DermaWound® vs. Debriding

Introduction:
The efficacy and success of DermaWound® has a direct correlation to, and is dependent on, the health care professional or novice strictly adhering to the time-tested protocol its inventor David M. Dixon, MD has perfected over the past 25 years – treating over 150,000 clients and patients around the world.

Health Care personnel, no matter how long in this specialty or amount of education, must realize that DermaWound® is like no other product on the market. Therefore, it cannot be stressed enough – If one uses DermaWound® like the rest of the traditional salves and ointments recommended by health care professionals, the results may seem confusing. However, if a caregiver follows the algorithm presented below correctly, and is not “creative” by inserting any knowledge gleaned from other treatment protocols or wound care experience – the beginning, middle and end results using DermaWound® will be remarkable.

A central theme for the successful treatment of Chronic and Non-healing wounds while using DermaWound® (which is counter thought to legacy wound care protocols), is that virtually NO debriding is done or is ever necessary. In fact, over the years we have discovered debriding is very counterproductive and will retard the healing process significantly.

The Science Behind DermaWound’s® No Debriding Protocol:
DermaWound® is like no other product on the market. DermaWound® does not require debriding and in fact, debriding is counter-indicated. Because of the inherent proteolytic properties of this product to eliminate biofilm and dead tissue, caustic debriders like Santyl or “Sharp” debriding with a surgical instrument are simply unnecessary.

DermaWound® when used with a regular gauze pad (not a non-stick gauze pad) will:

1. Debride a target area completely without causing the patient severe discomfort (e.g. Santyl).
2. Decrease treatment cost by eliminating unnecessary medical procedures (e.g. sharp debridement).
3. Decrease the healing time by preserving viable tissue that is incidentally removed while attempting to obtain “clear margins” during a debriding procedure.
4. Decrease the opportunity of the wound to become infected from the incidental introduction of a nosocomial infection (e.g. MRSA) during multiple exposures to personnel whose job it is to cause bleeding while removing “non-viable” tissues at the ulcer or wound site.
5. Provide a platform (gauze pad) that the wound exudates and slough will adhere to, with subsequent removal during a dressing change.
6. Will leave an ulcer or wound bed virtually undisturbed while it gathers strength to begin the push to heal – without the additional burden of regenerating what is lost during a surgical debridement.
7. Leaves intact the granulation or primordial cells that have migrated to the area.

What to Expect Using DermaWound’s® No Debriding Protocol:

1. Depending on the wound type – upon introduction of the product, the wound will rapidly heal or in the case of a long-standing Venous Stasis or Diabetic Ulcer, the wound area may increase in size at the beginning of treatment. This is normal as it is auto-debriding and removing the biofilm that covers non-viable or infected tissues that would normally be removed by enzymatic or sharp debridement as treatment options.
2. The wound bed itself may have all the colors of the rainbow present during different phases of healing. This is not infection (patient is afebrile and comfortable); but is the result of natural pigments found within the natural mineral source in our formulas.
3. Our wounds and ulcers generally heal from the bottom up and the outside in. This will result in a larger defect becoming flush with the skin first, before it has a chance to heal completely around its circumference.
4. Fistulas and tracts may be packed with DermaWound®. We have never seen a fistula close at the top while tunneling is still present underneath. However, the healing can be so rapid that it appears that the tunnel will close first. In that case, simply use a finger or probe to gently dilate and keep the tract open until the bottom has come up to be flush with the top.
5. The wound bed may look like it has a colorful web of exudative slough. Again, this should not be removed. The exudative yellowish, reddish, greyish, greenish stringy adherent slough is actually a type of soft scab that is protecting what is going on underneath it. When this slough is ready to come off, it will come off by itself, by sticking to the gauze pad that is covering it. If it does not stick to the gauze pad when a dressing change is done – then it’s simply not ready to come off and should be left undisturbed.
6. The wound, if large enough or a venous stasis ulcer, may appear to go into a slumber period where it doesn’t appear like much is happening and healing has stopped. This will only last between 7-15 days, as the wound itself is gathering its strength to begin another push to heal.
7. If a large eschar is present, this should not be removed. The DermaWound may be placed on top of it, overlapping the edges by about 1cm or .5inch. The eschar will either become friable and break up in pieces, or it will come off as a single “plug”. Underneath this broken up eschar or plug will be a bed of healthy granulation tissue working to fill in the defect.
8. If you find you are sensitive or becoming sensitive over time while using DermaWound® (1-3%), you may have an increase in redness or stinging sensation that lasts more than 30-45 minutes after application. It may “smart” a bit at first, but one should not be in pain or discomfort after 30-45 minutes while using any of our products. If this happens, simply rinse off the product and give us a call to discuss.
9. If the wound/ulcer is on the bottom or side of the toe, foot, ankle or leg and is weight bearing during the day (as are ALL Venous Stasis Ulcers), DermaWound VS should be applied only at night when “down” for the evening (covered with a Regular Gauze Pad/Sponge) and removed in the morning to avoid unnecessary agitation while active or working. The wound site should then be covered during the day or while active, with a Bacitracin, Polysporin, Vaseline or Triple Antibiotic type of product (avoid Neosporin or Silvadene) and a Non-Stick Gauze Pad/Sponge to maintain a moist environment until the DermaWound® is reapplied at night or when not active.

   Believe it or not, after following this algorithm for over 25 years, we know from experience that if you are active and your wound is on the bottom or side of the toe, foot, ankle or leg – you will heal faster if you only use it at night or when down, rather than trying to use it 24/7!