A Few Notes Concerning Wound Debridement
Wounds are created when there is a break in the integrity of the skin. Wounds can be categorized as either clean, contaminated, clean and contaminated and finally, dirty wounds. Clean wounds are those created by surgeons as they make incisions. Clean contaminated wounds come about when either the gastrointestinal, respiratory or genitourinary tract is breached but without a sign of active infection. If signs of infection are present, the wound is said to be contaminated. Wound debridement is indicated for dirty, chronic wounds.
When a surgical wound is complicated by foreign bodies such as bullets, wood or metal, the affected tissues are said to be dirty since they usually ooze large amounts of pus among others signs of infection. This can happen acutely if the foreign body was originally full of harmful bacteria. In other circumstances, it may take a while for a dirty environment to occur as bacteria take time to accumulate. Removal of the foreign object needs to be timely so as to minimize the chances of dirty wound creation.
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 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.
Once the decomposed tissues have been removed, the area is dressed and given time to heal. In the event that the area is too large to allow for natural re-growth of new tissues, grafting may be required. Grafting uses portions of human tissue from elsewhere to replace those lost around the decayed area. The graft will usually take up the blood supply of the destination area and integrate with the new found environment.
The important thing to remember is that all wounds need to be given maximum attention to prevent complications. Wounds may take longer to heal for patients with underlying diseases such as diabetes and cancer. Sterility needs to be given priority when managing any break in skin to expedite the healing process.
When a surgical wound is complicated by foreign bodies such as bullets, wood or metal, the affected tissues are said to be dirty since they usually ooze large amounts of pus among others signs of infection. This can happen acutely if the foreign body was originally full of harmful bacteria. In other circumstances, it may take a while for a dirty environment to occur as bacteria take time to accumulate. Removal of the foreign object needs to be timely so as to minimize the chances of dirty wound creation.
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 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.
Once the decomposed tissues have been removed, the area is dressed and given time to heal. In the event that the area is too large to allow for natural re-growth of new tissues, grafting may be required. Grafting uses portions of human tissue from elsewhere to replace those lost around the decayed area. The graft will usually take up the blood supply of the destination area and integrate with the new found environment.
The important thing to remember is that all wounds need to be given maximum attention to prevent complications. Wounds may take longer to heal for patients with underlying diseases such as diabetes and cancer. Sterility needs to be given priority when managing any break in skin to expedite the healing process.
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