Restarting the Healing Process of Chronic Wounds Using a Novel Desiccant: A Prospective Case Series

Abstract

Introduction: Chronic skin wounds represent a major global health problem and financial burden. The blocked healing process of chronic wounds involves excess inflammatory proteins, persistent microbial burden, and often, drug-resistant biofilm on the wound bed. Wound-bed debridement is considered crucial to restart the healing process.

Objective: The authors developed a novel desiccant (desiccating agent A) to serve as a new form of chemical debridement. The objective is to establish the working mechanism of desiccating agent A.

Materials and methods: Desiccating agent A was exposed to 7 pathogens in vitro and a prospective trial investigation was performed in vivo on 10 cases to establish a timeline to reach granulation.

Results: The growth of a pool of the 7 pathogens showed an inhibition ring at 24 hours was 54 mm ± 5 mm. The prospective trial investigating 10 cases (5 females, 5 males) had a median age of 72.5 years (range, 50-90 years). The duration of the ulcers ranged from 6 weeks to 52 weeks (interquartile range, 6-24 weeks). The wound bed (median area, 64 cm2) was rinsed and dried. Desiccating agent A was applied directly to the wound bed with a gloved finger; after 30 to 60 seconds, desiccating agent A was rinsed and the remaining desiccated material was mechanically removed with dry sterile gauze. The wound bed was dried and covered with sterile gauze soaked in fitostimoline; dressings were changed as needed. The only observed side effect, transient pain, graded on a visual analog scale. Pain intensity ranged from 1 to 7 on a scale from 0 to 10. No nodules, welts, or blisters were observed. Median time to full granulation was 20.5 days (range, 7-78 days).

Conclusions: These data support continued development of desiccating agent A as a chemical debridement agent.