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Informational/Educational Report
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New information regarding why polyacrylate debridement may be a better alternative to other methods of debridement Debashish Chakravarthy, PhD, Cynthia Fleck, RN, BSN, MBA, ET/WOCN, CWS, DAPWCA, FCCWS Background: .Polyacrylate* dressings have long been used to promote gentle, yet fast and effective debridement and eschar removal. The use of polyacrylates* also results in significantly lower levels of pain compared to sharp debridement. Materials and Methods: .A modified literature search was performed to ascertain the effectiveness of polyacrylate* debridement systems compared methods. Two pertinent studies were uncovered focusing on polyacrylate's efficiency.. .Study 1: The efficacy of polyacrylates* as a debrider was compared in a prospective, controlled, randomized trial performed on 42 patients with venous leg ulcers. A collagenase enzyme debridement product** was used as the control. . .Study 2: polyacrylates* and the control, gauze, was placed on confluent cultures as well as on planktonic suspensions of microbes. Some of the test points examined the interaction with pathogens isolated and cultured from chronic wounds. Electron micrographs of the immobilized bacteria on the polyacrylate particles were obtained. . .Results: . .Study 1: During days 1-14 slough/eschar was reduced by 19% for polyacrylates* and 9% for the collagenase** product, followed by an increase of 25% and 10% respectively in granulation tissue. By Day 21, there was a further 11% improvement in tissue debridement for the polyacrylate* group, and a relapse of 9.1% in the collagenase** group. There was no statistical difference seen between the two groups, though the trends were generally in favor of the polyacrylate* product.. .Study 2: Significant multilog reductions of bacterial population were seen both in confluent as well as planktonic cultures. The immobilized pathogens seemed to be irreversibly bound to the polyacrylate* polymer particles in the test product.. .Discussion and Conclusion: .The polyacrylate* therapy offers a treatment regime that is as effective as enzymatic debridement, and that is less painful than sharp debridement. An additional novel benefit is the probable removal of bacteria and associated products from the wound site. *Tenderwetª Active Polyacrylate System, Medline Industries, Inc., Mundelein, IL.**Iruxol N (Santyl) Bruggisser R. Bacterial and fungal absorption properties of a hydrogel dressing with a superabsorbent polymer core. J Wound Care. 2005;14(9) Konig M, Vanscheldt W, Augustin M, Kapp H. Enzymatic versus autolytic debridement of chronic leg ulcers: a prospective randomized trial. J Wound Care. 2005;14(7) Paustian C, Stegman MR. Preparing the wound for healing: the effect of activated polyacrylate dressings on debridement. Ostomy Wound Manage. 2003;49(9):34Ð42. . |
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