July 28, 2013
Cleaning Wounds More Frequently Could Lead To Faster Healing
redOrbit Staff & Wire Reports - Your Universe Online
Frequently cleaning chronic wounds such as diabetic foot ulcers and pressure ulcers could help them heal more quickly and more completely, according to new research appearing online in the journal JAMA Dermatology.
Debridement - the process of surgically, mechanically or chemically removing dead, damaged or infected tissue to improve the healing potential of remaining healthy tissue - is typically performed when a patient initially visits a medical center with a wound, University of Miami Miller School of Medicine dermatologist Dr. Robert Kirsner told Reuters Health.
"The real question is, how often do you have to do this?" added Kirsner, co-author of a commentary published with the new study. A handful of small studies had suggested there are certain types of wounds that tended to heal faster with frequent cleaning, the news organization said, but officials with Jacksonville-based wound cleaning services provider Healogics set out to perform a more comprehensive analysis.
Dr. Scott Covington of Healogics and colleagues reviewed the records of 155,000 patients treated at one of 525 wound centers between the years of 2008 and 2012, according to Reuters reporter Genevra Pittman. In total, those patients were treated for 313,000 wounds, including diabetic foot and pressure ulcers, surgical wounds, accidental cuts and other forms of trauma. On average, the injuries underwent the debridement process twice.
Covington's team found cleaning the wound out on at least a weekly basis resulted in shortened healing times across all wound types when compared to less frequent debridement, said MedPage Today Contributing Writer Sarah Wickline. Furthermore, he and his colleagues wrote, "The more frequent the debridements, the better the healing outcome."
"For example, diabetic foot ulcers healed in an average of 21 days when they were debrided at least weekly and in 76 days, on average, when they were debrided once every two weeks or more," Pittman said. "Traumatic wounds healed in 14 days, on average, with frequent debridement and in 49 days when they were cleaned out least often."
Of the patients who participated in the study, 47.1 percent were male and the median age of the group was 69, Wickline said. The majority of patients (59.2 percent) had just one wound, while 16.4 had two, 7.9 had three, 4.7 percent had four and 11.7 percent had at least five such injuries. None of the study participants had received any advanced therapeutic treatments, the researchers reported.
"A healed wound was defined as complete epithelialization. Overall, 70.8 percent of wounds were recorded as having healed," Wickline explained. "The highest rate of healing occurred in traumatic wounds at 78.4 percent, and the lowest rate was found among pressure ulcers at 56.6 percent. The median number of debridements was two across the sample (range 1 to 138), but it varied considerably among different wound types."