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To better understand biofilm development and persistence in chronic wounds, Figure 2 illustrates the stages of the biofilm life cycle, including adhesion, microcolony formation, maturation, and dispersion, as well as host immune responses such as neutrophil recruitment, M1/M2 macrophage polarization, and cytokine signaling (e.g., interleukin-1 beta [IL-1β], tumor necrosis factor-alpha [TNF-α], interleukin-6 [IL-6], interleukin-8 [IL-8], interleukin-12 [IL-12]), which collectively contribute to immune evasion and chronic infection 40 - 43
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