A chronic wound becomes a challenge to treat because it does not follow the natural pathway of healing comprising of the four stages of wound healing. A chronic wound usually gets halted at the inflammatory stage owing to the presence of necrotic material and wound infection…
ough new techniques have been developed improving the conventional method of wound debridement including hyperbaric oxygen, negative pressure wound therapy, adjuvant growth factors and tissue-engineered products as discussed by
Clinically, wound debridement is the conventional method in use for many years for gaining wound closure. Wound debridement comprises of removal of the dead and devitalized tissue from a wound to minimized the number of toxins, microbes and other harmful substances inhibiting wound healing.
The choice of debridement technique is dependent upon the nature of wound, effectiveness of debridement technique, pain management, exudates levels, risk of infection and cost effectiveness of procedure.
Surgical debridement is amongst the fastest known methods of debridement till now, but it is very painful and was earlier restricted only to treatment of diabetic foot ulcers which already have lost sensations and do not have much need of anesthesia. Side effects include bleeding and possible damage to viable tissue as well which can be controlled by pressure application and hemostatic calcium alginate dressing.
Autolytic debridement is the natural method of debridement experienced by all kinds of wounds to some extent. It is a process of breakdown of necrotic wound material with the help of endogenous proteolytic enzymes produced by neutrophils. These include acid hydrolase, myeloperoxidase, elastase, collegenase and lysosomal enzymes.
It is not a fast method of debridement and needs assistance by occlusive dressings in order to maintain a moist wound bed. It is painless but produces significant quantities of exhudate which is managed by use of hydrogel covered with an absorptive dressing.
It makes use of especially prepared proteolytic enzymes meant for wound debridement. These exogenous enzymes concomitantly work with the endogenous enzymes. Some of these include bacterial collegenase, trypsin, streptokinase and fibrinolysin.
It is a physical ...
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Venous leg ulcers are one of the most difficult wounds to manage. For many nurses, it can prove to be a significant challenge to resolve this medical issue, especially for diabetic patients and long-term care patients.
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