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Some Principles Regarding Wound Debridement

By Michael White

In the event that the underlying Tissues are exposed to the external environment, a Wound is created. This can happen when a surgeon intentionally makes an incision in the skin for the purpose of accessing internal structures. Such wounds are generally referred as surgical wounds. When the respiratory, genitourinary or gastrointestinal tracts are entered, the wound is said to be contaminated and need to undergo wound debridement, even though there may be no signs of infection. Clean, contaminated surgical wounds have signs of infection.

In the event that a person is shot for one reason or another, the bullet stuck in the body is considered a foreign body. If it is not removed in time, an infection can quickly set in and complicate the situation. Pieces of wood or metal can also get lodged in tissues accidentally. Other than foreign bodies, dirty tissues can be the result of complications of medical procedures. This means that healthcare providers may be the cause of a clean wound getting complicated.

It takes time for necrotic tissues to spread and cover larger areas. It also takes some time for a bad smell to be detected. One does not need to wait for such extensive complications to set in for them to seek intervention. Infection prevention and rapid healing should begin with the person who has sustained the injury at home or in a work setting. One should ensure that the wound is tentatively dressed to minimise bacterial entry. They should then seek medical care as soon as possible in which case measures such as administration of antibiotics as prophylaxis.

When normal tissues are exposed to the environment, they are at risk of getting infected by the many bacteria that exist in nature. Once bacteria get in contact with vulnerable skin, the body immediately mounts an immune response. The cells responsible for fighting infection (white blood cells) are transported to the site of bacteria. These cells release substances that are toxic to the survival of the bacteria inside the body. In the event that the immune system fails to correct the anomaly, pus begins to form and the tissues begin to decay.

Debridement of wounds can be achieved using a number of techniques. The commonest form is that which involves the use of surgical methods. Here, the necrotic tissues can be literally removed manually with the help of certain surgical equipment. Depending on how much tissue needs to be extracted, local or general anaesthesia can be incorporated. Use of tissue breakdown (autolysis) by special chemicals is another way to achieve debridement.

Occasionally, maggots can be utilized to manage certain wounds. They work by consuming the bacteria deposited in a given area and prevent its spread to the rest of the body. The only downside to this is that it may not be pleasant site to behold.

The area is usually dressed after every debridement session to prevent further exposure to microbes and to provide some time for it to heal. Grafting should be considered for wounds that are extremely extensive. This may mean that a plastic and reconstructive surgeon be incorporated into the management team.

It is important that sterile measures are observed when to prevent further spread of infection to the rest of the body. Patients with a low immunity level are disadvantaged because their wounds tend to take longer to heal. Such include persons with diabetes and cancer.

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Some Principles Regarding Wound Debridement


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