Wound care debridement may be contraindicated.3 In
such scenarios, alternative methods should be considered, which are generally classified according to their varying levels of invasiveness. (Table 1). Less invasive modalities, including autolytic,
oxidative, osmotic, enzymatic, chemical, chemo-mechanical, and surfactant-based debridement are generally less traumatic but may demonstrate reduced efficacy when used in isolation, particularly in complex or heavily contaminated wounds.3
Consequently, these
approaches are often used in combination with adjunctive therapies or more direct methods, such as mechanical debridement (MD), to optimise clinical outcomes.3
wounds, as it aids in the removal of devitalised tissue and effectively disrupts biofilm, a significant barrier to wound healing.3,8,9
The
Wound Hygiene Protocol (WHP), developed by an international panel of wound care specialists, outlines a systematic four step approach to managing biofilm and supporting effective wound care.8
This protocol is designed to
be applied methodically and consistently at each patient encounter (Table 2). Despite the proven effectiveness of advanced wound care approaches like this, access remains limited in many settings due to restricted funding and ongoing gaps in education, training, and clinical resources.10
Ongoing
and systematic debridement is vital in the management of chronic, non-healing, or static
Role of mechanical debridement in modern wound care In recent years, MD has gained significant prominence in wound care practice, largely driven by recommendations from the National Institute for Health and Care Excellence.11 Although the original guidance was published in 2014, it was updated in March 2019 to incorporate a revised cost model based on more current data. This growing adoption reflects a broader shift towards evidence-based, patient centred approaches to wound care. Debrisoft Duo provides an effective method for removing devitalised tissue and debris, while preserving healthy granulation and epithelial layers.11,12 The increased use of MD is supported by its
Fig.1 Debrisoft Duo: a dual sided debridement pad Less invasive
Oxidative: Cold atmospheric plasma technology disrupts devitalised tissue and biofilm. Autolytic: Hydro-responsive dressings, such as alginates and hydrocolloids, stimulate the body’s natural enzymatic process. Osmotic: Hyperosmolar agents, including honey and hypertonic gels, help extract devitalised tissue from the wound bed. Enzymatic: Exogenous enzymes such as bromelain-collagenase, glucose oxidase and lactoperoxidase degrade necrotic tissue.
Chemical / Chemo-Mechanical / Surfactant-Based: Involves the use of agents like desiccating topical gels, amino-buffered hypochlorite formulations, and poloxamer 188-based surfactants to facilitate targeted removal of devitalised tissue.
Biological: Use of sterile larvae (maggot therapy) to enzymatically break down devitalised tissue.
Mechanical*: Typically involves using pads to physically clear devitalised tissue and debris from the wound bed, edges, and surrounding skin.
Technology-Enhanced*: Involves the use of advanced modalities such as hydrosurgery, ultrasound (low- or high-frequency), and negative pressure wound therapy with instillation and dwell time (NPWTi-d/ROCF).
More invasive
Table 1: Classification of debridement methods based on adjunctive therapy needs (adapted from Mayer et al 2024) *Adjunctive Agents: Hypochlorous acid or sodium hypochlorite may enhance debridement and can be used before or during any debridement technique to support efficacy.
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Selective Sharp and Surgical: Selective sharp or surgical debridement requires skill and precision to accurately remove devitalised tissue using surgical tools such as scalpels, scissors, or curettes.
More invasive standalone methods
May require adjunctive therapy such as
mechanical or sharp
debridement
clinical efficacy, cost-effectiveness, and ease of use.11
NICE identified Debrisoft as both a clinically effective and economically advantageous
alternative to traditional debridement techniques. Supporting studies have shown that its use can accelerate wound bed preparation, reduce the frequency of nursing interventions, and potentially lower overall healthcare costs for providers such as the National Health Service;13,14,15 As such, MD remains a widely utilised strategy in advanced wound care, playing a key role in the removal of devitalised tissue and the stimulation of granulation and epithelialisation.11 Debrisoft Duo represents a recent
advancement, providing a gentle yet effective method of debridement for both superficial and deeper wounds. As an enhanced MD device, it supports the treatment of both acute and chronic wounds where debridement is indicated. Building on the established performance of the original Debrisoft Pad,11,12 Debrisoft Duo incorporates a new dual sided design (Fig. 1), tailored for use on wounds containing different types of devitalised tissue and debris. The new textured side of Debrisoft Duo is designed to gently loosen and lift stubborn devitalised tissue and debris from the wound bed, enhancing effective wound bed preparation, while preserving healthy granulation tissue. This dual-texture feature helps provide a more comprehensive and efficient debridement experience. Additionally, the pad’s unique fibre structure (white side), facilitates the effective removal and retention of slough, exudate, and microorganisms, helping to lower the wound’s bioburden and promote a more favourable healing environment.
t
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