Debridement

By the WoundSource Editors

The wound healing cascade is a complex process that follows a strict sequence of molecular events. The complex series of events depend on one another and must take place in a timely and orderly fashion within the body’s natural host processes. The phases of acute wound healing, in order, are hemostasis, inflammatory, proliferative, and maturation. If the cascade of events is interrupted, the acute wound status then develops into a non-healing or chronic status. Wound stalling occurs in the inflammatory and proliferative stages of healing. In chronic wounds, there appears to be an overproduction of matrix molecules resulting from underlying cellular dysfunction and dysregulation. Non-viable or devitalized tissue lengthens the inflammatory phase of healing and increases risk of infection.

By the WoundSource Editors

Wound chronicity is a major concern, and removing barriers with each stage of healing is paramount. Debridement may occur naturally by the body’s own ability to slough off dead tissue; however, often this tissue needs to be removed medically. The goal of wound debridement is to provide consistent wound bed preparation along with good healing outcomes. Removing non-viable tissue and foreign material is the first goal of debridement. Non-viable tissue not only inhibits the development of healthy new tissue but also increases the risk of infection. Non-viable tissue includes slough and eschar, which create the perfect recipe for bacterial growth and infection. Viable tissue is granulation and epithelial tissue, which is beneficial to normal healing. Wounds that present devitalized tissue and/or biofilm warrant one or more of the debridement methods to promote healing. Since 2006, debridement has been found to be advantageous in managing complex wounds.

By the WoundSource Editors

A wound specialist’s job is to outline the options available for treatment. It is the patient’s job to choose a treatment option. Patients do not even have to select the best option. They must choose an option that works for them given their unique circumstances having a wound. When it comes to selecting debridement methods there are several options to choose from. This article will provide an overview of the most common debridement methods.

By the WoundSource Editors

In chronic wounds, debridement can be used to remove dead and necrotic tissue or to remove foreign material. Debridement has repeatedly been shown to expedite healing and is recognized as a critical element in wound care. There are several methods of debridement, some of which may or may not be the best option, depending on the health care setting, so practitioners should follow their individual state licensure boards’ professional scope and practice and the facilities’ policies when considering debridement.

by the WoundSource Editors

Autolytic debridement: A method of debridement that uses the body’s own enzymes and the moisture trapped beneath the dressing to liquefy non-viable tissue. Although it is the safest method, it is also very slow and therefore not the best option for wounds with large amounts of necrotic tissue.

Biofilm: A complex microbial community containing bacteria and fungi. The microorganisms synthesize and secrete a protective matrix that attaches the biofilm firmly to a living or non-living surface. The biofilm contributes to underlying wound infection, chronic inflammation, and delay in healing, and it is present in 60% of chronic wounds and 6% of acute wounds.

By Gregory Schultz, PhD

In my recent WoundSource webinar on the assessment and treatment of chronic wounds and biofilms, I discussed the pathogenesis of chronic wounds and offered a biofilm-based wound care protocol to promote healing.

by Martha Kelso, RN, HBOT

By Cheryl Carver, LPN, WCC, CWCA, CWCP, DAPWCA, FACCWS, CLTC – Wound Educator

As a veteran of the U.S. Army, and having a grandfather who was a U.S. Army combat medic, I have always had an interest in combat wound care. Wound care has evolved immensely throughout the years in the military arena. The treatments used as far back as the fifth century B.C. were inconceivable. Examples are keeping wounds dry, wound irrigation with water and wine, burning oil into infected wounds, and topicals such as egg yolks, rose oil, and turpentine applied to the wound bed. Odor was controlled with bags of lavender at the soldier’s bedside.

by The WoundSource Editors

by The WoundSource Editors