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Patients with non\u2010healing DFUs with suspected chronic biofilm infections were eligible for enrolment. Patients were randomised to receive either two or six weeks of treatment with topical Cadexomer Iodine. Tissue biopsies from the ulcers were obtained pre\u2010and\u2010post treatment and underwent DNA sequencing and real\u2010time quantitative polymerase chain reaction (PCR) to determine the total microbial load, community composition, and diversity of bacteria. Scanning electron microscopy confirmed biofilm in all 18 ulcers with suspected chronic biofilm infections. Cadexomer Iodine resulted in 14 of 18 (78%) samples achieving a mean 0.5 log10 reduction in microbial load. Regardless of treatment duration, there was no statistical difference in the reduction of total microbial loads. No difference in the rate of wound healing in the two groups was seen at 6\u2009weeks. Cadexomer Iodine reduces the total microbial load in DFUs with chronic biofilm infections and affects microbial community composition and diversity. All ulcers in both groups showed an initial reduction in wound size with application of Cadexomer Iodine, which might reflect its effect on biofilms.<\/jats:p>","DOI":"10.1111\/iwj.13219","type":"journal-article","created":{"date-parts":[[2019,9,5]],"date-time":"2019-09-05T09:25:00Z","timestamp":1567675500000},"page":"1477-1486","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Effect on total microbial load and community composition with two vs six\u2010week topical Cadexomer Iodine for treating chronic biofilm infections in diabetic foot ulcers"],"prefix":"10.1111","volume":"16","author":[{"given":"Matthew","family":"Malone","sequence":"first","affiliation":[{"name":"South West Sydney Limb Preservation and Wound Research South West Sydney Local Health District  Sydney New South Wales Australia"},{"name":"High Risk Foot Service Liverpool Hospital, South West Sydney LHD  Sydney New South Wales 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