Dr. Wang pointed out that there are three main purposes of debridement: removing infected necrotic tissue, removing biofilm and removing aging cells, and promoting wound healing by achieving the above three goals. The correlation between these three targets and the wound will be explained below.
1. Remove infected necrotic tissue: When there are too many infected or necrotic materials in the wound, our immune system will stand up first to resist the invasion of bacteria, fungi and viruses. This is the natural protection process of the body, but just like war, local adjacent tissues will always be infected, inflamed, swollen and painful. In this case, it is difficult to reconstruct and heal the wound.
2. Removal of biofilm: biofilm is a "colony formed by a variety of bacteria", that is, a thin yellow-gray film on the wound, which is difficult to wipe off with a cotton swab. At present, it is found that this biofilm has resistance to organism immunity and general dressing change.
3. Eliminate aging cells: When the wound exists for a long time, the differentiation and proliferation ability of some cells in contact with air will be greatly reduced, and inactive cells will be formed, which makes the growth rate of the wound extremely slow, which is also the reason why chronic wounds often fail to heal. Therefore, clearing the aging cells by debridement can make the following active cells appear, play a role in wound recovery and increase the speed of wound healing.
Dr. Wang Guanzhi also said that in a broad sense, in addition to the well-known surgical debridement, there are actually other debridement methods, such as mechanical and physical debridement, biological debridement and autolysis.
1. Mechanical physical debridement: gauze dressing change. Simple gauze dressing change actually has a debridement effect. When the gauze is torn off, more or less necrotic tissue is removed with the tearing off of the gauze, so the dressing change process itself is a good example of wound debridement.
2. Biological debridement: At present, it is rarely mentioned in Taiwan Province Province, because its main method is to use "medical maggots" for treatment. At present, there is no such treatment for debridement in China.
3. Autolysis debridement: protein is used to dissolve the necrotic tissue of the wound and promote the metabolism of local necrotic tissue. At present, some wound gels have this function. When the wound is small or the amount of necrotic tissue is small, the doctor can open the wound gel to promote the removal of necrotic tissue and accelerate the recovery of the wound.
4. Surgical debridement: Once the wound is too large, there are too many necrotic tissues or too many visceral colonies in the wound, surgical debridement is the best debridement method, which is usually carried out under local anesthesia or general anesthesia in medical institutions. Through the doctor's clinical judgment, foreign bodies and necrotic tissues in unclean wounds can be removed, so as to control infection and promote healing.
(Health Care Network)