Wound Bed Preparation and Negative Pressure Wound Therapy (NPWT)

In our last discussion, I had used the EZDebride Wound Instrument in conjunction with NPWT with excellent results.  In fact, the patient’s wound healed 2 weeks following discontinuance of the NPWT.  We also surprised the Wound Vac company since we discontinued it prior to their anticipated date:  the patient was receiving supplies after the fact.  

Therefore, I collated the pictures and framed everything including the case study, literature review, data and conclusions into a poster of which I will be presenting at the Mayo Wound Symposium later this month.  I am actually looking forward in conducting ongoing clinical trials with the EZDebride and NPWT, and perhaps research-stay tuned.

Final Thoughts:  This was the first case in which I had used the EZDebride Wound Instrument with a negative pressure device and noted several key advantages.  First, I noticed how easy the surface tissue slough was debrided even in leu of anti-coagulation therapy.  In the past, I wound have normally used a combination of mechanical debridement (4×4 gauze application with abrasive scrubbing) along with the use of a #10 scalpel with the belly of the blade gently guided over the surface of the wound.  Of course, the later would often times bleed more than anticipated and slow down the process of the wound vac application.  I wound often times have to continue to apply a moisture barrier to prevent the blood from getting under the 1-2 dressing as well trying to prevent the canister from becoming full.  This would ultimately end with a lot of discomfort to the patient especially with the abrasive mechanical debridement across the surface of the wound not to mention switching from negative pressure to compression therapy along with the application of SurgiCel.

I was very impressed overall with all of the wounds surface tissue as noted, and I did not realize the depth of the surface slough and how uneven it was spread across the wound.  It was a reality check since the EZDebride was allowing for a smooth depth-controlled debridement so much that I was able to see areas where the slough was deeper.  Therefore, I was able to concentrate on specific areas of the wound bed without damaging the already debrided tissue.

Secondly, I noticed how effective the EZDebride Wound Instrument was on the wound edges and how it just glided with ease in and around the peripheral wound bed.  The debridement transition from within the wound and to the periphery and vice versa was seamless and there was no injury to the healthy tissue as well as to the edges of the normal skin or epithelium.  The wound bed went from a dull colored tissue slough surface to an instant bright red granular bed instantly.  The tissue afterwards was smooth, not bleeding, oxygenated, and healthy.  This was the perfect scenario for the next steps in application of the wound vac.

Lastly, the patient tolerated the debridement with minimal to no pain involved.  Actually, he was quite surprised not only with the debridement, but also with having no discomfort or pain during the procedure.  He actually commented on how pleased he was not to see a lot of bleeding down his foot, and that it was painless.

Thank you again for tuning in and I will be leaving for the Mayo clinic after next week.  We will continue our discussion next time and I will let you all know how it went in Rochester, Minnesota. Please check back often and until next time, fair winds and following seas.


Dr. F. Derk

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