A Few Essentials On Wound Debridement

By Michael White


Wounds are created when there is a break in the integrity of the skin. Wounds can be categorized as either clean, contaminated, clean and contaminated and finally, dirty wounds. Clean wounds are those created by surgeons as they make incisions. Clean contaminated wounds come about when either the gastrointestinal, respiratory or genitourinary tract is breached but without a sign of active infection. If signs of infection are present, the wound is said to be contaminated. Wound debridement is indicated for dirty, chronic wounds.

A dirty wound is one that is seen when a foreign substance has been introduced into the body. This happens, for example, when someone gets pricked say by a small piece of wood which gets stuck in tissues. It may also result when one gets shot and the bullet remains lodged in the body. In other situations, dirty wounds may be created in hospital if healthcare providers are not diligent enough when caring for clean wounds. Regardless of which foreign body is involved, the end result is infection if the object is not removed in time.

It takes time for necrotic tissues to spread and cover larger areas. It also takes some time for a bad smell to be detected. One does not need to wait for such extensive complications to set in for them to seek intervention. Infection prevention and rapid healing should begin with the person who has sustained the injury at home or in a work setting. One should ensure that the wound is tentatively dressed to minimise bacterial entry. They should then seek medical care as soon as possible in which case measures such as administration of antibiotics as prophylaxis.

Exposure of body cells to the external atmosphere puts them at risk of invasion by harmful microorganisms. Fortunately, the human body has its own immune system that helps in fighting off infection. This is composed of white blood cells which are recruited to the site of infection immediately the bacteria start multiplying. If the infection is too extensive, the immune system may become overwhelmed and the end result is formation of pus cells and accumulation of dead smelly tissues.

Debridement can be done manually or by use of a chemical. During the manual procedure, the surgeon scraps off dead tissues using special surgical instruments. The patient is put under general or local anaesthesia depending on how much tissue has decayed. In the chemical form of debridement, special chemicals are used to break down the unwanted tissues and lift them off.

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.

In conclusion, wounds can be caused at home or in the hospital when sterility is not observed. People who have a reduced level of immunity(such as those with diabetes) are more likely to suffer from chronic wounds compared to the general population. It is important that debridement is done to allow new, normal skin to form.




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