Surgical debridement involves the use of sharp instruments like scalpels or scissors to remove the devitalized tissue to make a chronic wound look like an acute wound. The removal of the devitalized tissue hastens healing by allowing for the granulation tissue to grow. Chronic wounds require a series of debridement also known as âmaintenance debridementâ which should be accurate and efficacious. Surgical debridement allows rapid clearance of the devitalized tissue and is optimal for wounds with extensive and adherent eschar. The disadvantage is associated inadvertent viable tissue removal as there is lack of any objective biological/molecular marker to discriminate impaired and nonimpaired tissue to direct the extent of debridement. The limiting factors include inadvertent bleeding and poor pain tolerance by the patient .The use of high pressure saline beam to debride the devitalized tissue from wound bed has been advocated in place of scalpel debridement. This hydrodissection or hydrocision with the use of Versa jet acts tangentially over the soft tissue surface and creates a smooth wound bed while preserving dermal tissue. It has been found to be effective modality in treatment of chronic leg ulcers and burns.
Techniques in Chronic Wound Management: Review of the Literature and Recent Concepts: Dinker R Pai and Simerjit Singh Madan
Last date updated on September, 2014