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Introduction:

Debridement is a basic necessity to induce the process of tissue repair especially in chronic wounds.

Methods:

In this prospective, blindly assessed pilot study we used a new debrider technology with specific monofilament fibres in a unique texture to evaluate its efficacy, safety and tolerability. In altogether 11 patients exhibiting all kinds of wound-associated debris (biofilms, slough, necrotic crusts, ‘hyperkeratotic’ plaques, see table 1) the debrider*, wetted with physiological solution, was wiped without specific force over the wound for about 2-4 minutes.

Results:

The debrider* removed almost all debris leaving healthy granulation tissue (including even small epithelialised islands of vital tissues) intact. (fig. 1 - 4) The patients didn’t feel adverse symptoms, in particular no pain. The healthcare professional’s global assessment revealed that the use of the debrider* was easy, fast and very efficient. Scanning electron microscopic analyses identified the majority of the removed debris tightly packed within the monofilament texture (fig. 5 and 6). Finally, a surgeon blindly assessed pictures of wounds (taken before / after the debridement), ranked all debridement results into the best category and one wound formerly classified for a need of surgical debridement as “equal to surgical debridement”.

Conclusion:

We have generated the basic proof of concept that the new debrider*-based technology is easy, fast, highly efficient, safe and well-tolerated. Further, since the new debrider* allows its broad use not only by specialised physicians but also by all healthcare professionals, it is anticipated that its use would save substantial costs. Hence, the new debrider* puts the need of other wound bed preparation procedures into question.

lntroduction:

Devitalised tissue may present as sloughy or necrotic tissue within a wound or it may form dead, scaly tissue as hyperkeratosis in the peri wound area of chronic wounds. lf this tissue is not removed, healing may be delayed and the risk of infection is increased. As there are no standardised methods of debridement, and evidence is low, practitioners who are untarined in sharp debridement rely on autolytic debridement of necrotic tissue with occlusive and other dressings. ln the UK hyperkeratotic skin surrounding leg ulcers is softened by soaking the leg in a bucket of water with emollients and picking off the scales with forceps. 8oth methods can be time consuming with additional costs of nursing time and associated products for dressing changes

Aim:

The aim of this study was to evaluate a new method of debridement for a non specialist setting

Method:

An evaluative study compared the new intervention with standard best practice in the clinic. Patient consent was obtained and treatmentwas measured on standardised case report forms.

Results:

10 patients completed the study. The debriding product was easy to use, removing devitalised tissue and hyperkeratosis more quickly than standard treatments, particularly for hyperkeratosis. Time to treat was decreased and patients found the treatment comfortable