Microbiome Dynamics in Chronic Wound Healing
Summary
Chronic wounds, including diabetic foot ulcers, venous leg ulcers and pressure sores, represent a major global health and economic burden. Healing of these lesions is governed not only by host factors such as immune response, angiogenesis and tissue regeneration, but also by the dynamic communities of microorganisms that colonise the wound bed. These polymicrobial consortia encompass bacteria, fungi and occasionally viruses, organising into structured biofilms that resist clearance and modulate local inflammation. Interactions among microbial species and between microbes and host cells can either impede or promote repair. For example, certain commensal bacteria secrete factors that enhance epithelial barrier function and regulate immune cell recruitment, whereas pathogenic biofilms drive chronic inflammation, protease over‐expression and tissue degradation. Modern molecular techniques, notably 16S rRNA and ITS sequencing, have revealed complex shifts in community composition over time and in response to therapies such as antibiotics and debridement. Understanding these dynamics is essential for developing targeted microbiome‐based interventions—ranging from selective antimicrobials and phage therapy to beneficial microbial transplants—that restore a balanced ecosystem and facilitate wound closure.
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Microbiome Dynamics in Chronic Wound Healing publication trend
The graph below shows the total number of articles in microbiome dynamics in chronic wound healing across all publications each year (not limited to Nature Index journals).
Technical terms
Biofilm: A structured community of microorganisms encased in an extracellular matrix, attached to a surface and resistant to antimicrobial agents.
Dysbiosis: A disturbance or imbalance in the normal microbial community associated with disease or impaired healing.
Mycobiome: The fungal component of a microbiome, encompassing all fungal species within a given environment.
16S rRNA sequencing: A molecular technique that identifies and quantifies bacterial taxa by analysing conserved ribosomal RNA gene regions.
Functional equivalent pathogroup: A consortium of distinct microbial species that together exhibit pathogenic functions akin to a single high‐virulence organism.
References
- Redefining the Chronic-Wound Microbiome: Fungal Communities Are Prevalent, Dynamic, and Associated with Delayed Healing. mBio (2016).
- The Cutaneous Microbiome and Wounds: New Molecular Targets to Promote Wound Healing. International Journal of Molecular Sciences (2018).
- Biofilm-Innate Immune Interface: Contribution to Chronic Wound Formation. Frontiers in Immunology (2021).
- Microbial predictors of healing and short-term effect of debridement on the microbiome of chronic wounds. npj Biofilms and Microbiomes (2020).
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