Wound debridement and dressing

Wound debridement and dressing

Last Updated December 20th, 2021

Overview of wound debridement and dressing

Ulcers and wounds are very common in two categories of people- professional athletes and bed-ridden patients. The statistics of the Center for Disease Control and Prevention (CDC) show that around 3.5 million sports injuries are reported per year. CDC also reports that nearly 5-10% of the global population suffer from ulcers at some point in time. In either case, proper treatment and healing of the wounds is necessary. Debridement and dressing are the two popular techniques that are employed to facilitate a speedy recovery. This article will discuss both the methods and explain its effectiveness in various cases.

 

Wound debridement

Wound debridement and dressingWound debridement is defined as the scientific removal of the damaged, infected or dead tissues from the site of injury in order to facilitate speedy recovery and healing of the remaining healthy tissues as well as the affected tissues.

The effectiveness of the debridement technique determines the healing potential of the damaged tissues.

Different methods such as chemical, mechanical, surgical, autolytic and maggot therapy are utilized in the process of wound debridement.

In certain serious cases, the boundaries of the damaged tissues are not discernable. In such cases, a portion of the healthy tissues is also removed in order to make sure that residues of the infected tissues are not present.

 

Types of wound debridement

Based on the mechanism involved, wound debridement is categorized into the following types-

  • Autolytic Debridement

This method utilizes autolysis, which is a technique of destruction of cells and is often called self-digestion. It is the process of complete destruction of a cell with the help of its very own enzymes. This method utilizes the body’s own enzymes and moisture to re-hydrate, soften and melt the slough or the eschar (rough coating on a wound surface). 

Wound debridement stitchesThis method is not applicable to all kinds of damaged tissues. Only the necrotic tissues can be liquefied and removed in this manner. Therefore autolytic debridement is selective in nature. The main advantage of this process is that it is absolutely painless. The most recommended technique of autolytic debridement is the use of occlusive or semi-occlusive dressings. This helps maintain the wound fluid that is in contact with the necrotic tissues.

The commonly used materials for autolytic debridement are- hydrogels, hydrocolloids, and transparent films. This method of debridement is most effective for Stage III or Stage IV wounds where mild to moderate exudates are released.

  • Enzymatic Debridement

This method involves chemical enzymes that eat off or peel off the necrotic tissues. These enzymes are mainly derived from microbes like histolyticum and Clostridium. Plants like Papain, Bromelain, Varidase, and Collagenase can also act as sources of these enzymes. Few of these enzymes are selective, while the rest are non-selective. 

This technique is best employed for wounds, especially burns having a large concentration of necrotic debris or eschar formation. In this technique, however, complete and speedy recovery is not always guaranteed. Therefore the doctors do not regard this technique as a standard debridement method for wound treatment.

  • Mechanical debridement

Hydrotherapy is commonly used in this technique. This helps in selective mechanical debridement, wherein a tissue is removed for the treatment of wounds. The popular means of mechanical debridement are- directed wound irrigation and mechanical irrigation. 

Whirlpool water baths should be avoided for the hydrotherapy because a selective tissue cannot be targeted and the healthy tissues may be damaged in the process.

Non-selective mechanical debridement involves drying up of a moist dressing, followed by removal of the dressing. Mechanical debridement turns out to be most effective for wounds with dead tissues (necrotic debris).

  • Surgical debridement

It is the fastest method of wound debridement, though somewhat costly. It is normally carried out under the effect of anesthesia and has two types- laser debridement and sharp debridement. These techniques are very selective, and the level of selectivity depends on the skill and the control of the person handling the instruments. This makes sure that only the selected tissues are uprooted and the rest is left untouched. After the completion of the process, normal blood circulation and the viability of the tissues are revived.

  • Maggot therapy

Maggots are microscopic creatures that feed on dead and decayed tissues. In this therapy, a number of maggots are incorporated into to the site of the wound, after which they start feeding on the necrotic tissues in a manner more selective than the surgical procedures. The healthy tissues are left intact. The process gets completed in 3-4 days.

 

Wound dressing

Wound dressing is the process of applying a sterile pad or a compress that is applied to the wound to accelerate the healing process and also protect the wound from further infections. In this regard, it is necessary to understand the differences between dressing and bandage. While a dressing is placed directly in contact with the wound, a bandage is used as a support to the dressing. A bandage basically attaches the dressing firmly to the wound. To eliminate the troubles of using bandages along with the dressings every time, the dressings these days usually have adhesives.

 

What are the main objectives of wound dressing?

The primary purposes of wound dressing are:

  • Stem bleeding: It helps seal the wound and accelerates blood coagulation.
  • Protection: It protects the wound from germs and mechanical trauma.
  • Fluid absorption: It helps in the absorption of the exudates (blood and plasma released from the wounds) and prevents skin maceration.
  • Pain reduction: The analgesic effect helps lessen the pain to some extent.
  • Debridement: It removes slough and infectious tissues from the wound to enable speedy healing

 

Type of wound dressing

Wound debridementWound dressing is typically classified into the following types-

  • Gauze Dressings
  • Biologics
  • Skin substitutes
  • Scaffolds
  • Bio-membranes
  • Hydrocolloid dressing
  • Foam dressing
  • Film / composite dressing
  • Stretch gauze/stretch net

 

Important points to remember

Surgical wounds, which have been sutured properly just after the surgery usually don’t require much dressing.  There are few important measures that need to be taken with dressing and debriding wounds in order to prevent infections:

  • The site of the wound should have an apt level of moisture. Too wet or too dry wounds can lead to exacerbation of the wound.
  • The wound should be kept free from environmental toxins, including the ones that could contaminate the dressing components.
  • The optimum temperature for wound healing is 37 deg C, which is the normal body temperature.
  • Unnecessary wound dressing should be avoided.
  • Just like moisture and temperature, the pH level should also be maintained at right levels to facilitate proper wound healing.

