Sharp wound debridement: patient selection and perspectives

Abstract

Conservative sharp wound debridement, as part of the wound bed preparation paradigm, can be performed in a wide variety of settings including the patients' home or community clinic settings, by health care professionals who perform within their scope of practice and have been certified to be competent. This paper reviews the components that must be in place to ensure safe delivery of conservative sharp wound debridement for an increased number of clinicians, with organizational support, based on practices in a Canadian context. Expected goals are a cleaner wound bed, with an increased percentage of viable tissue, decreased amount of wound exudate, corresponding decreased risk of wound infection and malodor, and improved periwound skin.

Bactericidal Effect of Ultrasound-Responsive Microbubbles and Sub-inhibitory Gentamicin against Pseudomonas aeruginosa Biofilms on Substrates With Differing Acoustic Impedance

“…The longest established method of biofilm eradication from chronic wounds is debridement (Yazdanpanah et al 2015), which has been found to expedite wound healing and reduce the overall size of a wound (Rhoads et al 2008). However, complete wound healing requires multiple invasive treatments, typically carried out over a period of months (Harris et al 2018;Michailidis et al 2018). Although the efficacy of debridement can be increased with the use of chemicals such as hydrogen peroxide or certain enzymes (Watters et al 2016), failure to remove biofilm persister cells from the wound bed is a common cause of recalcitrance (Percival et al 2011).…”

Analisis Asuhan Keperawatan melalui Penggunaan Teknik Conservative Sharp Wound Debridement (CSWD) pada Tn. H dan Ny. S dengan Diagnosa Diabetic Foot Ulcer di Wocare Center Kota Bogor

“…Hal ini dianggap sebagai standar perawatan dan dilakukan berulang kali (Thomas et al, 2021). Tujuan melakukan CSWD adalah untuk menghilangkan non-viable jaringan sehingga mencapai dasar luka yang lebih bersih, dengan peningkatan dalam persentase jaringan yang layak, penurunan jumlah luka eksudat, penurunan risiko infeksi luka dan bau busuk (Harris et al, 2018).…”

“…Setelah jaringan nekrotik diangkat kemudian inflamasi sudah berhenti maka luka akan masuk ke fase proliferasi dan mulai membentuk jaringan granulasi. Saat itulah proses perbaikan luka akan dimulai (Harris et al, 2018).…”

Preparation for a Successful Skin Grafting

“…We should assess the wound using a validated wound assessment tool such as the Bates-Jensen Wound Assessment tool [2]. Skin grafting can be done in the presence of well-vascularized peritendon and periosteum.…”

“…Conservative Sharp Wound Debridement (CSWD) is a suitable method of debridement when there is dead necrotic tissue such as slough or eschar, callustissue around the wound, or hyperkeratosis (which is clearly demarcated from the healthy tissue, where other types of debridement may not give optimum result and/or where speed is essential) [2].…”