Jwc ewma final indd

particles, with a hydrophilic polymer-modified 

starch, can accommodate up to seven times 

their dry weight in exudate, and then generate 

a hydrogel. Even if the gel supports autolytic 

debridement, its primary indication in wound 

therapy is the antimicrobial treatment of  

infected wounds.

41,42

e

 Some multi-component dressings include an 

enzyme alginogel, which is claimed to create a 

protective film, protecting the wound borders 

from maceration.

38

Administration

For correct use of an autolytic debridement, the 

dressing is directly applied to the wound surface. 

As the administration of the available dressings 

varies according to the properties of the dressings, 

specific administration guidance apply to different 

types of products.

For autolytic dressings without absorptive properties, 

it should in general be mentioned that these may 

be combined with an exudate-absorbing secondary 

dressing to allow already-detached, non-viable tissue 

to be absorbed. For autolytic debridement, it is most 

common to change dressings once daily. Remains 

of the gels can be removed with tap water or sterile 

irrigation solutions.

34,43

In addition, it should be mentioned that:

a

  For hydrogels, a coating with a thickness of 

at least 5mm is necessary; smaller or deeper 

wounds may be completely filled with the gel. 

Hydrogel sheets should be applied so that they 

overlap 2cm around the wound edges. 

c

  Dressings with highly absorptive properties 

should be applied at a thickness of a least 3mm. 

The dressing should be replaced after 1–3 days, 

depending on the level of exudate.

For cadexomer iodine, it is recommended that 

the total dose should not exceed 150g/week and 

the overall treatment should not be longer than 

3 months, for a single course of treatment.

44

Benefits

Products for autolytic debridement are fairly 

well documented as easy to use and causing 

little-to-no pain. They do not damage healthy 

tissues (selective debridement) and are claimed to 

promote the formation of granulation tissue and 

epithelialisation.

22,37

 Most of these products are 

likely to require few dressing changes.

45

With regard to specific groups of products, it 

should be mentioned that:

a

  A further benefit of hydrogel sheets is that they 

are mostly transparent, thus allowing wound 

inspection without having to remove the 

dressing. As well as the debridement effects, 

certain hydrogel sheets are claimed to provide 

a cooling effect, which may lead to pain relief, 

especially for patients with burns. However, for 

other patients, for example patients with arterial 

disease, this cooling effect may be unpleasant.

34

c

  Benefits of the absorptive dressings with 

autolytic properties include removal of 

slough, provision of moisture, absorption and 

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