Statement of the Problem: The purpose of this study is to explore the effectiveness of a sodium chloride (NaCl) impregnated non-woven gauze dressings in debriding necrotic tissue.

Rationale:  Removal of necrotic tissue is crucial for wound healing.  When surgical debridement is not indicated, a safe and reliable alternative is needed to optimize outcomes.   The use of NaCl gauze dressing provides fast, efficacious, cost effective debridement of non-viable tissue. 

Methodology: The study examined 3 complex geriatric patients with a total of four necrotic wounds.  All wounds were chronic, had moderate to copious drainage compounded with periwound erythema, induration, and had sub-optimal progress with debriding enzymes.  Dry NaCl gauze dressings were applied daily with appropriate periwound protection and absorbent cover dressings to soften the tenacious slough to wound bed.  Conservative sharp debridement was used in some cases to selectively to remove resulting softened slough.  Patients were all treated in their place of residence.

Results:  Elimination of necrotic tissue was achieved in a 2-3 week period.  The NaCl protocol removed visible devitalized tissue but also necrotic tissue within indurated areas, allowing true determination of tissue damage.  Supply cost was a fraction of past expenses on prescription enzymes and other products.  Treatment protocols were safe and easily administered at the bedside. 

Conclusion:  Use of NaCl gauze dressing led to successful debridement of necrotic tissue in a timely and cost effective manner. The reliability and consistency of outcome allowed for future planning for other protocols that would take these wounds to healing.