Granulation is a crucial step in wound healing, where new tissue forms over a wound to facilitate healing. Faster granulation means quicker recovery times and improved patient outcomes.

Reaching granulation in wounds like Diabetic Foot Ulcers (DFUs), Carbuncles, and Dehiscent Wounds is not easy. It requires skilled professionals, repetitive procedures, and high costs. Effective debridement—removal of biofilm and necrotic tissue—is a primary prerequisite for effective granulation in these wounds.

DEBRICHEM® is an innovative single-use debridement agent that effectively targets and eliminates biofilm and non-viable tissue in just 60 seconds, creating an optimal environment for granulation tissue formation. Its application does not require specialized skills or equipment, making it suitable for use in any medical setting and simplifying wound care procedures.

According to a study conducted at the Wound Care Unit, Hospital Kuala Lumpur, where DEBRICHEM® was applied to debride DFUs, Carbuncles, and Dehiscent Wounds, patients reached granulation in an average of just over 3 weeks. The maximum duration of wounds in this study was 24 weeks, while the largest lesion size treated with DEBRICHEM® was 72 cm².

This LinkedIn article draws inspiration from this study performed in Malaysia.

Key Results of the Study:

✅ Effective Debridement: Successful debridement of DFUs, carbuncles, and dehiscent wounds in 60 seconds.

✅ Rapid Granulation: All patients reached granulation within an average of just 3.17 weeks.

✅ Safe and Reliable: No adverse effects such as excessive bleeding, burns, or rashes. Surrounding healthy tissue was unaffected.

✅ Cost-Effective: Reduced hospital stays and minimized need for surgical interventions.

Challenge of The Study: Carbuncles, Diabetic Foot Ulcers, and Dehiscent Wounds

Diabetic Foot Ulcers

DFUs are a common complication of diabetes, often caused by neuropathy and poor blood circulation. They carry severe risks, including:

• Limb Amputations: Persistent infections and poor wound healing can necessitate partial or complete limb removal.
• Increased Healthcare Costs: Managing DFUs is resource-intensive, with annual treatment costs 23% higher in private settings than in public settings, in Malaysia (Nair et al., 2017).
• Reduced Quality of Life: Chronic pain, mobility issues, and the psychological burden of chronic illness significantly impact patients’ daily lives.

Carbuncles

A carbuncle is a cluster of interconnected furuncles (boils) caused by a bacterial infection, typically Staphylococcus aureus. These infections are characterized by multiple pus-filled cavities connected under the skin, leading to:

• Severe Pain and Discomfort: Carbuncles can be intensely painful and may cause systemic symptoms such as fever and malaise.
• Delayed Healing: Biofilms within carbuncles make them resistant to standard antimicrobial treatments, complicating the healing process.
• Risk of Spread: Without effective treatment, the infection can spread to surrounding tissues, increasing the risk of more serious complications.

Dehiscent Wounds

Wound dehiscence refers to the reopening of a previously closed wound, often due to inadequate healing or excessive tension on the wound edges. This condition poses several challenges:

• Increased Infection Risk: Open wounds are more susceptible to bacterial invasion, leading to infections that can impede healing.
• Prolonged Healing Time: Dehiscent wounds require additional interventions to close, extending the overall healing period.
• Need for Re-debridement: Reopened wounds often necessitate repeated debridement to remove necrotic tissue and biofilms, increasing the burden on healthcare resources.

The increasing prevalence of diabetes exacerbates the situation, with a substantial rise in related complications, especially in regions like Malaysia.

Major Hurdle to Granulation: Biofilm

A major impediment to granulation in these wounds is the presence of biofilms—slimy, translucent layers of bacteria that resist antimicrobials and antibiotics. Biofilms, often composed of Staphylococcus aureus and Pseudomonas aeruginosa, protect pathogens and hinder the body’s natural healing mechanisms.

Although over 80% of wounds contain biofilm, diagnosing biofilm quickly is challenging. In clinical practice, healthcare professionals typically rely on slough (a secondary effect of biofilm) to determine the need for debridement (Snyder et al., 2017).

How Does Debridement Support Granulation?

Wound healing itself is typically divided into four overlapping phases: hemostasis, inflammation, proliferation (granulation), and remodeling. Debridement supports each of these phases in specific ways, enhancing overall healing outcomes.

It supports granulation phase by eliminating barriers – non-viable and infected tissue – that impede new tissue growth and reduces the risk of infection. This process stimulates the body’s natural healing mechanisms, the migration of vital cells and enhancing the supply of oxygen and nutrients to the wound site.

