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.

 

Facts

  • The manual removal of dead tissues (necrotic tissues) from the point of wound is called as active debridement.
  • Larval debridement is a component of active debridement in which maggots or their larvae are placed at the site of wound and allowed to eat away the dead cells.

Facts

  • There are certain types of wounds which will usually require manual debridement, such as pressure ulcers.
  • If a wound is not debrided properly, it may cause the infection to spread into the bloodstream and ultimately require amputation of the infected area.

Facts

  • Burnt tissue, which is usually black in color and has yellowish skin underneath, is called as eschar. Such tissues also need debridement.

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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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Cayenne: The remarkable benefits of these red hot chili peppers These may make you rush for a glass of water, but cayenne pepper is actually a healthy additive…
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)…
BRAT Diet: What is the right way to follow this diarrhea-relieving diet? BRAT diet, a simple diet consisting of just bananas, rice, applesauce, and toast, can help you combat the…
What is the right way to take a pregnancy test? A pregnancy test is undertaken to determine if you have conceived. A home pregnancy test is the most…
Gatorade: Top things you need to know about this staple energy drink Gatorade is a popular (in fact the most popular) energy drink worldwide. But this power-packed drinks comes with…
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…
liver cleanse detox
14 go-to foods that are best for a complete natural liver detox Liver cleanse can be achieved by just choosing or avoiding certain types of food. Liver itself is a detoxifying…
Vitamin-D-blood-test
25-Hydroxy Vitamin D test 25-hydroxy Vitamin D test is a blood test used to measure the level of vitamin D in the…
blood elements analysis
Blood Element Analysis Test A blood element analysis is a blood test performed to measure the level of toxic elements such as…
malarial antigen test
Malaria Antigen Test A malaria antigen test is a rapid diagnostic test (RDT) that can detect malarial antigens (proteins) in your…
Unbelievable health benefits of gooseberries (and a few tasty recipes) Gooseberries are antioxidant-rich tasty fruits that can be easily added in daily diet to improve overall health and…
piles fissure fistula
Allopathy vs homeopathy vs ayurveda treatment for piles, fissures, and fistula Read to know the best form of treatment among allopathy, homeopathy,or ayurveda for piles, fissures, and fistula
hidden causes obesity
8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
liver detox facts
7 liver detox facts and why ignoring these could kill you! Are you taking care of this organ that handles over 500 different vital functions in your body? Your…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
Dragon Fruit – Blessing from Nature’s Basket Dragon fruit is packed with nutrients but low on calories. It is the dream food that can help…
Valerian Root: The best way to achieve tranquil sleep every night Valerian root is probably one of the oldest and safest way to cure your insomnia. Find out how…
Did you know drinking alkaline water could be the healthier choice for you? Ever wondered how safe is your drinking water in terms of pH? Recent studies have revealed that Alkaline…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Goji berry: A traditional Chinese berry that packs the best of antioxidants Goji berry is an ancient berry that is considered to be power-packed with nutrients and antioxidants. Which means…
Sciatica pain relief: Get rid of the pain with these easy daily tips Researchers have claimed that not only heat but icing the area too helps relieve sciatica pain. Find out…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
shakeology woman
Meal replacement or protein drink? Learn all about Shakeology and its claims Shakeology from Beachbody claims to be the most suitable shake that can aid in weight loss, regulate blood…
C-Reactive Protein Test A CRP or c-reactive protein blood test is an important diagnostic tool used to determine the risk of…
free psa test
Free PSA Test The free PSA test is used to detect the level or percentage of free PSA in the body…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
shiitake mushrooms healthy
What are Shiitake Mushrooms and why should you eat them? Shiitake Mushrooms are well known for their smoky and robust taste. However, did you know they are replete…
DHEA wrinkles
DHEA: Now get unbelievable age defiance with this wonder hormone! DHEA is known popularly as the age-defying hormone. This supplement is widely used to slow down aging and…
Surgery or home-remedy; what is the right way to treat a burn The treatment of a burn injury depends on its severity. You can save a life by offering the…
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…
asab antisperm antibody test
Antisperm Antibody Test The ASAB or anti-sperm antibody test is a blood/semen test that analyzes the level of sperm-killing antibody protein…
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…
AHBC Igm
Anti-Hepatitis B Core Antigen (AHBc) IgM Anti-hepatitis B core antigen (AHBC) IgM is an investigative procedure to detect the presence of IgM antibodies in…
AUTOIMMUNE HEPATITIS liver
Hepatitis Profile A hepatitis profile or a hepatitis panel is a blood test that checks for markers of hepatitis infection…