In this article, you will find:

✅ Importance of Debridement: Why removing biofilm and necrotic tissue is critical for wound recovery.

✅ Debridement Methods: Insights on traditional techniques (surgical, autolytic, enzymatic, etc.).

✅ A chemical debridement method that completely eliminates biofilm in 60 seconds, promotes healing, and reduces costs.

✅ Practical Resources: Links to further reading and opportunities for demonstration of advanced debridement solution.

Hard-to-Heal Wounds

Hard-to-heal wounds are those that do not progress toward healing within an expected timeframe. Often referred to as chronic, non-healing, or recalcitrant they are caused by a variety of factors, with research suggesting biofilm as the leading cause of their persistence.

Debridement – Effective Removal of Biofilm – is Key

Biofilm – microbes embedded in a protective layer – forms within 24 to 48 hours on wound surfaces after first contamination of the wound by microorganisms. Once established, it stalls the wound healing process, leads to infection, and can also cause sepsis if not removed timely.

This layer is particularly tough to break through, as it resists immune responses, antibiotics, and other antimicrobial therapies. It disrupts the wound healing process by constantly triggering inflammation, impeding cell migration, and promoting infection.

This is why it’s removal is a top priority for clinicians to restore conditions conducive to healing. They achieve this via Debridement – the medical process of removing dead, damaged, or infected tissue from a wound.

How Does Debridement Help?

Debridement essentially helps in promoting healing and preventing infection by clearing away any tissue that could hinder the body’s natural healing processes. While helping to reduce the microbial load, it stimulates the body’s healing response, and create a clean environment where new tissue can form, thus supporting the wound’s recovery. This cleansed wound allows clinicians to better assess the extent of the wound, including the depth, edges, and underlying structures, which is crucial for planning further treatment.

No debridement, no healing!

Before we dive into various debridement methods, let’s first understand the economic burden infected hard-to-heal wounds pose and therefore the importance of searching an ideal debridement method.

Economic Burden!

The cost of managing hard-to-heal wounds is substantial. A cohort study of 3.8 million patients treated for wounds by the NHS revealed that £5.6 billion of the NHS’s £8.3 billion annual wound care expenditure was spent on unhealed wounds.

Additionally, the cost of managing infected wounds varied significantly, with £2,000 for non-infected wounds and £5,000 to £11,200 for those with infection.

For pressure ulcers, the 12-month average cost varied significantly by severity, with category 1 ulcers costing £1,400 to manage, compared to over £8,500 for more severe categories. Unhealed pressure ulcers had an average management cost of £12,300, more than twice the £5,140 required for healed ulcers.

What Would Be An Ideal Debridement Method?

While there are many ways to debride a wound, the costs of repetitive procedures, delayed healing, and frequent hospital visits underscore the need for more effective, accessible debridement options. An ideal option would:

✅ Quickly & easily eliminate biofilm, infection, & necrotic tissue.

✅ Promote granulation & help get rid of inflammation.

✅ Restart the wound healing process & prevent repetitive procedures.

✅ Reduce risk of re-infection & re-formation of biofilm.

✅ Decrease pain & prevent complications.

✅ Improve patients’ quality of life.

✅ Be clinically & cost-effective.

✅ Be available at point of need for the patient.

✅ Can be implemented in any setting, hospital or community.

Debridement Types

Surgical Debridement

Surgical debridement involves using surgical instruments to remove devitalized tissue, typically under anesthesia. This method may not be suitable for all patients, especially those with comorbidities, and is costly due to the need for hospital admission. Surgical debridement is typically reserved for special cases, such as abscesses, and may need to be repeated.

Key Considerations:

• Requires specialized skills and equipment
• Often performed hospital setting (Operation Room).
• Anesthesia and hospital admission carry risks such as infection, mobility issues, and complications like blood loss or nerve damage.
• The procedure may need to be repeated several times, and patients may be unwilling to undergo it due to its invasive nature.

Sharp Debridement

Sharp debridement uses tools like scissors, scalpels, or a curette to debride non-viable tissue and manage biofilm. This technique can be performed in various settings, but it demands specialized training to avoid complications, such as accidental injury to healthy tissue.

Key Considerations:

• Requires significant skill and training which means it is not always readily available at patients’ point of need.
• Contraindicated in very large wounds, patients being treated with anticoagulants or with a raised risk of bleeding.
• Comes with the risk of damage to blood vessels, nerves, and tendon.
• Not always effective in addressing biofilm, which may persist in the wound bed after debridement.

Autolytic Debridement

This approach relies on hydrogel, hydrocolloid, or hydrofiber dressings that maintain a moist environment, allowing the body’s natural processes to break down dead tissue. While less invasive and easy to use, it can be slow and does not effectively target biofilm.

