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.
The methods that may be used here include surgical (sharp), enzymatic, autolytic, biosurgery and mechanical debridement. The choice of option to be used in a given case will depend on a number of factors that include the type of wound, its position, anticipated level of pain and the risk of infection among others. Some cases may require that more than one option be used to attain maximal results.
The surgical procedure is one of the oldest techniques that have been used. It is also the fastest. The main side effects include pain, bleeding and damage to viable tissues among others. It stimulates the release of cytokines and growth factors which in turn result into a faster healing process. Local anesthetic agents (such as lignocaine) are usually administered to minimize the pain. Application of pressure and dressing usually controls the bleeding.
Autolytic debridement is a type that can be used for a wide range of wound types. Unlike the surgical option, it is highly selective. Specific proteolytic enzymes are used to digest and breakdown the necrotic tissues. Examples of these enzymes include collagenase, acid hydrolase, elastase and myeloperoxidase among others. The main downside of this option is that it is very slow. Occlusive dressings are sometimes used to enhance the healing process.
Chemical (enzymatic) debridement has many similarities with the autolytic process. The major difference is that the enzymes that are used here are artificial. Examples include paparin, trypsin, collagenase and streptokinase among others. Many, if not all of these enzymes are available commercially. Of all the options available, the collagenase option is the most effective and the most commonly used.
Biosurgery (also known as myiasis) is a biological form of debridement that is achieved using fly maggots. The maggots selectively eat necrotic tissues and spare the normal ones. Since they are sterile, they are unlikely to aggravate the infection. Apart from the consumption of dead tissue, they are also believed to work in a number of other ways. One of them involves the direct killing of bacterial organisms.
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.
The methods that may be used here include surgical (sharp), enzymatic, autolytic, biosurgery and mechanical debridement. The choice of option to be used in a given case will depend on a number of factors that include the type of wound, its position, anticipated level of pain and the risk of infection among others. Some cases may require that more than one option be used to attain maximal results.
The surgical procedure is one of the oldest techniques that have been used. It is also the fastest. The main side effects include pain, bleeding and damage to viable tissues among others. It stimulates the release of cytokines and growth factors which in turn result into a faster healing process. Local anesthetic agents (such as lignocaine) are usually administered to minimize the pain. Application of pressure and dressing usually controls the bleeding.
Autolytic debridement is a type that can be used for a wide range of wound types. Unlike the surgical option, it is highly selective. Specific proteolytic enzymes are used to digest and breakdown the necrotic tissues. Examples of these enzymes include collagenase, acid hydrolase, elastase and myeloperoxidase among others. The main downside of this option is that it is very slow. Occlusive dressings are sometimes used to enhance the healing process.
Chemical (enzymatic) debridement has many similarities with the autolytic process. The major difference is that the enzymes that are used here are artificial. Examples include paparin, trypsin, collagenase and streptokinase among others. Many, if not all of these enzymes are available commercially. Of all the options available, the collagenase option is the most effective and the most commonly used.
Biosurgery (also known as myiasis) is a biological form of debridement that is achieved using fly maggots. The maggots selectively eat necrotic tissues and spare the normal ones. Since they are sterile, they are unlikely to aggravate the infection. Apart from the consumption of dead tissue, they are also believed to work in a number of other ways. One of them involves the direct killing of bacterial organisms.
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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