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Case Series/Study
Complex Chronic Wounds mixed with multiple comorbidities, typically evoke pain and anxiety which make treatment a challenge. This case series examines adjunct modalities in our Advanced Wound Care Mobile Practice (AWCMP) allowing providers to utilize technologies improving patient care and improving healing rates in the patient’s home setting. The novel vibrating wound hygiene system is a mechanical debridement tool (VMDT) which uses low sonic level frequency vibrations to scrub and debride wounds. This tool is battery powered with a reusable handpiece that can be wiped clean. This novel hand-held tool uses vibrational technology in combination with debridement and scrubbing heads and has been used to cleanse wounds, safely disrupt biofilm and necrotic tissue. The purpose of the study was to evaluate this new technology, determining effectiveness for those patients who cannot tolerate traditional debridement methods, or the provider felt it was medically necessary to enhance management of wounds/ulcers bioburden/necrotic tissue.
Methods:
Several patients with different types of chronic wounds managed by our AWCMP in the home setting were evaluated wound bed status varied from clean to heavily contaminated. Wounds were assessed and cleaned/ debrided according to standard protocol. The VMDT replaced/augmented standard methods (curette/scalpel). Images were captured before/after debridement, patients were asked about overall satisfaction and pain. A random sampling of ie. venous, arterial, diabetic ulcers and pressure. Data was collected prospectively, and patients were followed to the end of the trial. Weekly progress was evaluated to include wound measurements, fluorescence imaging, pain scale, and patient satisfaction survey.
Results:
Clinically, the VMDT achieved a similar result in cleansing/ debridement as traditional methods (scalpel and sharp curettes). However, patient satisfaction/ compliance increased along with the pain reduction through vibratory analgesia. Which in turn decreased patient anxiety, depression, and time to debride compared to standard method of debridement. VMDT improved the patients' engagement with their plan of care.
Discussion:
One of the top priorities of wound management is adequate debridement and granulation tissue. Having access to advanced technology in the patient's home at bedside improves overall satisfaction and time to resolution.