Chronic wound care is a wound that persists after 4-6 weeks, and a complex wound is one that a health care professional is the one who needs to take care of it. The lack of progression and the complex nature of the wounds are due to multiple reasons and can be explained by the following factors1:
patient-related factors (lack of assessment of comorbidities or factors contributing to the wound, and difficulties related to the patient’s behavior and cooperation);
factors related to the wound (surface, volume, damage to the noble tissues, misdiagnosis of the etiology of the wound, and lack of diagnosis of infectious or ischemic complications of the wound);
factors related to the skills and knowledge of health professionals (absence of standardized or appropriate care protocols);
factors related to environmental or social difficulties in terms of resources available for the treatment of the wound.
OUR INNOVATIVE WOUND THERAPY IS DESIGNED FOR OUTPATIENT SETTINGS
Stiehl Tech is a medical device company focused on creating innovative surgical products for both outpatient and inpatient settings.
Selective Mechanical Debridement
Our Perilav wound irrigation system adapts time-tested surgical debridement methods for the outpatient setting. We make it easier for nursing home staff or home health providers to treat wounds in a more comfortable patient setting. Our unique treatment enclosure bags make a standard treatment safer and simpler by containing fluid and wound debris in an easily disposable bag … read more
Chitosan has been proven to be helpful in wound care as a hemostatic agent. The hemostatic effect is due to the positively charged chitosan interacting with negatively charged red blood cell membranes, initiating the agglutination of red blood cells and platelets. This promotes the activation of thrombin, which activates the clotting pathway, leading to thrombus formation. Objective. Based on the properties of chitosan as a rapidly acting hemostatic agent, the authors sought to determine if a chitosan gelling fiber wound dressing could control bleeding of freshly debrided wounds. The effect of the chitosan dressing on overall healing and patient and provider satisfaction was also evaluated. Materials and Methods. Wounds of any etiology requiring sharp debridement in patients older than 18 years who were capable of consent were eligible. Wounds were sharply debrided by curettage … read more
My goal of care with this six‑week‑old wound on this very anxious patient was to support healing while limiting aggressive debridement to try to mitigate her anxiety. Therefore, the wound hygiene protocol was initiated … I first cleanse the full wound area, including the peri-ulcer skin, with a noncytotoxic antiseptic wound cleanser. Then, I sharply debrided that hard, a sharp cap that you see, and dry fatty necrosis as tolerated by the patient … Then, I refashion the rolled wound edges by abrading the epidermis to promote flattening of the epiboly. Then, I ordered daily dressing changes within an enzymatic debrider … The wound hygiene treatment protocol promotes attention to all aspects of a wound’s healing … read more
Chronic wounds are estimated to affect over 6 million people annually in the United States with an estimated annual cost of $25 billion. Debridement represents a key step in their management and is considered a basic necessity to induce the functional process of tissue repair. However, there is an unmet need for an efficient rapid acting non-surgical debridement agent. Bromelain-based enzymatic debridement has been proven to provide an effective, selective and safe non-surgical debridement in deep burns. EscharEx (MediWound Ltd, Yavne, Israel), is a bromelain-based enzymatic debridement agent currently in development for chronic wounds. The aim of this study was to assess its safety and efficacy in chronic wounds. Seventy-three patients suffering from a lower extremity ulcer of diabetic/venous insufficiency/post-surgical/traumatic aetiology were enrolled in a multicentre … read more
In the English language, the word debridement is used in the specific sense of cleaning a wound of infected, potentially infected, necrotic (dead), eschar (Figure 1), or foreign material (such as fragments of old dressings). To the best of the authors’ knowledge, the word is not used in any other context in English. The word debridement comes from the French language and is even pronounced in English as a French word (de-breed-ment), where it means taking a bridle (the head straps that hold the mouthpiece in place) off a horse … read more
Debridement is the cornerstone of wound care management. It allows for the removal of fibrinous and necrotic debris from the wound bed as well as the reduction of bacterial bioburden, thus allowing for proper granulation and wound healing. Hydrosurgical debridement uses a controlled, high-pressure fluid jet to cut and remove necrotic debris, contaminants, and bacteria, thereby facilitating a potentially more aggressive debridement. Objective. The efficacy of this system was compared with that of other methods of debridement in reducing … read more
