Align the wound bed to sufficiently loosen superficial devitalised tissue, wound debris, foreign debris and biofilm. Cleanse the periwound skin to remove scales and callus, and to decontaminate the area.

Using gentle force where necessary and as tolerated, cleanse the skin located 10-20cm around the wound, complying with local guidance when cleansing 'clean' (farthest from the wound) and 'dirty' areas (nearest the wound/the wound itself).

Use gauze or commercially available cleansing pads an ideally an antiseptic or surfactant wash.

Remove all attached devitalised tissue, wound/foreign debris and biofilm. Continue until pinpoint bleeding occurs (where patient consents/tolerates it and local practice permits), leaving the wound bed in a condition that is conducive to the effective use of antimicrobial and/or antibiofilm dressings.

Methods include manual/mechanical, sharp, ultrasonic or biological and can depend upon setting and skill level.

Continually assess wound edges, removing curled or rolled-under tissue and dry, callused or hyperkeratotic tissue to remove any biofilm that could be colonising the wound edges.

Examples of appropriate approaches for this purpose include mechanical, sharp, ultrasound or biological and can depend upon setting or skill level.

Choose a dressing containing antibiofilm/antimicrobial agents that can address any residual biofilm and prevent contamination and recolonisation, therefore, biofilm reformation. It should also manage exudate effectively, thereby promoting healing.