A desiccation compound as a biofilm- and necrosis-removing agent: a case series.

OBJECTIVE: A new compound, Debrichem (DEBx Medical BV, the Netherlands), a topical desiccation agent (TDA), is an active gel that contains an acidic species with a potent hygroscopic action. When in contact with microorganisms and necrosis, rapid desiccation and carbonisation of the proteins in these microorganisms, as well as of the extracellular matrix of biofilms and necrosis, occurs. The resulting 'precipitate' rapidly dislodges from the wound bed, resulting in a clean wound which granulates, which is a prerequisite for healing by secondary intention. METHOD: In a retrospective study, a series of mostly large and hard-to-heal lesions of different aetiologies were treated with a one-time application of the TDA, followed by weekly dressing changes. RESULTS: Of the total of 54 lesions included in this case series, 22 were diagnosed as venous leg ulcers (VLUs), 20 as diabetic foot ulcers (DFUs), nine as post-traumatic, hard-to-heal lesions, two as vascular ulcers and one as an ischaemic ulcer. All of the VLUs, 75% of the DFUs and all of the other lesions reached complete granulation. CONCLUSION: The use of a TDA may contribute to the consistent, fast and easy removal of both biofilms and necrosis, and hence to wound healing.

Restarting the Healing Process of Chronic Wounds Using a Novel Desiccant: A Prospective Case Series.

INTRODUCTION: Chronic skin wounds represent a major global health problem and financial burden. The blocked healing process of chronic wounds involves excess inflammatory proteins, persistent microbial burden, and often, drug-resistant biofilm on the wound bed. Wound-bed debridement is considered crucial to restart the healing process. OBJECTIVE: The authors developed a novel desiccant (desiccating agent A) to serve as a new form of chemical debridement. The objective is to establish the working mechanism of desiccating agent A. MATERIALS AND METHODS: Desiccating agent A was exposed to 7 pathogens in vitro and a prospective trial investigation was performed in vivo on 10 cases to establish a timeline to reach granulation. RESULTS: The growth of a pool of the 7 pathogens showed an inhibition ring at 24 hours was 54 mm ± 5 mm. The prospective trial investigating 10 cases (5 females, 5 males) had a median age of 72.5 years (range, 50-90 years). The duration of the ulcers ranged from 6 weeks to 52 weeks (interquartile range, 6-24 weeks). The wound bed (median area, 64 cm2) was rinsed and dried. Desiccating agent A was applied directly to the wound bed with a gloved finger; after 30 to 60 seconds, desiccating agent A was rinsed and the remaining desiccated material was mechanically removed with dry sterile gauze. The wound bed was dried and covered with sterile gauze soaked in fitostimoline; dressings were changed as needed. The only observed side effect, transient pain, graded on a visual analog scale. Pain intensity ranged from 1 to 7 on a scale from 0 to 10. No nodules, welts, or blisters were observed. Median time to full granulation was 20.5 days (range, 7-78 days). CONCLUSIONS: These data support continued development of desiccating agent A as a chemical debridement agent.