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LINK Scientific Content – Poster

BIOMES - A New Tool for Early Recognition of Chronic and Non-Healing Wounds

Scientific Content

BIOMES - A New Tool for Early Recognition of Chronic and Non-Healing Wounds

Exudate Management, Chronic Wounds, Complex Wounds, Debridement, Wound Dressing, Superabsorbent Polymer Dressings, Wound Care, Leg Ulcer, Wound Healing, Wound Balance, Wound Infection, Patient Quality of Life
Publication Year
Trent Brookshier, DPM
Ibrahim Abukhieran, DPM
Approx. reading time
5 min (1 page)


Most recent reports show an increase in individuals who have been treated for at least one chronic wound in the United States. An estimated 16.3% of Medicare beneficiaries have a chronic or hard-to-heal wound (Carter).

The need for early recognition and early advanced treatment is imperative to improving wound healing outcomes, improving patient quality of life, and decreasing the burden on the healthcare system.


As discussed in a recent publication, the two key take-aways from the Wound Balance Concept transition the focus of managing wounds to healing wounds as early as possible and recognizing red-flags of chronicity for early intervention rather than waiting for up to 12 weeks to deem a wound ‘chronic’. It becomes increasingly important to recognize early signs of risk for a wound to become stalled or non-healing. Early recognition will identify the need for more advanced treatments and/or more frequent visits.

Method / Intervention

The BIOMES acronym serves as a pivotal tool in determining wound risk, classifying wounds based on Blood flow, Infection control, Overloading, Overloading, Metabolic/Co-morbidities, Exudate/Moisture/Bioburden, and Social/Economic Barriers. Each element influences the patient’s healing trajectory and recognizing them early becomes paramount. Low, moderate, and high-risk wounds are discerned based on the presence of BIOMES factors, guiding practitioners in deciding if advanced therapies should be implemented and when to refer to a wound specialist.


BIOMES has been successfully integrated into practice and the approach aligns seamlessly with the six pillars and principles of wound care. These encompass understanding the disease process, wound bed preparation, nutritional status, mental/social factors, adjunctive processes/procedures, and prevention.
Adherence to these principles ensures comprehensive care, addressing hemostasis, wound classification, risk assessment, infection control, debridement, moisture control, analgesia, and wound closure.


The BIOMES approach offers a paradigm shift, emphasizing the early identification of wound risk factors and a tailored, collaborative intervention strategy. This method not only enhances the understanding of wound healing but also aligns with established principles and pillars of wound care, ultimately improving outcomes in limb salvage and diabetic wound management.


Trent Brookshier, DPM, Podiatric Surgeon | North Park Podiatry, San Diego, CA
Ibrahim Abukhieran, DPM, Resident Physician | Scripps Mercy San Diego

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