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There is no difference in infection rates for performing surgery within 6 hours of injury when compared to until 72 hours after injury. [5] [21] NICE guidelines suggest that the surgical debridement should be done immediately for open fracture that are highly contaminated or where there is a lot of bleeding (vascular compromise). [22]
Wound bed preparation (WBP) is a systematic approach to wound management by identifying and removing barriers to healing. The concept was originally developed in plastic surgery. [1] [2] It includes wound assessment, debridement, moisture balance, bacterial balance, and wound cleaning.
Debridement is the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. [2] [3] Removal may be surgical, mechanical, chemical, autolytic (self-digestion), or by maggot therapy.
At some point before surgery a health care provider conducts a preoperative assessment to verify that a person is fit and ready for the surgery. [ 1 ] [ 2 ] For surgeries in which a person receives either general or local anesthesia, this assessment may be done either by a doctor or a nurse trained to do the assessment. [ 2 ]
The wound is initially cleaned, debrided and observed, typically 4 or 5 days before closure. The wound is purposely left open. Examples: healing of wounds by use of tissue grafts. If the wound edges are not reapproximated immediately, delayed primary wound healing transpires. This type of healing may be desired in the case of contaminated wounds.
Maggot therapy (also known as larval therapy) is a type of biotherapy involving the introduction of live, disinfected maggots (fly larvae) into non-healing skin and soft-tissue wounds of a human or other animal for the purpose of cleaning out the necrotic (dead) tissue within a wound (debridement), and disinfection. There is evidence that ...
The wound can be allowed to close by secondary intention. Alternatively, if the infection is cleared and healthy granulation tissue is evident at the base of the wound, the edges of the incision may be reapproximated, such as by using butterfly stitches , staples or sutures .
A wound is any disruption of or damage to living tissue, such as skin, mucous membranes, or organs. [1] [2] Wounds can either be the sudden result of direct trauma (mechanical, thermal, chemical), or can develop slowly over time due to underlying disease processes such as diabetes mellitus, venous/arterial insufficiency, or immunologic disease. [3]