Development of a bio-inspired wound model for debridement training

Abstract

AbstractWound debridement is commonplace in expediting wound healing in the clinic. Despite this, there are limited resources available for simulation training for practitioners prior to facing real-life patients. Typically, citrus peels or porcine skin are employed in a vain attempt to improve debridement proficiency, yet these fail to provide a realistic experience of the textures and consistencies of wounds. Therefore, there is a clear unmet need for a safe and effective tool that can facilitate hands-on learning under the instruction of an experienced debrider. To fill this niche, a life-like wound model was designed and developed, featuring leathery necrotic eschar, an intermediary sloughy layer, and a rough granulation tissue in the bottommost layer, all within a healthy skin base. The healthy tissue portion of the model was designed to exhibit similar mechanical properties to those found in human skin. Likewise, the sloughy layer was viscous enough to remain within the model under static conditions yet could be removed using any appropriate debriding tool synonymous with real slough. Mechanical testing of the necrotic eschar revealed brittle fracture behaviour, akin to what is observed in patients. Each layer of the wound model provided the visual and haptic feedback of how it would look and feel to debride a patient’s wound in the clinic, giving invaluable experience for potential trainees in a safe and effectual way. It is envisaged that these models can be developed in a personalised way to suit the individual needs of the user, such as incorporating underlying models of bone or tendon, while retaining the key elements of the wound, which make it successful. This model is proposed as an important step forward in bridging the gap between becoming a newly qualified debriding practitioner and encountering the first wound in the clinic, subsequently improving the confidence of the debrider and enhancing patient outcomes.