Chronic wounds are at times quite difficult to manage especially if there is a lot of dead tissue. Wound debridement is the process through which this dead tissue is removed. In some cases, there may be a need to remove foreign materials such as wood, glass and metal. The number of sessions varies depending on the amount of tissue to be removed. We will look at the benefits of this procedure and the methods that can be used.
There are a number of reasons as to why a wound needs to be debrided. The first of them is the fact that healing is expedited. Dead tissue tends to trap bacterial organisms and its removal reduces the number of organisms that one has to deal with. Dead tissue also hides pockets of pus that is associated with odor and the onset of new infections. Removal of this tissue gets rid of the odor and provides an opportunity for newer tissues to grow.
Methods used for this exercise are greatly variable. Examples include surgical, autolytic, enzymatic, mechanical and biosurgery debridement. Each of these may be used singly or in combination. Combinations usually yield the best results. The choice is determined by factors. These include, among others, the type of wound involved, the level of pain anticipated and the risk of infection.
The surgical technique has been in existence for a fairly long period of time. It is associated with the quickest results. Unfortunately, it causes considerable pain, blood loss and damage to normal tissues. Apart from the removal of necrotic tissue, this method also leads to the release of cytokines and growth factors that may contribute to the healing process. Pressure dressing helps minimize excessive bleeding and local anesthesia is usually administered for the pain.
Autolytic debridement is facilitated by enzymes that are released by body cells. These enzymes selectively digest the dead and decaying tissues but usually spare normal cells and tissues. Examples include enzymes such as collagenase, myeloperoxidase, acid hydrolase and elastase among others. This process is among the slowest and may need occlusive dressing to enhance the process of healing.
Enzymatic or chemical debridement works in the same way as the autolytic process. The main difference is that the chemicals are introduced artificially. It is common for this procedure to be done alongside surgical debridement. The exogenous enzymes that are required are available commercially and include paparin, trypsin, collagenase and streptokinase among others. The collagenase-based option is the most commonly used and the most effective in this category.
Biosurgery (also termed myiasis) is a biological debridement method that uses fly maggots. The maggots are bred in a sterile environment before being introduced to the wound. They selectively destroy the dead tissue and spare the normal areas. Other mechanisms are believed to be involved as well. For instance, they are said to kill and ingest bacteria as well by producing a number of enzymes. They also increase the PH of the area as well as oxygenation both of which favor healing.
Debridement of wounds is an important process in the management of chronic skin infections. The decision to have the procedure is usually made by the doctor opening on a number of factors such as the location, the size and the severity of infection among others. These factors also determine the type of procedure that will be chosen and the frequency at which debridement will be done.
There are a number of reasons as to why a wound needs to be debrided. The first of them is the fact that healing is expedited. Dead tissue tends to trap bacterial organisms and its removal reduces the number of organisms that one has to deal with. Dead tissue also hides pockets of pus that is associated with odor and the onset of new infections. Removal of this tissue gets rid of the odor and provides an opportunity for newer tissues to grow.
Methods used for this exercise are greatly variable. Examples include surgical, autolytic, enzymatic, mechanical and biosurgery debridement. Each of these may be used singly or in combination. Combinations usually yield the best results. The choice is determined by factors. These include, among others, the type of wound involved, the level of pain anticipated and the risk of infection.
The surgical technique has been in existence for a fairly long period of time. It is associated with the quickest results. Unfortunately, it causes considerable pain, blood loss and damage to normal tissues. Apart from the removal of necrotic tissue, this method also leads to the release of cytokines and growth factors that may contribute to the healing process. Pressure dressing helps minimize excessive bleeding and local anesthesia is usually administered for the pain.
Autolytic debridement is facilitated by enzymes that are released by body cells. These enzymes selectively digest the dead and decaying tissues but usually spare normal cells and tissues. Examples include enzymes such as collagenase, myeloperoxidase, acid hydrolase and elastase among others. This process is among the slowest and may need occlusive dressing to enhance the process of healing.
Enzymatic or chemical debridement works in the same way as the autolytic process. The main difference is that the chemicals are introduced artificially. It is common for this procedure to be done alongside surgical debridement. The exogenous enzymes that are required are available commercially and include paparin, trypsin, collagenase and streptokinase among others. The collagenase-based option is the most commonly used and the most effective in this category.
Biosurgery (also termed myiasis) is a biological debridement method that uses fly maggots. The maggots are bred in a sterile environment before being introduced to the wound. They selectively destroy the dead tissue and spare the normal areas. Other mechanisms are believed to be involved as well. For instance, they are said to kill and ingest bacteria as well by producing a number of enzymes. They also increase the PH of the area as well as oxygenation both of which favor healing.
Debridement of wounds is an important process in the management of chronic skin infections. The decision to have the procedure is usually made by the doctor opening on a number of factors such as the location, the size and the severity of infection among others. These factors also determine the type of procedure that will be chosen and the frequency at which debridement will be done.
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