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Practice Innovations
Background: Chronic wound biofilms are a major barrier to healing, contributing to prolonged inflammation and treatment resistance. While traditional sharp debridement (TSD) is a standard treatment, its limitations include the need for specialized training, potential for pain and bleeding, and scope of practice restrictions. This study investigated a novel sharp debridement device (EZD) as a potential alternative.
Methods:
Methods: This prospective study enrolled 80 patients with chronic wounds, randomized to either EZD sharp debridement (EZ-Debride, MDM Ventures, San Antonio, TX) or TSD (scalpels/curettes). Biofilm presence and extent were assessed pre- and post-debridement using a modified Alcian Blue wound blotting technique, graded on a 0-3 scale. Biofluorescent imaging (BFI) and provider clinical assessments provided additional evaluation of the biofilm removal efficacy.
Results:
Results: Both EZD and TSD significantly reduced biofilm, as evidenced by decreased Alcian Blue staining grades post-debridement (p < 0.005 for both). However, EZD resulted in a significantly greater reduction in biofilm (84.97% vs. 34.87%, p < 0.0001). While BFI showed limited correlation with Alcian Blue staining overall, in cases with positive pre-debridement BFI imaging results, EZD achieved a 100% reduction in bacterial fluorescence compared to 50% with traditional methods. Clinical assessment confirmed a higher rate of complete biofilm removal in the EZD group (60% vs. 12.2%).
Discussion:
Conclusion: This study demonstrates that the novel sharp debridement device, EZD, is a safe and effective tool for biofilm removal in chronic wounds, potentially surpassing TSD methods. EZD offers a less invasive, more efficient, and potentially less painful approach, suggesting its value in improving clinical wound management and patient outcomes. Further research should examine its impact on long-term healing and broader clinical applicability.