Biofilms play a significant role in slowing chronic wounds from healing. A wound implanted with biofilm, or a "critically colonized" wound, will be considered clinically infected if the number of microbes surpasses a critical level. 

Chronic wound biofilms symbolize a significant treatment challenge by demonstrating noncompliance with antimicrobial agents. Yet, a "window of opportunity" may still be present following wound debridement when biofilms are more susceptible to topical antiseptics. 

The present study discusses the role of antiseptics in managing chronic wounds and biofilm, focusing on povidone‐iodine (PVP‐I) compared with two commonly employed antiseptics: polyhexanide (PHMB) and silver. 

This article utilized the literature reviewed during a focus group meeting on antiseptics in wound care and biofilm management, along with the PubMed search. 

Compared with PHMB and silver, PVP‐I showed a broader spectrum of antimicrobial activity, potent antibiofilm efficacy, no acquired bacterial resistance or cross‐resistance, fewer cytotoxicity, adequate tolerability, and an ability to facilitate wound healing. 

Thus, it represents a viable therapeutic option in wound care and biofilm management, with the potential to treat biofilm‐infiltrated, critically colonized wounds. 

This study also proposed a practical algorithm to guide the management of chronic, non‐healing wounds due to critical colonization or biofilm using PVP‐I.

Alves PJ, Barreto RT, Barrois BM, Gryson LG, Meaume S, Monstrey SJ. Update on the role of antiseptics in the management of chronic wounds with critical colonisation and/or biofilm. Int Wound J. 2021 Jun;18(3):342-358. doi: 10.1111/iwj.13537. Epub 2020 Dec 13. PMID: 33314723; PMCID: PMC8244012.