title: [Role of debridement in treatment of chronic wounds].
abstract: Debridement is the process of removing dead tissue from the wound bed. Since devitalized tissue can obstruct or completely stop healing of the wound, it is indicated to debride wound bed as part of the treatment process. The aim of debridement is to transform a chronic wound into an acute wound and to initiate the process of healing. Debridement is the foundation of each wound treatment and it has to be repeated, depending on the necrotic tissue formation. There are several types of debridement: surgical, autolytic, chemical, enzymatic, mechanical, and biological. Using previous knowledge and advances in technology, new types of debridement have been introduced. Besides standard methods, methods of pulsed lavage debridement (hydro-surgery, water-jet) and ultrasound-assisted wound treatment (UAW) are ever more widely introduced. The method of debridement the clinician will choose depends on the amount of necrotic (devitalized) tissue in the wound bed, the size and depth of the wound, the underlying disease, the possible comorbidity, as well as on the general condition of the patient. Frequently, the methods of debridement are combined in order to achieve better removal of devitalized tissue. Debridement in addition significantly reduces bacterial burden. Regardless of the method of debridement, it is essential to take pain to the lowest point.
authors.affiliation: Center for Cosmetic and Reconstructive Surgery, University Department of Surgery, Sveti Duh University Hospital, Zagreb, Croatia.
authors.forename: Dubravko
authors.initials: D
authors.lastname: Huljev
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Gajić
authors.forename: Ciril
authors.initials: C
authors.lastname: Triller
authors.forename: Nada Kecelj
authors.initials: NK
authors.lastname: Leskovec
mesh_terms: D003646:Debridement / Q000379:methods; D006801:Humans; D014947:Wounds and Injuries / Q000628:therapy*