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To our readers: This article is the beginning of a series of articles on proper documentation practices for wound care. In this series, I will discuss different topics in wound care documentation practices that I have seen in my travels and found to be insufficient in light … read more
Sharp debridement is by far the fastest way to remove non-viable tissue from a wound bed. This modality must be performed by a licensed skilled practitioner using sharp instruments or tools to remove unhealthy tissue. It is reimbursed by most payers when documentation and medical necessity support its use. There are times when sharp debridement is contraindicated, however. This blog reviews the contraindications and alternatives to sharp debridement … read more
“Maggots are fantastic,” he says. “They eat all the dead and decaying tissue in the wound… [and] remove bacteria by eating them and digesting them, and through their excretions and secretions that they place into the wound.” … Frank explains that these “anti-microbial” properties of the humble maggot keep the infection under control and allow the body to properly heal the wound. The process is known as “debridement”: the removal of dead or infected tissue that in turn improves the healing potential of the healthy tissue. The maggot then disinfects the wound by secreting anti-bacterial substances, and stimulates the production of new, fresh capillaries over the top … read more
On July 24, 2018, I presented a webinar on the topic of the TIME (tissue management, infection or inflammation, moisture balance, and edge of wound) model of wound bed preparation as part of WoundSource’s Practice Accelerator series on wound bed preparation. Preparing a wound for healing is key to ensure that chronic wounds convert to healing wounds. The TIME mnemonic for wound bed preparation assists clinicians and bedside nurses to think critically when making decisions on treatment options. During the image-driven presentation, I discussed such topics as:
Use of the TIME mnemonic to evaluate various wound challenges
A review of terms related to the TIME wound bed preparation model
Visual guidance on different wound types and wound descriptors to determine appropriate next steps for wound healing
There are five types of non-selective and selective debridement methods, but many factors determine what method will be most effective for your patient.1 Determining the debridement method is based not only on the wound presentation and evaluation, but also on the patient’s history and physical examination. Looking at the “whole patient, not only the hole in the patient,” is a valuable quote to live by as a wound care clinician. Ask yourself or your patient these few questions: Has the patient had a previous chronic wound history? Is your patient compliant with the plan of care? Who will be performing the dressing changes? Are there economic factors that affect the treatment plan? Take the answers to these questions into consideration when deciding on debridement methods.
The Primary Methods of Debridement: BEAMS
BEAMS is an mnemonic that is widely used to remember the five types of wound debridement … read more
Debridement is essential to promote healing and prevent infection. There are five main types of debridement methods. BEAMS is the common mnemonic to remember all types: biological, enzymatic, autolytic, mechanical, and surgical. In recent years, new types of debridement technology have been introduced, such as fluid jet technology, ultrasound debridement therapy, hydrosurgery, and monofilament polyester fiber pad debridement.
Combining debridement methods has been found to be an advantage in managing complex wounds and different pathological tissues since 2006. One common method of combining debridement techniques is using enzymatic debridement first to liquefy the tissue and then following with sharp debridement. Combining debridement methods in this way can ensure that you are removing as much dead tissue from the wound as possible and helping to promote wound healing.
Chen and Wang studied chronic pressure ulcers that were described as dry, hard, black, crusting eschar … read more
Manufacturers are developing a wide range of products, like scalpels and pads to treat minor wounds. Innovative plans are underway to entice customers into knowing more about these products. The worldwide industry is segmented into products, end-users, and geographies.
The recent market developments has necessitated a ‘see through’ approach so as to avoid the slippery slope generated by the changing paradigms resulting from the powerful forces of economy, business models, competition and others. “Market Research future” presents its latest report titled “World Wound Debridement Products Market –forecast till 2023” to help clear the blur resulting from these developments and to give the reader a clear picture of the possibilities and nuisances lying ahead!
The worldwide debridement products market is reported to be driven by major traumatic wounds and burgeoning aged population. However, it would experience a sole digit growth rate over the forecast period. Debridement products help clear up germs, microbes, dirt, and infections from human injuries. This helps in the faster treatment of the injuries, rendering patients comfortable.
