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Current and Upcoming Debridement Technologies
At the 2023 Symposium on Advanced Wound Care Spring, Dot Weir, RN, CWON, CWS; Susie Seaman, NP, MSN, CWCN, CWS; and Jason Toranto, MD, FACS spoke on the methods of debridement both standard and yet to come in their session, “Current and Emerging Treatment Landscape: Debridement."
The session focused specifically on non-sharp debridement, highlighting tools and methods used to prepare the wound bed for re-epithelialization.
Dr. Toranto opened by stressing the importance of debridement as a whole, saying it's often not done, or not done fully, at which point the wound you're working with will not take to whichever treatment you're using. Also important is adequate nutrition, as studies are showing that a lack of nutrition puts patients at a disadvantage.
When it comes to debridement methods currently in use it is important to change gauze frequently, be wary of overpacking a wound with gauze, and focus on patient comfort and results.
Of note in the session was a method that is not yet on the market but is being used in clinical trials. Bromelain, an enzyme extracted from pineapple, has been used as a medicinal plant in several native cultures. Clinical studies have shown bromelain may help in treating osteoarthritis, post-surgery pain and inflammation, immunogenicity, and more. It is currently being developed for rapid, non-surgical debridement, and used in 4-hour applications. Bromelain could be used, with more research, in inpatient use.
The session continued, noting the successful use of negative pressure wound therapy with reticulated open cell foam with through holes, pulsed irrigation with and without suction, low-frequency ultrasound, and--in niche cases--maggots, while noting the importance of knowing how, when, and where to debride a wound completely and fully before treatment.
Disclosures: Susie Seaman, NP, is on the clinical advisory panel for Next Science. Jason Toranto is a Consultant for GLG Consulting, Smith & Nephew, Longeviti, and Surgical Advisory Board, Sylke. Dot Weir, RN is on the speaker’s bureau for Smith + Nephew.