A rapid and systematic review of the clinical effectiveness and cost-effectiveness of debriding agents in treating surgical wounds healing by secondary intention

Abstract

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Diagnosis and Treatment of Diabetic Foot Infections

“…The wound may require additional attention after the debridement performed during the initial assessment (table 4). The goal is to physically excise dead and unhealthy tissue, thereby enabling wound healing and removing a reservoir of potential pathogens [82,[192][193][194]. Any experienced clinician may perform limited debridement.…”

National Athletic Trainers' Association Position Statement: Management of Acute Skin Trauma

“…Overall, modern occlusive dressings were favored over gauze dressings for healing. Findings from individual trials in the review 79 produced no clear evidence of differences in rates of healing among polyurethane foam, silicone foam, and alginate dressings. Several authors 78,81,84 have investigated the effectiveness of autolytic, wet-to-dry, and enzymatic debridement among various chronic wounds.…”

“…Autolytic debridement is the use of the body's mechanisms to promote proteolytic digestion of necrotic tissue in a moist environment created by the application of occlusive dressings such as alginates, films, foams, hydrogels, and hydrocolloids. 76,79,83,85 The moist environment allows endogenous collagenase enzymes within the wound to liquefy necrotic tissue, which can then be more easily digested by macrophages. 51,55,57,58,75,77,80,82 The body selectively digests only nonviable tissue and the moist environment allows for painless debridement.…”

“…Autolytic debridement is slow, occurring over several days, and is not recommended for infected wounds. 57,66,75 In an evidence-based medicine review, Lewis et al 79 examined the use of dressings in the autolytic debridement of postoperative incisions. Overall, modern occlusive dressings were favored over gauze dressings for healing.…”

Silver colloid dressings score over conventional dressings in diabetic foot ulcer: a randomized clinical trial

“…The choice of dressings and topical agents for contaminated and infected wounds is not always based on a firm rationale. 27 In the trial of Münter, patients treated with silver-containing foam experienced less pain, showed a quicker reduction of odour, and required less frequent dressing changes due to leakage. These secondary advantages of silver can be used in balancing the pros and cons for the use of silver.…”