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Debridement is an important part of the healing process for burns and other serious wounds; it is also used for treating some kinds of snake and spider bites. Sometimes the boundaries of the problem tissue may not be clearly defined.
The wound is initially cleaned, debrided and observed, typically 4 or 5 days before closure. The wound is purposely left open. Examples: healing of wounds by use of tissue grafts. If the wound edges are not reapproximated immediately, delayed primary wound healing transpires. This type of healing may be desired in the case of contaminated wounds.
Debridement is defined as removal of devitalized or dead tissue, particularly necrotic tissue, eschar, or slough. Debridement is a critical aspect of wound care because devitalized tissue, particularly necrotic tissue, serves as nutrients for bacteria thereby promoting infection.
The optimal timing of performing wound debridement and closure is debated and dependent on the severity of the injury, resources and antibiotics available, and individual needs. [ 20 ] [ 1 ] Debridement time can vary from 6 to 72 hours, and closure time can be immediate (less than 72 hours) or delayed (72 hours to up to 3 months). [ 20 ]
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.
A chronic wound is a wound that does not heal in an orderly set of stages and in a predictable amount of time the way most wounds do; wounds that do not heal within three months are often considered chronic. [1] Chronic wounds seem to be detained in one or more of the phases of wound healing.
However, newer studies have shown that early wound closure and early fixation reduces infection rates, promotes fracture healing and early restoration of function. Therefore, assessment of all open fractures should include the mechanism of injury, the appearance of soft tissues, the likely levels of bacterial contamination and the specific ...
When debridement is necessary, wounds are left open so that serial debridements may be performed over the course of the wound's healing. [7] Antibiotic choice should be guided by deep tissue culture, severity of the infection, presence or absence of osteomyelitis, prior antibiotic treatment, and previous or current MRSA infection. [17]