 

 

Dos and Don'ts

Dos
  • Be very careful of cuts, abrasions, and wounds on your leg especially if you are diabetic.
  • Change your wound dressing regularly in order to prevent it from getting infected.
  • Always refer to the doctor if you get a wound that doesn’t heal in time.
Don'ts
  • Try to treat corns or calluses at home or use acid-based wart remover to get rid of these.
  • Consume a diet rich in sugar. High glucose level in the blood often hinders wound-healing.
  • Let the wound get dry and “scabbed”. Also, refrain from picking the wound with your nails or any sharp object.

 

 

 

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Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
Quinine: How gin and tonic came to be known as a potent health elixir The discovery of quinine-containing tree bark is sometimes considered the most serendipitous medical discovery of the 17th century.
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
Shilajit: A miracle Himalayan herb for an active and happy life The Himalayas contain more wonders than you thought. Shilajit is a miracle herb that is widely used in…
Jack in the box fast food
Jack In the Box : The perils of surging fast food culture in the USA Jack in the Box - How a culture of fast-food can clog your arteries, weaken your heart, fatten…
anti ds dna test
Anti Ds-DNA antibody Test The  Anti Ds-DNA antibody test is used to diagnose the disease called lupus or more aptly the SLE(Systematic…
These are the top foods to increase your hemoglobin count It is important to add iron-rich foods into your diet in order to increase hemoglobin. Deficiency of hemoglobin could…
Vagus nerve: 7 health benefits of stimulating the “gut-brain” connection As a matter of fact, there are two vagus nerves namely the left and the right but is…
Chest X-Ray A chest x-ray is a diagnostic test that uses x-rays to visualize the structures inside your chest. It…
CLA: A breakthrough weight loss supplement with minimal side effects Tried every weight loss supplement in the market with no substantial gain? Why not try CLA supplements, derived…
HSV-1_IGG
Herpes Simplex Virus I (HSV)-IgG Test Herpes simplex virus I(HSV)-IgG is an Immunoglobulin protein that acts as an antibody & stays in the blood…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
What is Qigong and how can it help you channelize you inner “Qi”? Qigong is an integrated way of performing a traditional exercise regimen that can help in promoting health, mental…
Tissue Transglutaminase Antibody (tTG) Test Transglutaminase is an enzyme present in our body and is involved in protein metabolism. A tTg test is…
6 arguments in favour of glucosamine and where can you find it Studies have shown that glucosamine works by preventing the breakdown of cartilage of the joints. This is usually…
xylitol gum
Xylitol : Is this the right sugar substitute for you? Discovered during World War 2 owing to sugar shortage, xylitol has become a common name in pharamaceutical industry.…
vital organ diseases
Common diseases that could cripple your vital organs Brain, heart, kidney, lungs, and liver - these vital organs are indeed vital for your survival. However, these…
Cordyceps: How the Caterpillar fungus works as a proven cancer-shield Strange as it may sound, but cordyceps or "caterpillar fungus", a fungus variety native to the Himalayas may…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
General adaptation syndrome: Understanding stress, one step at a time The struggle of the body to produce hormones during a stressful situation is the main theme of general…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
Tamarind: The top health benefits of this staple Asian ingredient Did you know this sweet and sour pulpy fruit does more than just add a tangy flavor to…
Hibiscus: Nourish your beauty and health with these vibrant blooms Hibiscus is a trumpet shaped flower found abundantly in tropical countries. It has been historically used for its…
Erythritol: A healthy sugar substitute or yet another marketing ploy? Erythritol is a popular choice of a healthy alternative sweetening agent in foods. But how healthy can a…
Miracle extract from the root of maca: 10 ways it can help you! Maca root has been used for years in herbal medicine. Today scientific research is unearthing fresh evidence in…
folate test
Folate test The Folate test measures and monitors the levels of folic acid in the blood. This test is also…
Hot cups for detox? Read all about the ancient technique of cupping Did you know inverted hot cups on your back can squeeze out and eject toxins from your body?…
Psyllium Husk: More than just an effective natural laxative Psyllium husk, or isabgol, is a popular natural laxative . But did you in addition to regulating bowels,…
Alp enzyme-test
ALP test – Alkaline Phosphate ALP or alkaline phosphate is an enzyme mainly produced by the liver and gallbladder. ALP test measures the…
Ca 19.9 test
CA19.9 Test CA 19.9 is a cancer antigen that exists on the surface of cancer-causing cells. The levels of CA…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…
edamame
Edamame: How healthy are these green baby beans? Edamame or "immature" soybeans are soft and easily digestable forms of soybeans that are great as an eveyday…
antiHEV IgM test
Anti hepatitis E virus (Anti HEV) IgM Test Anti HEV IgM test determines the level of the IgM antibodies in the blood, The disease is often…
sodium chloride
Halotherapy: How inhaling salt can work wonders for your body Halotherapy is quickly gaining popularity amongst those with respiratory diseases. It has shown promise in its treatment.
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…

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