Advertisement

Debridement

  • Vibhakar Vachhrajani
  • Payal Khakhkhar
Chapter

Abstract

Debridement plays a major role in wound management, it is a complete science. It requires expertise to know when to debride, how much to debride and when not to debride. Simple debridement with gauze and scoop is helped by advances in debridement technology like whirlpool, water pressure devices, water knife, ultra sound, laser, etc. Advances in dressing materials provides environment for better autolytic debridement. Maggot therapy is an age old biological debriding therapy.

References

  1. 1.
    Falanga V. Growth factors and chronic wounds: the need to understand the microenvironment. J Dermatol. 1992;19:667.CrossRefGoogle Scholar
  2. 2.
    Edwards R, Harding KG. Bacteria and wound healing. Curt Opin Inf Dis. 2004;17:19.Google Scholar
  3. 3.
    Armstrong DA. Clinical care of diabetic foot. Chapter 7. 2005.Google Scholar
  4. 4.
    Caselli A, Latini V, Lapenna A, et al. Transcutaneous oxygen tension monitoring after successful revascularization in diabetic patients with ischemic foot ulcers. Diabet Med. 2005;22(4):460–5.CrossRefGoogle Scholar
  5. 5.
    Wyss CR, Robertson C, Love SJ, et al. Relationship between transcutaneous oxygen tension, ankle bllo pressure, and clinical outcome of vascular surgery in diabetic and nondiabetic patients. Surgery. 1987;101(1):56–62.Google Scholar
  6. 6.
    Haynes LJ, Brown MH, Handley BC. Comparison of Pulsavac and sterile whirlpool regarding the promotion of tissue granulation. Phys Ther. 1994;74:S4.Google Scholar
  7. 7.
    Tao H, Butler J, Luttrell T. The role of whirlpool in wound care. J Am Coll Clin Wound Spec. 2012;4(1):7–12.CrossRefGoogle Scholar
  8. 8.
    Perry A, Potter P, Ostendorf W. Clinical Nursing Skills and Techniques. 8th ed. Elsevier Health Sciences; 2013.Google Scholar
  9. 9.
    Bohannon RW. Whirlpool versus whirlpool and rinse for removal of bacteria from a venous stasis ulcer. J Am Phys The Assoc. 1982;62:304–8.Google Scholar
  10. 10.
    Burke D, Ho C, Saucier M, Stewart G. Effects of hydrotherapy on pressure ulcer healing. Am J Phys Med Rehabil. 1998;77(5):394–8.CrossRefGoogle Scholar
  11. 11.
    Gogia PP, Hurt BS, Zirn TT. Wound management with whirlpool and infrared cold laser treatment: a clinical report. Phys Ther. 1988;68:1239–42.Google Scholar
  12. 12.
    Luedtke-Hoffmann KA, Schafer DS. Pulsed lavage in wound cleansing. Phys Ther. 2000;80:292–300.Google Scholar
  13. 13.
    Hess CL, Howard MA, Attinger CE. A review of mechanical adjuncts in wound healing: hydrotherapy, ultrasound, negative pressure therapy, hyperbaric oxygen, and electrostimulation. Ann Plastic Surg. 2003;51(2):210–8.CrossRefGoogle Scholar
  14. 14.
    Kloth LC, Feedar JA. Acceleration of wound healing with high voltage, monophasic, pulsed current. Phys Ther. 1988;68(4):503–8.CrossRefGoogle Scholar
  15. 15.
    Gogia PP, Hurt BS, Zirn TT. Wound management with whirlpool and infrared cold laser treatment. Phys Ther. 1988;68(8):1239–42.Google Scholar
  16. 16.
    David G Armstrong. Clinical care of diabetic foot. Chapter 7. 2005.Google Scholar
  17. 17.
    Crosskey RW. Introduction to the Diptera. In: Lane RP, Crosskey RW, editors. Medical insects and arachnids. London: Chapman & Hall; 1995.Google Scholar
  18. 18.
    Evans H. A treatment of last resort. Nurs Times. 1997;93:62–64,65.Google Scholar
  19. 19.
    Sherman RA, Wyle FA, Thrupp L. Effects of seven antibiotics on the growth and development of Phaenicia sericata larvae. J Med Entomol. 1995;32:646–9.CrossRefGoogle Scholar
  20. 20.
    Thomas S, Jones M. Maggots and the battle against MRSA. Bridgend: The Surgical Material Testing Laboratory; 2000.Google Scholar
  21. 21.
    Bexfield A, Nigam Y, Thomas S, Ratcliffe NA. Detection and partial characterisation of two antibacterial factors from the excretions/secretions of the medicinal maggot Lucilia sericata and their activity against methicillin-resistant Staphylococcus aureus. Microbes Infect. 2004;6:1297–304.CrossRefGoogle Scholar
  22. 22.
    Armstrong J, Zhang L, McClellan AD. Axonal regeneration of descending and ascending spinal projection neurons in spinal cord-transected larval lamprey. Exp Neurol. 2003;180:156–66.CrossRefGoogle Scholar
  23. 23.
    Lerch K, Linde HJ, Lehn N Grifka J. Bacteria ingestion by blowfly larvae: an in vitro study. Dermatology. 2003;207:362–6.CrossRefGoogle Scholar
  24. 24.
    Robinson W, Norwood VH. Destruction of pyogenic bacteria in the alimentary tract of surgical maggots implanted in infected wounds. J Lab Clin Med. 1934;19:581–6.Google Scholar
  25. 25.
    Mumcuoglu KY, Miller J, Mumcuoglu M, Friger M, Tarshis M. Destruction of bacteria in the digestive tract of the maggots of Lucilia sericata. J Med Entomol. 2001;38:161–6.CrossRefGoogle Scholar
  26. 26.
    Prete P. Growth effects of Phaenicia sericata larval extracts on fibroblast: mechanism for wound healing by maggot therapy. Life Sci. 1997;60:505–10.CrossRefGoogle Scholar
  27. 27.
    Sinclair RD, Ryan TJ. Types of chronic wounds: indications for enzymatic debridement. In: Westerhof W, Vanscheidt W, editors. Proteolytic enzymes and wound healing. Berlin: Springer Verlag; 1994. p. 7–21.CrossRefGoogle Scholar
  28. 28.
    Himel H. Wound healing: focus on the chronic wound. Wounds. 1995;7(Suppl A):70A–7A.Google Scholar
  29. 29.
    Donati L. Surgical versus enzymatic debridement. In: Westerhof W, Vanscheidt W, editors. Proteolytic enzymes and wound healing. Berlin: Springer; 1994. p. 31–47.CrossRefGoogle Scholar
  30. 30.
    Baharestani M. The clinical relevance of debridement. In: Baharestani M, Gottrup F, Vanscheidt W, editors. The clinical relevance of debridement. Berlin: Springer Verlag; 1999. p. 1–13.Google Scholar
  31. 31.
    Dealey C. The care of wounds. Oxford: Blackwell Scientific Publications; 1994.Google Scholar
  32. 32.
    Vowden KR, Vowden P. Wound debridement, Part 2: Sharp techniques. J Wound Care. 1999;8:291–4.CrossRefGoogle Scholar
  33. 33.
    Doughty P. Principles of wound healing and wound management. In: Bryant RA, editor. Acute and chronic wounds: nursing management. St. Louis: Mosby Year book; 1992.Google Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  • Vibhakar Vachhrajani
    • 1
  • Payal Khakhkhar
    • 1
  1. 1.Diabetic foot and wound managementVijay Vachhrajani Memorial Hospital RajkotIndia

Personalised recommendations