Publication search

BACKGROUND

Removal of nonvital tissue is an accepted method to eradicate biofilms and to stimulate wound healing. Debridement using a monofilament polyester fiber pad has clinically been shown to be effective as well as pain and trauma free.

METHODS

For in vitro determination of the cleansing capacity of this product compared to gauze swabs, a wound debridement model was used with glass plates coated with a bovine serum albumin solution, stained with hematoxylin. Both products were moistened and fixed to a weight connected to a regulated motor and were then pulled over the holding device with the coated glass plate under standardized conditions (power = 0.067 N/cm2, velocity = 1.6 cm/s).

RESULTS

At a low coating concentration (0.5%) both products were equally effective, but at a high concentration (1.5%) cleansing did not occur after 5 wipes. When wiping the plates 15 times, the debridement pad cleansed significantly (p < 0.001) better than gauze. When consecutively wiping 4 coated plates with a single debridement pad or swab, the pad exhibited and maintained a significantly higher cleansing capacity while gauze quickly lost its effect.

CONCLUSION

Our in vitro test results indicated a higher cleansing capacity of the debridement pad compared to gauze swabs.

Aim:

Debridement and removal of biofilm is a major challenge in treatment of patients with chronic wounds. Surgical debridement requires trained personal, operation theatre and is often associated with pain but conventional methods relaying on cotton gauze may not be enough. A monofilament debrider* consisting of polyester fibres presents a fast and almost painless option for debridement. Hence, we have investigated the capacity of this monofilament debrider* to remove biofilm in vitro and compared it to cotton gauze**.

Methods:

For the wound debridement model, a S.aureus biofilm is cultivated on glass plates. The monofilament debrider* and conventional cotton gauze** were used to debride/clean the glass plates under standardized conditions (p=0.067N/cm2, v=1.6cm/s). Afterwards, the glass plates were stained with crystal violet to visualize the bacteria residuals. Plate images were obtained and all images were processed using ImageJ 1.45m.

Results:

Monofilament debrider* and cotton gauze** initially exhibited a comparable cleansing performance. However, the monofilament debrider* demonstrated a significantly higher cleansing capacity. While the monofilament debrider’ was able to achieve a retained high reduction of the biofilm over wiping several plates, gauze** quickly lost its efficacy.

Conclusions: The reduction of biofilm achieved using the monofilament debrider* is significantly higher than that of cotton gauze**. Moreover, it presents a non-invasive and therefore almost painless alternative to other. Hence, this technique should provide a valuable tool in the treatment of patients with chronic wounds to improve the quality of life as well as to safe costs.

Aim:

Biofilm development is a major impediment of wound healing. Current research targets antibiofilm strategies to restore optimal wound-healing. Combined treatment involving debridement and addition of antibacterial agents may provide high success rates. A monofilament debrider* consisting of polyester presents a fast and painless option for biofilm removal. We analyzed the re-growth properties of biofilm underneath different wound dressings.

Methods:

A S.aureus biofilm was cultivated on glass plates. The monofilament debrider* was used to wipe the glass plates under standardized conditions (p=0.067N/cm2, v=1.6cm/s). Afterwards, glass plates were covered with various antimicrobially active wound dressings# and incubated for 24h at 37°C. Then, dressings were removed and glass plates further incubated for 48h. Biofilm on the glass plates was evaluated directly after dressing removal and following 48h re-growth period using the fluorescent alamar blue assay.

Results:

It was shown that the monofilament debrider* effectively removed biofilm. It was observed that subsequent treatment with dressings reduced formation of new biomass. Significantly fewer bacteria were found after incubation with dressings containing antimicrobials. Polihexanide-containing dressings further exhibited a persistent decrease of biofilm re-growth, while biofilm quickly reformed in untreated controls and after removal of antimicrobial-free and silver-containing dressings.

Conclusions:

It can be concluded that the combination of biofilm removal on the infected or critically colonized wound using a monofilament debrider* and subsequent treatment with antimicrobial dressings presents a successful antibiofilm strategy.