However, traditional debridement methods often have disadvantages, such as the risk of bleeding, high costs, the requirement for skilled professionals, and the potential for infection (Strohal et al., 2013; Nowak et al., 2022). These challenges can hinder effective wound management and prolong healing times.

How Did the Clinicians Reach Faster Granulation in This Study?

Clinicians achieved this by adopting DEBRICHEM®’s innovative approach to wound debridement, which helps overcome the disadvantages of conventional methods. DEBRICHEM® requires only 60 seconds to achieve effective debridement, facilitating the transition of the wound stalled in the inflammatory phase to active tissue regeneration phase, pushing it towards faster and more reliable healing.

Mode of Action of DEBRICHEM®

DEBRICHEM® works through a targeted biochemical reaction with water in the biofilm, releasing an impressive amount of energy—approximately 1500 kJ/mol. This energy denatures and carbonizes the biofilm’s extracellular polymeric substance (EPS), breaking its structure and eliminating its barrier. Over time, the denatured and carbonized material detaches from the wound surface. As it remains in place initially, granulation tissue begins to form underneath, creating the foundation for healing. By eliminating the biofilm barrier, DEBRICHEM® facilitates granulation and reopens the natural path to wound recovery.

Implementation of DEBRICHEM® in Clinical Practice

The Study spanned 2–4 weeks. It enrolled ambulatory patients from the outpatient clinic who met the inclusion criteria.

Inclusion Criteria:

• Diagnosed with DFU, wound dehiscence, or carbuncle
• Wound surface area of 30 cm² or larger
• Ability to comply with twice-weekly hospital visits

Exclusion Criteria:

• Neoplastic ulcers
• Underlying abscesses or fasciitis requiring incision and drainage
• Underlying osteomyelitis

Clinical Protocol:

1. Preparation: Removed all previous dressings and rinsed any remaining medications with sterile water.
2. Debridement: Gently rubbed necrotic material or slough using sterile gauze with sufficient friction.
3. Drying: The wound bed was thoroughly dried.
4. Anesthesia: Applied Emla cream (lidocaine 2.5% and prilocaine 2.5%) for 10–15 minutes on patients with lower pain tolerance, then wiped off before debridement.
5. Application: DEBRICHEM® was spread evenly over the wound and approximately 1 cm of surrounding healthy skin using a gloved finger. Left on for 60 seconds.
6. Rinsing and Removal: The wound bed was rinsed thoroughly with sterile water and rubbed dry with sterile gauze to remove any detachable material.
7. Dressing: Primary and secondary dressings were applied according to standard care protocols.
8. Monitoring: The lesion’s length, width, and general condition were monitored biweekly during dressing changes until granulation was reached.

Patient Demographics & Wound Condition

The patient demographics were evenly split between males and females, ranging from 63 to 73 years (median age: 69 years). All patients had underlying diabetes mellitus. The duration of wounds before treatment ranged from 2 to 24 weeks (median: 10.5 weeks), and lesion sizes varied from 30 to 72 cm² (median area: 55.25 cm²). Initially, all wounds exhibited sloughy conditions, indicating the presence of biofilms.

Results: Efficacy of DEBRICHEM®

Healing Outcomes:

• Granulation: Reached within 2 to 5 weeks (mean: 3.17 weeks) for all patients.
• Pain Relief: Three patients experienced notable improvement in pre-existing pain. The mild to moderate discomfort during treatment was temporary and entirely resolved within one hour post-treatment.
• No Side Effects: Importantly, no excessive bleeding, nodules, boils, burns, rashes, or lasting pain were observed, emphasizing the safety profile of DEBRICHEM®.
  
  

Conclusion

As the prevalence of diabetes and related complications continues to rise, especially in regions like Malaysia, innovative solutions like DEBRICHEM® become increasingly vital in improving patient outcomes and optimizing wound management practices.

This Malaysian study underscores DEBRICHEM®’s significant role in accelerating granulation and enhancing wound healing outcomes. By swiftly removing biofilms and necrotic tissue within just 60 seconds, DEBRICHEM® creates an optimal environment for new tissue growth, accelerating granulation and leading to faster recovery times. Its easy bedside application simplifies wound care, enhances patient comfort, and reduces healthcare costs by minimizing the need for surgical interventions.

Take the Next Step in Advanced Wound Care

Interested in enhancing wound management strategies?

By adopting DEBRICHEM®, healthcare professionals offer a more effective and patient-friendly debridement option in both outpatient and inpatient settings. Simplify care processes and achieve better healing outcomes today.

👉 Request a complimentary demonstration: https://www.debx-medical.com/request-a-demonstration/

👉 Access the Study: https://www.debx-medical.com/scientific-papers/

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