Sunday, June 10, 2018

A Few Essentials On Wound Debridement

By Michael White


When the protective barrier of the skin is breached, a wound is formed. Whether the wound remains clean or becomes infected depends on a number of factors. Surgical wounds are usually clean unless certain systems are directly involved. These systems are the gastrointestinal, genitourinary and respiratory. When this happens, the wound is said to be contaminated. Introduction of foreign bodies and complication with intense foul smelling pus qualifies a wound to be dirty. This is when wound debridement comes in handy.

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.

When normal tissues are exposed to the environment, they are at risk of getting infected by the many bacteria that exist in nature. Once bacteria get in contact with vulnerable skin, the body immediately mounts an immune response. The cells responsible for fighting infection (white blood cells) are transported to the site of bacteria. These cells release substances that are toxic to the survival of the bacteria inside the body. In the event that the immune system fails to correct the anomaly, pus begins to form and the tissues begin to decay.

Debridement of wounds can be achieved using a number of techniques. The commonest form is that which involves the use of surgical methods. Here, the necrotic tissues can be literally removed manually with the help of certain surgical equipment. Depending on how much tissue needs to be extracted, local or general anaesthesia can be incorporated. Use of tissue breakdown (autolysis) by special chemicals is another way to achieve debridement.

Occasionally, maggots can be utilized to manage certain wounds. They work by consuming the bacteria deposited in a given area and prevent its spread to the rest of the body. The only downside to this is that it may not be pleasant site to behold.

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.

It is important that sterile measures are observed when to prevent further spread of infection to the rest of the body. Patients with a low immunity level are disadvantaged because their wounds tend to take longer to heal. Such include persons with diabetes and cancer.




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