Cleansing Versus Tailored Deep Debridement, a Fresh Approach to Wound Cleansing: an Italian experience

04 September 2018
Volume 2 · Issue 4


Objective: To evaluate if cleansing, using a solution containing the antimicrobial polyhexanide and the surfactant betaine (polyhexanide propylbetaine [PP], Prontosan Solution, B. Braun), can aid effective wound bed preparation (WBP).

Method: A solution containing the PP was used in two different treatment regimens. Group A was treated with a single application at different time durations (2, 5, 10 and 15 minutes) to evaluate efficacy in the removal of residues from the wound bed. Group B was treated with PP for 10 minutes, followed by application of an inert dressing, at daily dressing changes for 14 days, to evaluate efficacy of debridement.

Results: A total number of 70 patients took part in the study. In Group A (n=40), after the two and five minute application, no change was observed. At 10 minutes, an improvement was seen in 4/10 cases and at 15 minutes the improvement was in 5/10 patients. In Group B (n=30), over the 14 days, an improvement in the condition of the tissue, i.e. the wound bed was cleaned and debrided in 73% of cases, was observed. Patients experienced a reduction in pain and no adverse effect or complication was reported. Periwound skin was improved in 29/30 cases, with only one case where the tissue deteriorated, as determined by the presence of maceration.

Conclusion: PP is effective in helping debridement during wound cleansing. Efficacy depends on time of application. However, randomisation and further study is required to confirm these results.

The cleansing of a wound is a routine part of the treatment of both acute and chronic wounds.1 Cleansing a wound means to deeply clean the skin and the wound bed, removing dead cells and slough. Guidelines and documents have evaluated different methods for wound cleansing.2 Andriessen3 talks about cleansing and debridement — the two terms identifying the stages of wound cleansing. They report the results of a retrospective study of polyhexanide propylbetaine solution (PP) versus a saline solution, which showed a statistically significant difference towards the PP in terms of healing and treatment times. Similar results were reported by Bellingeri et al.,4 where patients were treated with PP or saline. A significant difference was seen between days 0 and 4, using the Bate-Jensen Wound Assessment Tool (BWAT), in favour of PP. The assessment of pain did not show any significant difference between the two groups.

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