Debriding Wounds in Acute Care Using a Unique Hydropolymer Absorbent Dressing

Introduction: Clinicians have many choices when it comes to debridement methods including autolytic, surgical, chemical (enzymatic) and mechanical debridement. The goals of this case series were to reduce the cost and number of dressing changes of expensive enzymatic daily dressing changes currently used. In addition, the new dressing reduced bioburden and was easy to use for both inpatient and home care staff nurses. Dressings were reduced from daily to twice a week.

Methods/Materials: Selected case series consisting of patients with necrotic wounds representing different etiologies using a unique hydropolymer gel dressing with microbial binding characteristics. The hydropolymer gel is absorbent and contains a sodium content that facilitates autolytic debridement through osmosis and stimulation of wound perfusion. The wound contact layer is coated with a fatty acid derivative (dialkylcarbamoyl chloride) that irreversibly binds with bacteria. This binding renders the bacteria inert and unable to replicate through a physical mode of action called hydrophobic
interaction. Wounds in this case series include a necrotic pressure injury, several traumatic and mixed etiology (PAD and venous disease) lower extremity ulcers and an infected dialysis fistula graft site.

Results: All wounds were effectively debrided within 1-2 weeks. Dressing changes were provided by the WOC or staff nurses every 3-4 days. There were notable decreases in necrotic tissue and improvement seen in the wound beds after the first dressing change in each case. Signs of inflammation and local wound infection improved with the first dressing change in each case presented. This dressing was continued past the debridement goal until closure due to the bioburden management and continued improved healing of wounds.

Conclusions: Necrotic wounds were effectively debrided with less dressing changes and as effectively as an enzymatic debridement agent. There were improved healing outcomes from the effective debridement and the addition of bioburden control. The WOC and staff nurses in inpatient and home care stated the dressings were easy to use and easily transitioned to the home care setting upon discharge.

References:
1. Cutting, Keith MN, RGN& McGuire, James DPM, PT.; Safe bioburden management; A clinical review of DACC technology. Journal of Wound Care (2015) 24/5 S1-S30.
2. Kammerlander G. et al; Non-medicated dressing as an antimicrobial alternative in wound management. Die Schwester Der Pfleger (2007) 46: 84-87.
3. Ljungh A Yanagisawa N., Wadstrom T: Using the principle of hydrophobic interaction to bind and remove wound bacteria. Journal of Wound Care (2006) 15/4 175-180.
4. Acute and Chronic Wounds: Current Management Concepts, 5th edition Bryant, R.A. and NIX, D.P. Mosby 2016.
5. Wound and Ostomy Continence Nurses Society Core Curriculum: Wound Management, Wolters Kluwer. 2016.