Jwc ewma final indd

J O U R N A L  O F WO U N D  C A R E   Vo l   2 2 .  N o   1 .  E W M A   D o c u M E N t   2 0 1 3  

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with paraffin gauze, found patients with split-skin 

donor sites treated with the latter experienced 

significantly more pain and a less rapid rate of 

epithelialisation (p < 0.01).

Gauze 

Background

Traditionally, gauze has been used as the basis 

dressing in wound management and is frequently 

used as a comparator in wound studies. However, 

there is limited information and support available 

with regards to its use as a debridement agent.

23,24

Indications

A Cochrane systematic review identified 10 trials 

in which gauze was used as a comparator, in 

studies investigating dressings and topical 

agents for surgical wounds healing by secondary 

intention. However, they did not use time to 

debridement as an outcome, instead using time to 

healing. In four of the trials, gauze was associated 

with significantly more pain for patients compared 

with use of other dressings.

 

This finding is 

compounded by the data from three trials, which 

identified that patients treated with gauze were 

less satisfied with their treatment than those 

receiving alternative dressings.

25

Dryburgh et al.,

23

 in a Cochrane systematic review 

on the debridement of surgical wounds, identified 

three studies that used soaked gauze (with a variety 

of solutions) as a comparator. However, they 

concluded that the RCTs were small, evaluated out-

dated products and were of poor methodological 

quality, and that there was no RCT evidence to 

support any particular debridement method.

23

The debridement of diabetic foot ulcers was the 

topic of a subsequent Cochrane review, which 

identified two studies that use gauze as an 

intervention.

24

 The authors concluded that the use 

of a hydrogel increases the healing of diabetic foot 

ulcers compared with gauze or standard wound 

care; however, it is unclear whether this effect is 

due to debridement.

24

Limitations

The primary limitation for use of gauze as a 

debridement agent is that gauze is associated with 

significantly more pain for patients than with use 

of other dressings.

A general limitation related to wound management 

using gauze is the frequent dressing changes 

needed, for example to avoid pain. This increases 

the demand for staff resources.

26

Costeffectiveness

A Health Technology Assessment, looking at the 

clinical and cost effectiveness of debriding agents 

used to treat surgical wounds healing by secondary 

intention, reported that modern dressings were 

found to have lower costs than plain or impregnated 

‘

Mechanicaldebridementhas

beenreportedtobethemost

commonly-useddebridement

techniqueintheUSAandisamethod

thathasbeenusedfordecades

’

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