Safe debridement in the community

Chemical debridement

Chemicals that debride devitalised 

tissue include topical antimicrobials 

and honey, which can also be used for 

this purpose (Thomas, 2010).

Honey is available on prescription in a 

variety of formats, e.g. combined with 

calcium alginate or in a gel format. It 

is important to realise that the type 

and amount of honey varies between 

dressing products. In the presence of 

wound exudate, the honey dilutes and 

as a consequence the enzyme glucose 

oxidase is activated and hydrogen 

peroxide is produced. The hydrogen 

peroxide component was thought to 

work alongside the natural osomotic 

pull of the honey to debride non-

viable tissue. 

However, there is thought to be an 

additional non-peroxide debriding 

element to honey (Thomas, 2010). 

Honey may appeal to patients due 

their perception of the product as a 

natural remedy. Following a review 

of the literature, Gethin (2008) 

recommends honey as an effective de-

sloughing agent for chronic wounds. 

This is in opposition to a Cochrane 

Review, which stated that there was 

insufficient evidence to guide the 

use of honey in wounds other than 

superficial and partial thickness burns 

(Jull et al, 2008).  

Antimicrobial dressings are chosen for 

their ability to debride and lower the 

bacterial load in the wound bed. The 

antiseptic agents that are incorporated 

into antimicrobial wound dressings 

include polyhexamethyl-biguanide 

(PHMB), chlorhexadine, povidone 

and cadexomer iodine, honey, 

silver sulfadiazine, ionic silver and 

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Clinical