Key Considerations:

• Slow process, requiring days or even weeks to achieve effective debridement.
• Carries the risk of invasive infection and wound-edge maceration.
• Less effective in removing biofilm, which can persist and slow down healing.
• May not be suitable for heavily contaminated or infected wounds.

Hydrosurgical & Ultrasonic Debridement

Hydrosurgical method uses high-pressure application of a liquid such as water, saline, polyhexanide, etc while ultrasonic debridement uses direct or indirect application of low-frequency energy.

Key Considerations for Both:

• Requires specialist equipment and professional training.
• Has the potential to disseminate bacteria into the environment due to aerosolisation.
• Limited effectiveness against biofilm.
• Expensive and not suitable in all settings.

Biological Debridement

Biological or larval debridement uses larvae of the green bottlefly to ingest devitalised tissue and microbes. The larvae are administered loose or in a biobag.

Key Considerations

• Costly and patients find it physically uncomfortable.
• It is psychologically off-putting for patients.
• Not suitable for very dry wounds or very wet wounds.
• Not suitable for wounds with exposed blood vessels, malignant wounds or patients with decreased perfusion.

Mechanical Debridement

Mechanical debridement involves use of monofilament cloths, pads, or wipes to remove slough and devitalized tissue from the wound bed.

Key Considerations

• Not used for management of necrotic tissue.
• Slow Method.
• Not suitable for dry eschar.

Enzymatic Debridement

This method also called biochemical debridement is implemented using topical application of enzymes. These agents have a specific action based on the enzyme used and the protein it breaks down.

Key Considerations

• Relatively expensive.
• Not recommended for large and infected wounds.
• Has been shown to work slowly.

Chemical Debridement with DEBRICHEM®: A Targeted Approach

Chemical debridement with 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 down its structure and destroying its contents. 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.

Broad Spectrum Nature & Integration with Advanced Therapies

DEBRICHEM® is suitable for a wide range of non-surgical infected wounds, including challenging, end-stage cases. It works as an adjuvant tool that supports a range of advanced wound care therapies by making the wound bed more responsive to these therapies. After its application, treatments like Negative Pressure Wound Therapy (NPWT) can be used more effectively, as the wound bed is now primed for better healing responses. This makes DEBRICHEM® a versatile and valuable tool in wound management, enhancing the overall effectiveness of subsequent treatments and reducing the need for repeated visits or specialized equipment.

Key Considerations

➡️ Eradication of Biofilm + Infection & Preventing Its Reformation

DEBRICHEM® completely eliminates biofilm and enables the body’s immune system to prevent it from returning.

➡️ Immediate Results with a Single Application

DEBRICHEM® delivers rapid results in just 60 seconds, often requiring only one application.

➡️ Promotion of Granulation & Decreased Pain

By facilitating a clean wound environment, DEBRICHEM® reopens the pathway to healing and reduces inflammation and pain.

➡️ Prevention of Complications

By effectively removing necrotic tissue and biofilm, DEBRICHEM® helps prevent further complications.

➡️ Cost-Effective Treatment

With fewer visits and no need for specialized equipment, DEBRICHEM® offers significant cost savings.

➡️ Generates Results without Specialized Expertise

As a topical agent, DEBRICHEM® is easy to apply and requires no specialized training, making it accessible to a wide range of healthcare professionals.

Supporting Evidence and Real-World Results

Studies have shown that DEBRICHEM® improves health-related quality of life for patients and reduces overall treatment costs. A UK cost-effectiveness study found that DEBRICHEM® improved healing rates by up to 75%, reduced infection risks, and significantly cut overall treatment costs by up to 57%. In real-world clinical settings, case studies have time and again demonstrated rapid and biofilm eradication with DEBRICHEM® application, facilitating faster wound healing and improving patient comfort.

Effective Debridement: Future of Wound Care

The role of debridement in managing biofilm cannot be overstated in addressing the growing global challenge of hard-to-heal wounds. By ensuring a clean, well-prepared wound bed, debridement facilitates faster healing and reduces the risk of complications like infection and sepsis. Debridement helps break the cycle of biofilm formation and enhances the effectiveness of subsequent therapies. As new method like DEBRICHEM® become more widely available, healthcare providers are having better tools to manage biofilm, reduce chronicity, and ultimately improve patient outcomes.

By choosing the right debridement technique and adopting a structured approach to wound-bed preparation, clinicians can make significant strides in accelerating healing and reducing the impact of chronic wounds on patients and healthcare systems alike.

Delve Deeper

Dive deeper into effective debridement strategies in the article: Comparing Methods of Debridement for Removing Biofilm in Hard-to-Heal Wounds by Karen Ousey and Liz Ovens. Download the article for free here: https://www.debx-medical.com/scientific-papers/.

Additionally, experience the benefits of DEBRICHEM® firsthand! Request a free debridement demonstration here: https://www.debx-medical.com/request-a-demonstration/