The characteristic clinical signs of chronic wounds, which remain in a state of prolonged inflammation, include increased production of devitalised tissue and exudate, pain and malodour. The presence of necrotic tissue, slough and copious exudate encourages microbial proliferation, potentially resulting in planktonic and/or biofilm infection. For patients, the consequences can include leakage of exudate, pain and reduced mobility, which can impair their ability to socialise and perform activities of daily living. This can severely reduce their quality of life and wellbeing. Concentrated surfactant-based gels (Plurogel and Plurogel SSD) are used in wound cleansing to help manage devitalised tissue. In vitro studies indicate they can sequester planktonic microbes and biofilm from the wound bed, although there is, limited clinical evidence to support this. A group of health professionals who have used this concentrated surfactant gel, in combination with standard care, in their clinical practice for several years recently met at a closed panel session. Here, they present case studies where topical application of these gels resulted in positive clinical outcomes in previously long-standing recalcitrant wounds. In all cases, the reduction in inflammation and bioburden alleviated symptoms that previously severely impaired health-related quality of life and wellbeing.
Keywords: biofilm; devitalised tissue; healing; health-related quality of life; inflammation; surfactant.