Simultaneous Chemical Debridement of Bilateral VLUs: A 14-Week Case Review
Published in the Peer-Reviewed Supplement of the Journal of Wound Care
Managing two chronic wounds at once is rarely straightforward. Performing debridement on both simultaneously even less so.
This peer-reviewed case study, featured in the Journal of Wound Care supplement, documents how chemical debridement using DEBRICHEM®, performed in a single clinical session on both venous leg ulcers located on the inner ankles of a patient with over eight years of recurrent ulceration, led to the following outcomes in just 14 weeks:
➡️ Visible healthy granulation tissue in both ulcers
➡️ Marked reduction in slough, odour, and exudate
➡️ Wound beds reached surface level
➡️ Reduction in wound surface area
➡️ Improved tissue quality and periwound skin
➡️ No reinfection and no need for antibiotics
In many settings, wound debridement is done in stages. Tolerance, time, and clinical resources often lead to one wound being addressed at a time. Yet here, both VLUs were treated during the same session and achieved positive outcomes.
Patient Background: A Long History of Recurrence
The patient was a 67-year-old man with a long-standing history of bilateral venous leg ulcers one on each inner ankle (medial malleolus). These wounds had repeatedly broken down and reformed over time, creating a pattern of temporary closure followed by recurrence and had remained unresponsive to treatment for an extended period.
Contributing factors included
Before DEBRICHEM®: A Stalled Wound Environment
Before DEBRICHEM® was considered, the patient had received multiple courses of treatment, including topical antimicrobial dressings, each used for extended periods:
He was also prescribed intermittent antibiotics due to wound infections. During self-care periods, particularly when clinic access was limited, the wounds deteriorated further. Despite appropriate dressing regimens and compression therapy, the ulcers remained static, and slough reformed consistently between visits. Given the persistent non-response and repeated reinfection, biofilm was suspected as a major contributor to the stagnation.
Eventually after 19 months of trying treatment, both ulcers were found entirely covered with yellow slough and were producing purulent exudate. The right ulcer measured 4.5 × 2.5 cm; the left 2.0 × 1.5 cm. There was malodour, purulent exudate, and maceration of the surrounding skin. The wound edges were raised and surrounded by hard, dry periwound tissue.
Introduction of DEBRICHEM® to the Treatment
With no further progress despite evidence-based care, the team decided to try chemical debridement using DEBRICHEM®.
About DEBRICHEM®:
DEBRICHEM® is a CE-marked Class IIb medical device designed for chemical debridement of chronic wounds. It eliminates devitalized tissue, infection, and biofilm from chronic wounds in just 60 seconds creating a clean and stable wound bed, while preserving healthy skin. Used across etiologies, it is an advanced wound bed preparation tool and helps accelerate granulation, pushing the wounds towards healing.
How Does it Work?
DEBRICHEM® works by coming in contact with water in the biofilm, releasing an impressive amount of energy - approximately 1500 kJ/mol. This energy denatures and carbonizes the biofilm’s extracellular polymeric substance (EPS), breaking down its structure and destroying its contents. Over time, the denatured and carbonized material detaches from the wound surface. As it remains in place initially, granulation tissue begins to form underneath, creating the foundation for healing. By eliminating the biofilm barrier, DEBRICHEM® facilitates granulation and reopens the natural path to wound recovery.
The Treatment Session
After seeing the process and discussing the rationale, the patient agreed to have both ulcers treated in the same visit.
Procedure:
No analgesia was required post-procedure and the patient was able to continue his regular follow-up and self-care protocol.
Follow-Up and Dressing Regimen
The patient continued with his usual regimen between weekly clinic visits, using zinc paste and compression wraps. At week four, his dressing preference was noted and care was adjusted accordingly. While he continued to remove compression at times between visits, his dressing adherence remained consistent, and clinic follow-up was uninterrupted. No additional topical antimicrobials or systemic antibiotics were required.
Primary Clinical Outcomes (14 Weeks Post-Treatment)
2. Visible wound progression
3. Reduction in wound size
4. Reduced exudate
5. Resolution of malodour
6. Healthier periwound skin
7. No adverse events
8. Improved patient engagement
Clinical Reflections
This case highlights several important takeaways for clinicians managing complex VLUs:
Simultaneous treatment is achievable. With the right patient and proper preparation, treating two chronic ulcers in a single session with DEBRICHEM® can reduce treatment burden, save clinical time, and improve continuity of care.
Persistent slough should raise suspicion of biofilm. When slough repeatedly reforms despite antimicrobial treatment and good compression, biofilm should be considered. Chemical debridement offers an effective and targeted approach to eliminating biofilm fast and precisely.
A single-session intervention yield sustained benefits. Wound progression was steady and the absence of reinfection or further need for antibiotics indicated meaningful change in wound environment and risk profile.
Visual progress supports patient adherence. The visible change in wound status helped improve the patient’s engagement and outlook, and likely contributed to better follow-through with follow-up and care.
This case illustrates the potential of single-session biofilm elimination with chemical debridement in breaking the cycle of stagnation in long-standing bilateral venous leg ulcers. After nearly two years of ineffective treatments, both wounds, located on the inner ankles, responded to a one-time 60 second application of DEBRICHEM®, with visible granulation, reduced slough, no reinfection, and no further need for antibiotics.
📄 Read the full peer-reviewed case study: https://www.debx-medical.com/pdf/DEBxMedical-supplement.pdf
📚 Further Clinical Use Cases
Explore how clinicians are using DEBRICHEM® across challenging wound types:
✅ Stabilisation of an End-Stage Wound in a Vascular Compromised Amputated Case: https://lnkd.in/dyRgTy8z
✅ Broad-Spectrum Success of DEBRICHEM®: https://lnkd.in/e-Nj6E7k
✅ Powerful Anti-Biofilm Agent Restarts Wound Healing in 60 Seconds: https://lnkd.in/dk_rKDw4
✅ Preserving the Limb in Severe Diabetic Foot: A Case Study in Integrated Wound Management: https://lnkd.in/eq4RWQRJ
✅ Innovative Treatment of Diabetic Ulcers: Combining Chemical Debridement and Xenograft Applications: https://www.linkedin.com/pulse/innovative-treatment-diabetic-ulcers-combining-chemical-debridement-r60ac
#DEBRICHEM #ChemicalDebridement #WoundCare #VenousLegUlcers #BiofilmDisruption #HardToHealWounds #ChronicWounds #WoundManagement #ClinicalPractice #TissueViability #BiofilmManagement #TopicalDesiccation #TargetedDebridement #ChronicUlcers #LowerLimbWounds #ComplexWounds #BilateralWounds #ClinicalInsights #WoundCareEducation #CaseBasedLearning #AdvancedWoundCare #EvidenceInPractice #WoundClinic #InterdisciplinaryCare #PatientOutcomes #AntimicrobialStewardship #NoMoreAntibiotics #HealthcareInnovation #WoundHealingJourney #PatientCenteredCare
C.E.O.
1moBel post, grazie