It is vital that all foreign matter and contaminated, devitalized or dead tissue be removed from wounds as first steps in preparing wound bed. The process of removing these substances is what clinicians refer to as wound debridement. All forms of non-viable tissue in wounds are referred to as slough or necrotic tissue. Necrotic tissue has a brown or black coloration while slough is colored yellow and is fibrinous.
Chronic wounds will often have a buildup of necrotic tissue. The necrotic tissue is composed of necrotic material, high bacterial levels, exudate, and non-viable tissue. As opposed to other forms of wounds, chronic wounds tend to accumulate necrotic tissue more. Chronic wounds result because of diabetes, venous insufficiency and other underlying and uncorrected pathogenic abnormalities. Often, these abnormalities are insolvable. Thus, preparing wound beds so as to facilitate closure of wounds become necessary.
Debridement is made useful and important by several diverse reasons. First, the clinician can assess the status of surrounding tissues and depth of wounds by eliminating devitalized tissue. Secondly, necrotic tissues usually hide any signs of infection in wounds. Also, the physical barrier that necrotic tissue presents supports development and growth of bacteria and also makes the healing process impossible.
Bacterial colonies are often contained in necrotic tissue and they produce damaging proteases. Proteases have a negative effect on reepithelialization process and the production of granulation tissue. As such, debriding wounds reduces the probability of contamination and tissue destruction. The cause for a reduction in tissue destruction is the elimination of cell debris.
There are four main methods of debriding wounds, that is, mechanical, autolytic, surgical or sharp, and enzymatic. Which method is chosen for debriding is made based on several factors. Some of the factors include the type, position, and size of wounds, pain management, time available for the process, moisture levels, and the healthcare setting. The overall condition of the patient is also considered a lot when choosing the methods to be used. Sometimes multiple methods may be employed at once.
Surgical or sharp debriding approach represents the fastest procedure for eliminating debris and necrotic tissues in wounds. The suitability of this method come in excess necrotic tissue is present in wounds, making it hard to determine their depth. Additionally, it is the most suitable procedure for removing bones and infected materials.
The surgical approach has many advantages and benefits associated with it. First, it causes least damage to surrounding tissues. Secondly, minor bleeding that may result helps in repairing wounds because it releases inflammatory mediators like cytokines. The only thing the clinician has to do is to assess the patient and make sure they are suitable candidates for the procedure.
The surgical procedure has shortcomings of its own. To begin with, it should never be used on individual who suffer from bleeding disorders and those whose immune systems are compromised. Secondly, it may cause transient bacteremia and some patients experience excess pain during the process. Lastly, there may be damage done to nerves, muscles, and tendons.
Chronic wounds will often have a buildup of necrotic tissue. The necrotic tissue is composed of necrotic material, high bacterial levels, exudate, and non-viable tissue. As opposed to other forms of wounds, chronic wounds tend to accumulate necrotic tissue more. Chronic wounds result because of diabetes, venous insufficiency and other underlying and uncorrected pathogenic abnormalities. Often, these abnormalities are insolvable. Thus, preparing wound beds so as to facilitate closure of wounds become necessary.
Debridement is made useful and important by several diverse reasons. First, the clinician can assess the status of surrounding tissues and depth of wounds by eliminating devitalized tissue. Secondly, necrotic tissues usually hide any signs of infection in wounds. Also, the physical barrier that necrotic tissue presents supports development and growth of bacteria and also makes the healing process impossible.
Bacterial colonies are often contained in necrotic tissue and they produce damaging proteases. Proteases have a negative effect on reepithelialization process and the production of granulation tissue. As such, debriding wounds reduces the probability of contamination and tissue destruction. The cause for a reduction in tissue destruction is the elimination of cell debris.
There are four main methods of debriding wounds, that is, mechanical, autolytic, surgical or sharp, and enzymatic. Which method is chosen for debriding is made based on several factors. Some of the factors include the type, position, and size of wounds, pain management, time available for the process, moisture levels, and the healthcare setting. The overall condition of the patient is also considered a lot when choosing the methods to be used. Sometimes multiple methods may be employed at once.
Surgical or sharp debriding approach represents the fastest procedure for eliminating debris and necrotic tissues in wounds. The suitability of this method come in excess necrotic tissue is present in wounds, making it hard to determine their depth. Additionally, it is the most suitable procedure for removing bones and infected materials.
The surgical approach has many advantages and benefits associated with it. First, it causes least damage to surrounding tissues. Secondly, minor bleeding that may result helps in repairing wounds because it releases inflammatory mediators like cytokines. The only thing the clinician has to do is to assess the patient and make sure they are suitable candidates for the procedure.
The surgical procedure has shortcomings of its own. To begin with, it should never be used on individual who suffer from bleeding disorders and those whose immune systems are compromised. Secondly, it may cause transient bacteremia and some patients experience excess pain during the process. Lastly, there may be damage done to nerves, muscles, and tendons.
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