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Hydroconductive Dressings Used to Minimize Debridement

Pearls for Practice

Hydroconductive Dressings Used to Minimize Debridement

Index: Ostomy Wound Manage. 2017;63(10):8,10.

Background

Wound bed preparation is the management of a wound in order to accelerate endogenous healing or to facilitate the effectiveness of other therapeutic measures.1 To effect wound bed preparation, it is necessary to debride necrotic tissue and debris, decrease excessive wound exudate, decrease the tissue bacterial level, remove deleterious chemical mediators, and set the stage for acceleration of endogenous healing or wound closure.2 Debridement can be accomplished in multiple ways, including surgical, mechanical, enzymatic, biological, and autolytic methods.3 Although Steed et al4 showed sharp debridement resulted in increased healing rates, overly aggressive debridement can delay the healing process. Unfortunately, the fee-for-service sharp debridement model can unnecessarily increase the frequency and extent of debridement.5 

Drawtex Hydroconductive Wound Dressings (SteadMed Medical LLC, Fort Worth, TX) have demonstrated the ability to draw out exudate, debris, bacteria, and deleterious cytokines, once obvious necrotic and/or devitalized tissue has been removed, to complete wound bed preparation without excessively removing viable tissue that may be important to the healing wound.2 Three (3) illustrative cases demonstrate effectiveness of the Drawtex dressings..              

Case Studies

Case 1.  A 76-year-old man with diabetes, chronic renal disease, bilateral pedal edema, and a 3.0 cm x 3.5 cm ulcer underwent sharp debridement of obvious necrotic tissue and then was provided Drawtex dressing changes 3 times per week. Figures 1A–D illustrate healing progress after 1, 2, 3, and 7 weeks, respectively, of Drawtex dressing treatment. 

Case 2.  A 75-year-old woman had a traumatic skin flap to her pretibial area, shown at the time of presentation before debridement of the obviously necrotic flap (see Figure 2A). The wound measured 4.0 cm x 5.0 cm after 3 weeks of treatment with Drawtex dressings (see Figure 2B) and was almost completely epithelialized after 4 weeks of Drawtex dressings (see Figure 2C). 

Case 3. A 74-year-old woman with a pretibial ulcer of unknown etiology measuring 8.5 cm x 7.0 cm is shown at time of presentation (see Figure 3A). Following sharp debridement of the nonviable tissue, Drawtex dressings were provided 3 times per week at dressing changes. The wound is shown after 1 week of dressing changes (see Figure 3B), after 7 weeks (see Figure 3C), and essentially healed after 9 weeks of Drawtex dressing changes (see Figure 3D).

Conclusion

In these 3 examples, hydroconductive wound dressings were applied 3 times per week to remove small areas of nonviable tissue and debris, facilitate wound bed preparation, and achieve wound closure while avoiding excessive sharp debridement. These cases demonstrate hydroconductive dressings can eliminate the necessity for repeated sharp debridement and can facilitate wound closure.

Disclosure

Pearls for Practice is made possible through the support of SteadMed Medical, LLC, Fort Worth, TX (www.steadmed.com). The opinions and statements of the clinicians providing Pearls for Practice are specific to the respective authors and not necessarily those of SteadMed Medical, LLC; OWM; or HMP Global. This article was not subject to the Ostomy Wound Management peer-review process.