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Debridement is the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. [2] [3] Removal may be surgical, mechanical, chemical, autolytic (self-digestion), or by maggot therapy.
In other words, though autolysis resembles the active process of digestion of nutrients by live cells, the dead cells are not actively digesting themselves as is often claimed, and as the synonym self-digestion suggests. Failure of respiration and subsequent failure of oxidative phosphorylation is the trigger of the autolytic process. [1]
Amorphous hydrogels are more effective than sheet-form dressings in treatment of full-thickness wounds because they can conform to the shape of the wound bed and facilitate autolytic debridement. [27] Impregnated hydrogel dressings are dry dressings (e.g. gauzes) saturated with an amorphous hydrogel. [28]
The dressing delivers absorption or hydration as needed over each independent wound area and aids in the natural process of autolytic debridement. It effectively removes liquefied slough and necrotic tissue, disintegrated bacterial biofilm as well as harmful exudate components, known to slow the healing process. [41]
It allows the movement of water vapor, oxygen, and carbon dioxide into and out of the dressing. It also plays an additional role in autolytic debridement (removal of dead tissue) which is less painful when compared to manual wound debridement inside the operating theater. It is highly elastic and flexible, thus is closely adhered to the skin.
Autolytic debridement is the use of moist dressings to promote autolysis with the body's own enzymes and white blood cells. It is a slow process, but mostly painless, and is most effective in individuals with a properly functioning immune system.
An open wound after debridement. Debridement is an essential element of effective wound care. [7] Although this view is deeply rooted in practice it is nonetheless based on empirical observation. Bradley et al. have stated that it is "unclear whether wound debridement is a beneficial process that expedites healing". [8]
Surgical debridement: Also known as sharp debridement, this is a process in which devitalized tissue is removed through use of surgical instruments such as scalpels, curettes, or surgical scissors. Surgical debridement can be done in a hospital bed, in an outpatient clinic , or in an operating room depending on the particular wound, risk of ...