all publications.

Conclusions: Despite the methodological heterogeneity of the studies included in this review, the findings indicate a high prevalence of biofilms in chronic wounds presented in the studies that made up the sample.