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A Few Essentials On Wound Debridement

By Michael White


When the protective barrier of the skin is breached, a Wound is formed. Whether the wound remains clean or becomes infected depends on a number of factors. Surgical wounds are usually clean unless certain systems are directly involved. These systems are the gastrointestinal, genitourinary and respiratory. When this happens, the wound is said to be contaminated. Introduction of foreign bodies and complication with intense foul smelling pus qualifies a wound to be dirty. This is when wound debridement comes in handy.

A dirty wound is one that is seen when a foreign substance has been introduced into the body. This happens, for example, when someone gets pricked say by a small piece of wood which gets stuck in tissues. It may also result when one gets shot and the bullet remains lodged in the body. In other situations, dirty wounds may be created in hospital if healthcare providers are not diligent enough when caring for clean wounds. Regardless of which foreign body is involved, the end result is infection if the object is not removed in time.

Tissues that require debridement usually are dead, smelly and extensive. This commonly happens when decomposition has been going on for too long without the necessary intervention. Early intervention and active surveillance should start with the affected persons. They need to undertake first aid measures at home and then check in to a hospital for further management on time. The role of the doctor is to prescribe antibiotics and monitor healing.

In the event that bacteria gain access to tissues, the human body responds by recruiting white blood cells to the site of injury in order to destroy the bacteria and stop further spread. The main players in this field are the white blood cells. When this fails due to one reason or the other, the bacteria trapped at the site of injury causes decomposition of normal tissues and production of pus by the very same cells intended to fight the bacteria.

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.

Removal of decomposing tissues can also be achieved through the use of larva. In this case, maggots are deposited in the dead region. The aim is to allow the maggots to devour decayed tissue leaving only the normal tissues.

New tissues are allowed time to develop once the procedure is done. The area is usually dressed with sterile gauze to reduce reinfection. If the decomposed area is too large, a graft tissue can be utilized to fill the gap. Extreme care should be given to ensure the graft takes.

In conclusion, wounds can be caused at home or in the hospital when sterility is not observed. People who have a reduced level of immunity(such as those with diabetes) are more likely to suffer from chronic wounds compared to the general population. It is important that debridement is done to allow new, normal skin to form.




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A Few Essentials On Wound Debridement

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