A Few Essentials On 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.

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 can be done manually or by use of a chemical. During the manual procedure, the surgeon scraps off dead tissues using special surgical instruments. The patient is put under general or local anaesthesia depending on how much tissue has decayed. In the chemical form of debridement, special chemicals are used to break down the unwanted tissues and lift them off.

In isolated situations, larvae from maggots can be utilized. The area to be debrided is marked and larvae deposited there. The main goal is to ensure that all bacteria are consumed by the maggots thus preventing systemic spread.

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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