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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 .
Symptoms may include pus from a wound, redness, swelling, pain, warmth, tachycardia, or tachypnea. [4] Complications can include infection of the bone, tissue death, amputation, or sepsis. [2] They are common and occur equally frequently in males and females. Older people are more commonly affected.
Diabetic foot ulcer is a breakdown of the skin and sometimes deeper tissues of the foot that leads to sore formation. It is thought to occur due to abnormal pressure or mechanical stress chronically applied to the foot, usually with concomitant predisposing conditions such as peripheral sensory neuropathy, peripheral motor neuropathy, autonomic neuropathy or peripheral arterial disease. [1]
Research into hormones and wound healing has shown estrogen to speed wound healing in elderly humans and in animals that have had their ovaries removed, possibly by preventing excess neutrophils from entering the wound and releasing elastase. [26] Thus the use of estrogen is a future possibility for treating chronic wounds.
Wound bed preparation (WBP) is a systematic approach to wound management by identifying and removing barriers to healing. The concept was originally developed in plastic surgery. [1] [2] It includes wound assessment, debridement, moisture balance, bacterial balance, and wound cleaning.
Timing is important to wound healing. Critically, the timing of wound re-epithelialization can decide the outcome of the healing. [11] If the epithelization of tissue over a denuded area is slow, a scar will form over many weeks, or months; [12] [13] If the epithelization of a wounded area is fast, the healing will result in regeneration.
A wound is any disruption of or damage to living tissue, such as skin, mucous membranes, or organs. [1] [2] Wounds can either be the sudden result of direct trauma (mechanical, thermal, chemical), or can develop slowly over time due to underlying disease processes such as diabetes mellitus, venous/arterial insufficiency, or immunologic disease. [3]
When proper blood flow is established, debridement is performed. If the wound is plantar (on walking surface of foot), patient is advised to give rest to foot to avoid enlargement of the ulcer. Proper glycemic control in diabetics is important. Smoking should be avoided to aid wound healing. [6]