[Options for debridement in the therapy of chronic wounds].
Debridement is defined as the removal of non-vital tissue from wounds. In chronic wounds, debridement means the elimination of necrosis as well as the clearing away of wound dressings, foreign bodies, and other non-vital substances. Sufficient debridement represents one basic prerequisite for a non-delayed wound-healing process. In addition to treating the causal factors for delayed wound healing, debridement should be the first step in an adequate phase-adapted wound-bed preparation for chronic wounds. This report aims to review the different options available in the execution of debridement in chronic wounds. The following therapeutic measures are available for the debridement of chronic wounds: surgery, maggot therapy, laser, ultrasound, hydrotherapy, wet-to-dry method, autolysis, proteolytic enzymes, osmotic or chemical debridement. There is no single correct debridement for all patients! Patients are individuals and therefore different methods of debridement may make sense. Which therapeutic option is chosen is determined by multiple factors. Moreover, depending on the wound milieu, the successive application of different methods can be useful.
Dissemond
Joachim
J
Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitatsklinikum Essen. joachimdissemond@hotmail.com
Goos
Manfred
M
D002908:Chronic Disease; D002986:Clinical Trials as Topic; D003646:Debridement / Q000379:methods*; D062109:Dermatologic Surgical Procedures; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011379:Prognosis; D012867:Skin / Q000293:injuries*; D016896:Treatment Outcome; D014945:Wound Healing; D014947:Wounds and Injuries / Q000601:surgery*