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Wound Hygiene

Wound Hygiene - Improving the patient's leg by cleaning and removing the biofilm ;

 

 

Wound Hygiene1,2 is a anti-biofilm protocol of care designed to clean and decontaminate a wound, and overcome the barriers to healing often caused by the presence of biofilm. Just as we follow basic hygiene every day by washing our hands, brushing our teeth and showering, we should apply regular basic hygiene to wounds to keep them clean and remove biofilm. By implementing Wound Hygiene, you can give every wound the best chance of healing.

Join the Movement

We need to reframe the way we talk about wounds

From chronic wounds: A wound that does not heal as expected because complexities that lead to stalled healing or even fails to occur, leading to long-term duration1

To Hard-to-heal wounds:
A wound that has failed to respond to an evidence-based standard of care – typically one that exhibits exudate, slough, and an increase in size by the third day of its occurrence. These conditions allow biofilm to develop and thrive, which in turn causes the wound to regress and prevents healing2

A wound that has failed to respond to an evidence-based standard of care – typically one that exhibits exudate, slough, and an increase in size by the third day of its occurrence. These conditions allow biofilm to develop and thrive, which in turn causes the wound to regress and prevents healing.

A close-up of a bunch of cells with the words biofilm and delayed wound healing. The cells are arranged in a cluster, and they appear to be covered in a slimy substance. ;

Wound Hygiene, 4 simple steps

Wound Hygiene1 is the biofilm-based regime designed to give every wound the best chance to heal. Wound Hygiene comprises 4 simple steps:
- Cleanse
- Debride
- Refashion the edges
- Dress

Wound Hygiene is a protocol of care developed by clinicians for clinicians and it has become one of the most used protocols of wound-care.
A Illustration of Wound Hygiene: 4 simple steps such as Cleanse, Debride, Refresh, Dress ; Step 1: A man and a woman cleaning the leg wound. ;

1. Cleanse

Definition: 
Actively removing surface contaminants, loose debris, slough, softened necrosis, microbes and/or remnants of previous dressings from the wound surface and its surrounding skin1, 2

Rationale:
Cleanse with intent to remove devitalised tissue, debris and biofilm1, 2

Step 2: A woman removing the biofilm from a leg wound. ;

2. Debride

Definition: 
Physically removing biofilm, devitalised tissue, debris and organic matter using mechanical aids1, 2

Rationale:
Debridement that does not achieve pinpoint bleeding may not physically remove the biofilm. Applied mechanical force and shear, in combination with a liquid surfactant or antimicrobial solution, is needed to break up and disrupt biofilm.1, 2

 

Step 3: A man standing at the table to cover the skin affected by wounds. ;

3. Refashion

Definition:
Agitating the wound edge to stimulate the expression of growth factors, to kick start the formation of healthy skin1,2

Rationale:
Devitalised tissue, callus, hyperkeratotic debris and senescent cells at the wound edges may be harbouring biofilm. Removal is necessary to facilitate epithelialisation and wound contraction 1,2

Step 4: A person standing by the leg to apply dressings to wounds ;

4. Dress

Definition:
Applying a dressing to address any residual biofilm and prevent contamination and recolonisation, and therefore biofilm re-formation 1,2

Rationale:
Biofilm can re-form rapidly, and repeated debridement alone is unlikely to prevent its regrowth. Applying topical antimicrobials and antibiofilm agents can address residual biofilm and prevent its reformation 1,2

Read Wound Hygiene Consensus document 1

Embedding Wound Hygiene into a Proactive Wound Healing strategy2

The consensus doc 2 came about in order to evolve some key concept of Wound Hygiene and to embed Wound Hygiene as part of a holistic approach to wound care.
The 5 stages of the wound healing trajectory. ;

The need for a holistic approach to Wound Hygiene

Embedding Wound Hygiene into a proactive wound healing  strategy means2
- Embedding Wound Hygiene into a holistic strategy that includes Assessment and Monitoring of the patient.
- Implement Wound Hygiene at every dressing change  until healing occurs
- Recognising  the crucial 5 stages of the healing trajectory:
    1. Necrotic tissue
    2. Sloughy tissue
    3. Unhealthy granulating tissue 
    4. Healthy granulating tissue 
    5. Epithilialising tissue 
 

Read Wound Hygiene Consensus document 2
A purple and pink logo with the words "Convatec" and "forevercaring ;

Wound Hygiene Resources

Consensus Document 1

A JWC international consensus document on embedding wound hygiene into a proactive wound healing strategy.

Embedding Wound Hygiene into a proactive wound healing strategy

The first wound hygiene consensus document defining the 4 key anti-biofilm steps

Read more

Consensus Document 2

An illustration of people working on a giant foot which represents the wound healing process.

Expert Opinion Article

The second Wound Hygiene consensus document embedding the 4 steps throughout the wound healing trejectory

Read more

Wound Hygiene Clinical Case Study Summary

A poster about wound hygiene in clinical practice, with the steps: cleanse, debride, refashion, and dress.

Implementation of Wound Hygiene in Clinical Practice

Early use of an antibiofilm strategy promotes positive patient outcomes

Read more

References:

1. Murphy C, Atkin L, Swanson T, Tachi M, Tan YK, Vega de Ceniga M, Weir D, Wolcott R. International consensus document. Defying hard-to-heal wounds with an early antibiofilm intervention strategy: Wound Hygiene. J Wound Care 2020; 29(Suppl 3b):S1–28

2. Murphy C, Atkin L, Vega de Ceniga M, Weir D, Swanson T. International consensus document. Embedding Wound Hygiene into a proactive wound healing strategy. J Wound Care 2022;31:S1–S24

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