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Text and Atlas of Wound Diagnosis and Treatment, 2e
Chapter 12: Wound Debridement Dot Weir; Pamela Scarborough
INTRODUCTION CHAPTER OBJECTIVES
At the end of this chapter, the learner will be able to: 1. Discuss the contribution of debridement to wound bed preparation. 2. Define the types of debridement currently used in wound care practice. 3. Differentiate selective from nonselective debridement. 4. Select the appropriate type of debridement for patients whose wounds would benefit from the procedure.
Debridement as a Component of Wound Bed Preparation Wound bed preparation is the global management of chronic wounds, which includes the goals of removing necrotic tissue from the wound, reducing the wound bacterial burden, managing the moisture content, and ensuring that the wound edges are conducive to cellular migration for resurfacing the wound (FIGURE 121). These components of wound bed preparation contribute to the correction of abnormal wound repair with the goal of facilitating the process of wound closure and subsequent healing. Adequate wound bed preparation is required prior to the use of advanced wound care therapies, such as cellular and tissuebased products, other biological wound interventions, collagen, and negative pressure wound therapy.1 FIGURE 121
The components of wound bed preparation are expressed in this paradigm of DIME, and can guide the clinician in the principles to facilitate wound healing.
Debridement of necrotic tissue from a wound bed is a key component of preparing a chronic wound for closure and subsequent healing (FIGURE 12 2).2–12 Numerous evidencebased wound care guidelines describe the importance of adequate and repeated debridement as a fundamental intervention for chronic nonhealing wounds. One of these wellknown international documents is the European Pressure Ulcer Advisory Panel (EPUAP) and the National Pressure Ulcer Advisory Panel (NPUAP) guideline Pressure Ulcer Prevention and Treatment: Clinical Practice, which states several reasons to debride a chronic wound (TABLE 121).13 Downloaded 2022323 7:58 A Your IP is 165.84.189.140 Chapter Wound Debridement, Dot Weir; Pamela Scarborough CLINICAL12: CONSIDERATION ©2022 McGraw Hill. All Rights Reserved. Terms of Use • Privacy Policy • Notice • Accessibility
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The presence of necrotic or devitalized tissue on the surface of a wound prevents accurate assessment of the extent of tissue destruction or depth of the wound.