I trust and hope everyone had a wonderful holiday season this year and I still can not believe that we are just about to enter 2024!
Today I wanted to continue discussing the EZDebride Wound Instrument and its advantages. But before I dive into that, I wanted to discuss some observations and discussions I had at the Desert Foot Conference in Phoenix, Arizona earlier this month.
As noted, this was the first time in seven years since I had attended the conference and it certainly brought back a lot of great memories. The venue is still the same and this year was no exception. The vendor area was packed as usual and I did take notice of a lot of different type of grafts, skin substitutes, biologics, etc. at this years event. In fact, there seemed to be much more than what I had remembered.
From the lecture hall point of view, quality lectures all around with more focus on wound care principles. It seemed the overall theme in wound care was wound bed preparation. There were several lectures that placed a lot of emphasis on the beginning stages of wound care with the initiation of a
thorough wound bed preparation via debridement. This was noted in several lectures as the first bullet which I found to my delight. The reason for this is that throughout my career, I have always advocated for sharp debridement in wound bed preparation and lectured on various topics with the former taking center stage. And this year, that was what I presented with the introduction of the EZDebride Wound Instrument.
Therefore, as I made my rounds in the vendor hall, I wanted to test a simple hypothesis especially with the tissue / skin substitute folks present. As I listened to several vendors outlining their products and how effective they were against the leading brands, I asked one simple question. “Do you prepare the wound bed prior to the application of your graft and how?” The answer was of course yes. Ten to fifteen years prior you would have received different answers and so I was very pleased that the graft industry was finally coming along. But it was the “how” that really did not resonate. I got answers that ranged from topicals to sharp debridement and really no substance or delineation at all. I then asked several skin substitute vendors what would constitute a good wound bed preparation in their opinion and with what instrument. Again, really no traction as the answers I received were very passive at best. I then discussed the EZDebride as an instrument that could help their graft perform better since it is controlled depth sharp debridement, less bleeding vs a curette, and less pain. Surprisingly, I got a lot of positive feedback and agreement with the concept. And yet, here we are not talking about the very foundation of wound care in the form of controlled sharp debridement with minimal to no damage to the surrounding quality tissue with minimal to no bleeding and pain, to jumping onboard to the greatest and latest in skin substitute technology. It is mind boggling to me that how can the wound graft industry be so advanced and yet not concentrating on the basic fundamental that is essential in wound care? Since 1915, the Bard-Parker scalpel handle and disposable blade were first introduced for surgery and has since been adopted in wound care: same for the curette. The EZDebride Wound Instrument was developed nearly 100 years later for the very purpose of sharp debridement with all the advantages as mentioned above.
To me I love to use the analogy of chocolate and peanut butter when it comes to sharp debridement and utilizing advanced wound technologies in the form of grafts, skin substitutes and biologicals. And I strongly feel that
soon you will begin to see a stronger cohesion of a sharp debridement instrument (EZDebride) paired with skin substitute usage as a best care practice. But there are risks and liabilities one has to also consider if using a curette or scalpel. Grafts are very expensive and more than ever you are now seeing multi-specialty clinicians using them routinely. Whether or not the scare of 2023 in which a regulatory control on skin substitutes went before our law makers in the utilization and the number of grafts allotted will influence the future, I have a feeling it may very well. Perhaps special guidelines in the future will be standardized and I have a feeling if so, sharp debridement and wound bed preparation will be at the forefront as a best care practice to ensure biofilm is removed, the wound bed is adequately debrided, minimal to no bleeding is performed so that the graft will not float, and vice versa to allow the graft to incorporate itself quickly.
We will continue our discussion next time and delineate further the advantages of the EZDebride Wound Instrument in Wound Bed Preparation. Please check back often and until next time, fair winds and following seas.
Dr. F. Derk