Debridement is essential for the optimal care of venous
leg ulcers. Several
debridement methods with different limitations may be deployed.
Trichloroacetic acid (TCA) is used for several dermatological purposes. Its application as a chemical
debridement method for
leg ulcers has never been explored. We designed a prospective study to determine the role of 80% TCA
solution as a chemical
debridement method for
leg ulcers, regarding efficacy and procedure-associated
pain. Chronic venous
leg ulcers were treated with 3 cycles of 80% TCA
solution or
curettage over 1 week.
Pain and the mean percentage of
fibrin and devitalized tissue covering
wound bed were evaluated. At the end of the study, a trend towards larger
fibrin mean reduction among the TCA treated
ulcers was observed, although this difference was not statistically significant (P = .35). The mean
pain score after TCA application was significantly reduced compared to
pain after
curettage alone (P < 0.001). TCA presented several advantages over mechanical
debridement: it is a more selective
debridement method, has haemostatic properties, and a simpler and faster application. The 80% TCA
solution may be a cheap, simple, and considerably less-painful chemical
debridement method for venous
leg ulcers compared to classical mechanical
debridement.