Rising wound patients, chronic diseases, & product-usage are also driving the market. Apart from these, the need for innovative medical technologies and viability of wound care products add market sales … read more
Background: Mechanical wound debridement is an essential intervention in the treatment of slough pressure ulcers. Therefore, a lot of products are presented in the current local market as effective tools to perform that procedure. There is a need to revise the clinical performance of the available used products in one of the biggest governmental hospitals in Saudi Arabia to support efficient resource utilisation and suggest clinical practice protocols for pressure ulcer treatment. Objectives: The current retrospective cohort study compares the clinical performance of two products regarding mechanical debridement for sloughy sacral and heel pressure ulcer. Methods: The researchers retrospectively cohort the progress of 32 patients with more than 50% slough pressure ulcer, received mechanical debridement by wound care nurse during hospitalisation in the same setting and using the same pressure ulcer treatment protocols, by using either monofilament debridement pads (Debrisoft®; Lohmann and Rauscher) (16 patients) or mechanical debridement by using impregnated sterile gauze monofilaments (UCS™; WelCare Industries S.p.A) for a period of three continuous weeks. The research used PUSH tools as a data collection tool. The Hospital Institutional ReviewBoard approved the study. Results: Both products show the positive progress of pressure ulcer healing status after 3 weeks of application (P<0.01). Also, the progress mean among the monofilament group was significantly higher than the progress mean among the impregnated sterile gauze (P<0.05). Conclusion: The study recommends monofilament debridement pads for mechanical debridement on sloughy (more than 50% of wound bed) pressure ulcers … read more (log in required)
During wound healing, the affected area can become overrun with necrotic – or dead – tissue. This can be harmful to the body’s ability to recover and develop new skin, so debridement may be necessary to remove that dead material. In this way, debridement is essential for preparing the wound bed to promote speedy and efficient healing.
Why is debridement important?
Debridement promotes the wound healing process in a variety of ways. Not only does dead skin inhibit the development of healthy new tissue, but it makes the affected area more susceptible to infection. It can also hide the signs of infection, as dead tissue can increase odor and exudate, making it easier for bacteria and other harmful foreign invaders to spread.
How does debridement work?
Sometimes, debridement occurs naturally on its own thanks to the body’s own ability to shed off dead tissue. However, more often, it requires a medical procedure. There are two different categories of debridement: active and autolytic. Autolytic debridement involves application of hydrocolloids and hydrogels to enhance moisture in the affected area in order to degrade it so the body will naturally deslough the dead tissue. Active debridement involves the manual removal of necrotic material, and it comes in several types of procedures, such as … read more
Abstract:Introduction. Sensory testing of patients with diabetes is an integral part of preventing new and recurrent wounds. The Semmes-Weinstein monofilament (SWM) test is considered the gold standard to screen for loss of protective sensation; however, the authors’ experience has shown that it is not only time consuming, but is of negligible value for a patient with a diabetic foot ulcer (DFU).
Methods. This article discusses the shortfalls with regard to the SWM test and reviews other techniques for sensory evaluation. In addition, the Quick & Easy system is introduced, which combines sensory assessment with guidance for anesthesia requirements during wound debridements or other surgical interventions. Results. A scale ranging from grade 2 (normal sensation) to grade 0 (absent sensation) reflects the patient’s responses to wound manipulation, palpation of an underlying deformity, and/or evaluation of the difference between light touch sensation with the patient’s hands compared to the feet. For patients with total loss of sensation (grade 0), no anesthesia is needed for surgical procedures. If there is diminished sensation (grade 1), surgical intervention can be performed following administration of either topical or local anesthesia. For patients with normal sensation (grade 2), complete anesthesia of the surgical site will be required. A preliminary observation was conducted on 50 patients with DFUs using the Quick & Easy system. Anesthetic requirements were accurately predicted in all cases without the need to modify the type of anesthesia during the procedure. Conclusion. The Quick & Easy system serves as a simple sensory evaluation for a patient with a DFU and provides valuable anesthesia guidance for wound care procedures … read more
Originally appears to be a typical looking callus on a diabetic; this is NOT a callus and is actually a diabetic foot ulcer that is superficially infected. These are serious wounds and are the beginnings of what lead to foot and leg amputations if they are not treated promptly by your healthcare provider, AKA Podiatrist. (or wound care doc – editors note)