THE SOCIO-ECONOMIC AND CLINICAL BURDEN OF BACTERIAL BIOFILM IN CHRONIC WOUND MANAGEMENT: A SOCIO-TECHNICAL REVIEW OF ADVANCED NURSING PROTOCOLS AND COST-MITIGATION TECHNOLOGIES

Vollständiger Abstract

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Aim: To analyze the clinical and socio-economic impact of bacterial biofilm on chronic wound healing stagnation and to evaluate the efficacy of structured, nurse-led biofilm-disruption protocols within the TIMERS framework, focusing on contemporary cost-mitigation technologies and healthcare resource allocation. Methodology: A comprehensive narrative review of literature published between January 2010 and March 2026 was performed across PubMed, CINAHL, and the Polish Main Medical Library (GBL). Methodological quality and structural reporting were evaluated using the Scale for the Assessment of Narrative Review Articles (SANRA) guidelines to ensure systematic rigor. Results: Bacterial biofilm represents a critical biological barrier present in the majority of non-healing wounds, driving a disproportionate socio-economic burden where approximately 30% of unresolved cases consume over 70% of specialized healthcare resources. Advanced nursing interventions incorporating specialized monofilament debridement technologies, surfactant-based cleansing protocols (e.g., polihexanide), and real-time bedside fluorescence imaging significantly enhance biofilm disruption compared to conventional saline irrigation. Discussion: Implementing structured wound management strategies mitigates the economic strain on public health systems by reducing long-term nursing hours, minimizing hospitalization frequencies, and optimizing material costs. The integration of advanced wound care technologies redefines nursing competencies, requiring interdisciplinary coordination and systematic clinical frameworks. Conclusions: Transitioning from reactive to proactive, technology-driven wound care protocols managed by specialized nursing staff is essential to alleviate both clinical stagnation and systemic economic pressures.