Hard to Heal wounds

Hard to heal wounds that are difficult to heal is a serious and costly complication of underlying diseases such as diabetes, venous insufficiency or injuries to the skin such as pressure ulcers.

Patients suffering from these wounds often experience pain, a bad smell, decreased mobility and other problems which seriously affecting the quality of life.

The number of patients suffering from chronic, hard to heal wounds is increasing due to the demographic trends and increased incidence of underlying diseases. It has been estimated that 1 to 2% of the population will experience a chronic wound during their lifetime1.

The number of adults with diabetes in the world increased from 151 million in 1980 to 425 million patients in 2017 with a clear trend pointing towards further growth in the coming decades2.
The global incidence of diabetic foot ulcers has been estimated to be 6.3 %. From 19 to 34 % of persons with diabetes are likely to be affected by diabetic foot ulcers during their lifetime3 Furthermore, approximately 50% of the ulcers will become infected requiring hospitalization and it has been reported that 20% of the lower extremity infections will result in amputation4. Mortality rates are very high after amputation with up to 70% of people dying within 5 years5.


Debridement is the removal of dead or devitalized tissue and debris from a wound bed. It is considered a corner stone of routine medical care for non-healing acute and chronic wounds together with infection control and creating a moisture-balanced healing environment6. The overall goal of debridement is to transform the wound bed of non-healing wounds to that of an acute wound, and thus promote the progression of the natural healing process7, 8, 9.

Debridement may be achieved using different techniques. Autolytic, enzymatic, mechanical, surgical, sharp, biologic and chemical debridement have been described6, 10, 11. The choice of debridement technique is depending on the clinical status of the wound, general health of the patient and the skill and qualification of the health care personnel6, 7, 8, 9, 10, 11.

Based on our experience from removing de-vitalized tissue for caries removal we are now developing a new innovative solution for debridement of hard-to heal wounds in need of debridement.


RLS Global develops a Gentle method for debridement of hard to heal wounds based on our unique Buffered Hypochlorite Technology Platform.

The Product

1. K. Sen et al., Human Skin Wounds: A Major and Snowballing Threat to Public Health and the Economy, Wound repair and regeneration, 2009 Nov–Dec; 17(6): 763–771.

2. International Diabetes Federation. IDF Diabetes Atlas, 8th edn. Brussels, Belgium: International Diabetes Federation, 2017. http://www.diabetesatlas.org

3. Armstrong et al. Diabetic Foot ulcers and their recurrence. N Eng J Med June 2017

4. Clinical Practice Recommendations on the Diabetic Foot: A guide for health care professionals. International Diabetes Federation; 2017.

5. Diabetic foot problems: prevention and management. National Institute for Health and Care Excellence, UK; 2015.

6. Strohal R. The EWMA document: debridement. J Wound Care. 2013;22(1):5.

7. Gould L, Stuntz M, Giovannelli M, Ahmad A, Aslam R, Mullen-Fortino M, et al. Wound Healing Society 2015 update on guidelines for pressure ulcers. Wound Repair Regen. 2016;24(1):145-62

8. Lavery LA, Davis KE, Berriman SJ, Braun L, Nichols A, Kim PJ, et al. WHS guidelines update: Diabetic foot ulcer treatment guidelines. Wound Repair Regen. 2016;24(1):112-26.

9. Marston W, Tang J, Kirsner RS, Ennis W. Wound Healing Society 2015 update on guidelines for venous ulcers. Wound Repair Regen. 2016;24(1):136-44.

10. Flanagan M. Principles of Wound Management. In: Flanagan M, editor. Wound Healing and Skin Integrity: Principles and Practice. First edition ed: John Wiley & Sons, Ltd; 2013. p. 66-83.

11. Schultz GS, Sibbald RG, Falanga V, Ayello EA, Dowsett C, Harding K, et al. Wound bed preparation: a systematic approach to wound management. Wound Repair Regen. 2003;11 Suppl 1:S1-28.