Blog | Tuesday, July 30, 2013

QD: News Every Day--Weekly debridement may heal wounds faster


More frequent debridements lead to shorter wound healing times, concluded a retrospective study of the largest wound data set reported in the literature and that was conducted by a corporate provider of wound healing services.

Researchers employed by the company, Healogics, collected data on a sample of nearly 313,000 wounds from all causes among nearly 155,000 patients from 525 wound care centers from June 2008 through June 2012.

Most wounds were diabetic foot ulcers (19%), venous leg ulcers (26.1%), and pressure ulcers (16.2%).

Results appeared online at JAMA Dermatology.

Just more than 70% of wounds healed with a median number of two debridements (range, 1 to 138). The highest heal rate was for traumatic wounds (78.4%) and the lowest rate was for pressure ulcers (56.6%).

Wounds that received weekly or more frequent debridement (P less than .001) healed in a shorter time, the study reported. For diabetic foot ulcers, the median time to heal for weekly or more frequent debridement was 21 days, compared with 64 days for 1- to 2-week intervals and 76 days for 2 weeks or more between debridements (log-rank test, P less than .001). For traumatic wounds, the median time to heal for weekly or more frequent debridement was 14 days, compared with 42 days for 1- to 2-week intervals and 49 days for 2 weeks or more between debridements (log rank test, P less than .001).

Study authors noted that significant variables for wound healing included male sex, physician specialty, wound type, increased patient age, and increased wound age, area and depth.

An editorial noted that chronic wounds require a consistent approach to remove inhibitors to healing, and also that wound centers such as those in the study use evidenced-based algorithms for care, resulting in improved outcomes.

The editorial stated, "In either case, these data provide a best-practice approach, to which most dermatologists likely do not adhere, and as such represent a practice gap. Because of a lack of either appreciation of the need for a consistent approach or understanding of the importance of debridement, many are likely not performing debridement enough."