Chronic wounds are usually blocked due to factors such as wound infection and foreign body residues. Debridement is one of the key steps in wound treatment, and wound cleaning is the first step in debridement. In the United States, 2.4 to 4.5 million people suffer from chronic wounds every year; in the United Kingdom, the cost of treatment for a patient with stage IV pressure ulcers is 14,108 pounds, and the total medical expenditure for chronic wounds exceeds 1 billion per year. Debridement is part of the natural wound healing process, but natural debridement of chronic wounds is not enough to promote wound healing, so timely artificial debridement intervention is necessary. The current relatively consistent understanding of debridement is that debridement is a wound treatment technique that removes inactivated tissue, slough and necrotic tissue, foreign matter, and poorly healed tissue that affects healing. The principle is to reduce damage to tissue and promote tissue repair and healing.

What is debridement?

Wound debridement is the removal of dead tissue from a wound in order to help it heal quickly. How long it takes a wound to heal depends on how severe it is. Debridement also determines the speed of wound healing. In some cases, some wounds require re -debridement, and the dead tissue in the wound bed slows the growth of healthy tissue.

What are the methods of debridement?

There are two main types of debridement: selective debridement and non-selective debridement. A selective approach is to remove only necrotic, nonviable tissue from the wound bed. A non-selective method to remove necrotic and living tissue.

1. Mechanical debridement is performed with irrigation, hydrotherapy, wet-to-dry dressings, and abrasion techniques. This technique is cost-effective, damages healthy tissue, and is often painful. Functional dressings are a good choice in nursing. This type of dressing is used to promote moist wound healing and to remove drainage and dead tissue from the wound. Deep wounds with sinus tracts require filling.

2. Enzymatic debridement is performed by applying a prescription topical agent that chemically liquefies necrotic tissue with enzymes. These enzymes dissolve and engulf the devitalized tissue within the wound stroma. Antimicrobials used in conjunction with collagenase can reduce the effectiveness of enzymatic debridement. This approach can be used in conjunction with surgery and sharps debridement.

3. Autolytic debridement is the slowest method and is most commonly used in long-term care settings. This method is painless. This method uses the body's enzymes and moisture under the dressing to liquefy nonviable tissue. It is important to maintain a hydration balance. Dressing frequency and absorbency. Commonly used dressing types are hydrocolloids, hydrogels, and transparent films.

4. Surgical sharps and conservative sharps debridement is performed by a skilled practitioner using surgical instruments such as scalpels, curettes, scissors, rongeurs, and forceps. This type of debridement promotes wound healing by removing biofilm and devitalized tissue. The level of debridement is determined by the level of devitalized tissue removal. Surgical debridement is the most aggressive type of debridement and is performed in a surgical operating room. Rapid and conservative debridement can be performed in the office or at the bedside using sterile instruments.

5. External treatment of traditional Chinese medicine debridement

Use traditional Chinese medicine to perform fumigation, external application, and other external treatment methods to debride the wound by reducing dampness and pain, promoting blood circulation, and promoting muscle growth. The mechanism of action is similar to autolytic debridement. The clinical dosage forms include powder, ointment, external lotion, wet dressing, tincture, etc., and the drug name often varies with the research institution.

Which debridement method is best?

The choice of debridement method is based on a variety of factors, including the following :

•  wound properties
•  Amount of wound necrotic tissue
•  Efficiency and selectivity of the debridement method itself
• Patient Pain Management
•  surgery cost
•  wound exudate level
•  presence or risk of infection

It is also important to remember that not every patient with necrotic tissue is a candidate for debridement. When choosing a suitable debridement method for a patient, please be sure to understand the indications and contraindications of each debridement method. When debridement is performed on a suitable patient in a timely manner, the wound healing can proceed faster, thus bringing more benefits. Good outcomes, higher patient satisfaction, and lower overall wound care supply costs.

How to prevent wound infection?

Here are some tips to avoid wound infection :

If a wound occurs, the wound and surrounding skin should be cleaned immediately. It is a good choice to cover the wound with a hydrocolloid dressing, which can prevent the invasion of foreign microorganisms and can also provide a closed space for the wound that is slightly acidic and conducive to healing. If you think an infection is developing, use Silver Ion Dressing, which promotes wound healing and inhibits wound bacterial growth, and if you think there are still some foreign objects in the wound, go to the nearest hospital.

For more information on Innomed® silver ion dressing, refer to the previous articles. If you have customized needs, you are welcome to contact us; we will serve you wholeheartedly.

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Editor: kiki Jia

Date: November 30, 2022