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Updated: Oct 9, 2026

Application of Lucilia sericata Larvae in Debridement of Pressure Wounds in Outpatient Settings
Published on: December 4, 2021
Continuous integral debridement: implementation in the Asia-Pacific region
Khong Yik Chew1, Harikrishna Kr Nair2, Kusuma Chinaroonchai3
1Associate Professor of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore.
Abstract:
The health-economic burden of hard-to-heal wounds is rising across the Asia-Pacific (APAC) region, yet regional data remain sparse, particularly for venous leg ulcers and pressure injuries. Effective wound bed preparation, including management of bioburden and biofilm, is central to healing outcomes, but debridement practice across APAC is inconsistent. In May 2026, the Journal of Wound Care published the continuous integral debridement (CID) concept, built around a four-step cleanse, debride, cleanse, dress (CDCD) cycle designed to standardise debridement in everyday clinical practice. This article reports the outcomes of a July 2026 APAC expert panel convened to review the CID concept and its applicability to the region. The panel considered the concept's alignment with established frameworks and its relevance across wound types and care settings. It identifies barriers to implementation, among them variable clinician competence, resource constraints and inconsistent access to education, and sets out recommendations for overcoming these through structured education, multidisciplinary collaboration and the development of local champions. The panel also highlights the role of audit in supporting quality improvement as CID is introduced into practice. These recommendations aim to support clinicians across the APAC region in adopting a consistent, evidence-based approach to wound debridement, with the goal of improving healing outcomes for patients with hard-to-heal wounds.
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