Research Roundup

Journal of Wound Care: Comparing methods of debridement for removing biofilm in hard-to-heal wounds.

Overview: Acute and chronic wounds are common throughout the world affecting a person's health and quality of life. It can be a financial burden for both the patient and the healthcare systems. All wounds are contaminated with microbes, but not all wounds become infected and result in impaired healing. Research indicates that approximately 70% of hard-to-heal wounds will develop biofilm, unique colonies of microbes that develop from planktonic (free-floating) microbes, and are resilient, thrive and survive with the formation of a protective environment of extracellular polysaccharide substance.

This article provides insight into wound bed preparation using TIMERS, a systematic clinical tool which offers a 6-step approach to identify, disrupt, and remove barriers impeding the wound healing process with various methods of debridement. Each letter of TIMERS signifies a specific focus for wound care interventions.

This article will focus on the ‘T’ representing tissue changes that can result in delay of wound healing. Findings from the comprehensive wound assessment help guide the type of wound debridement that would be most beneficial for each patient's wound. Currently, the gold standard for biofilm removal is surgical debridement, and if not a viable option, the next recommended choice is sharp debridement. It is important to remember that during wound bed preparation, use of TIMERS is an ongoing process that may require revisiting the letter ‘T’ to ensure complete debridement of biofilm, non-viable and necrotic tissue to support the path to wound closure. Also, an important part of the ‘T’ is to maintain a clean wound bed during the wound debridement process.