Understanding wound bed preparation and wound debridement

Ousey, Karen; McIntosh, Caroline

doi:10.12968/bjcn.2010.15.sup1.46908

Cited by 24 publications

(17 citation statements)

References 10 publications

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“…Serial sharp wound debridement is one of the mainstays in the chronic leg and foot ulcer therapy . Recurrent cleansing of the wound from necrotic tissue debris and concurrent reduction of bacterial load on the wound surface allows tissue granulation, wound size reduction and finally wound closure.…”

Section: Discussionmentioning

confidence: 99%

Analgesic efficacy of equimolar 50% nitrous oxide/oxygen gas premix (Kalinox®) as compared with a 5% eutectic mixture of lidocaine/prilocaine (EMLA®) in chronic leg ulcer debridement

Traber¹,

Held

Signer³

et al. 2016

International Wound Journal

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Chronic foot and leg ulcers are a common health problem worldwide. A mainstay of chronic ulcer therapy is sharp mechanical wound debridement requiring potent analgesia. In this prospective, controlled, single-centre, crossover design study, patients were assigned to either the administration of topical analgesia with 5% lidocaine/prilocaine cream or the inhalation of an analgesic 50% N O/O gas premix. Primary outcome parameter was level of pain at maximum wound depth during debridement as measured by a visual analogue scale. Secondary outcomes included level of pain after debridement, overall duration of treatment session, duration and completeness of debridement, and the patient's subjective perception of analgesic quality during debridement. Pain level increased from 0·60/0·94 (first/second debridement; baseline) to 1·76/2·50 (debridement) with 5% lidocaine/prilocaine and from 1·00/1·35 (baseline) to 3·95/3·29 (debridement) with 50% N O/O gas premix. Patient satisfaction was 90·48%/94·44% (first/second debridement) with topical 5% lidocaine/prilocaine analgesia and 90·48%/76·47% with the inhalation of 50% N O/O gas premix. Debridement was completed in a significantly higher percentage of 85·71%/88·89% (first/second debridement) with 5% lidocaine/prilocaine than with 50% N O/O gas premix (42·86%/58·82%) (odds ratio 6·7; P = 0·001). This study provides sound evidence that analgesia with topically administered 5% lidocaine/prilocaine cream is superior to the use of inhaled 50% N O/O gas premix in chronic leg ulcer debridement.

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Section: Discussionmentioning

confidence: 99%

Analgesic efficacy of equimolar 50% nitrous oxide/oxygen gas premix (Kalinox®) as compared with a 5% eutectic mixture of lidocaine/prilocaine (EMLA®) in chronic leg ulcer debridement

Traber¹,

Held

Signer³

et al. 2016

International Wound Journal

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“…76,79,83,85 The moist environment allows endogenous collagenase enzymes within the wound to liquefy necrotic tissue, which can then be more easily digested by macrophages. 51,55,57,58,75,77,80,82 The body selectively digests only nonviable tissue and the moist environment allows for painless debridement. 71 Autolytic debridement can be used with superficial-to full-thickness abrasions, avulsions, incisions, and lacerations; superficial-to full-thickness blisters after removal of the necrotic roof with conservative sharp debridement 71 ; and superficial-to partial-thickness punctures.…”

Section: 70mentioning

confidence: 99%

National Athletic Trainers' Association Position Statement: Management of Acute Skin Trauma

Beam

Buckley

Holcomb

et al. 2016

Journal of Athletic Training

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Objective: To present recommendations for the cleansing, debridement, dressing, and monitoring of acute skin trauma in patients.Background: Acute skin trauma is common during participation in athletic and recreational activities. Clinical decisions and intervention protocols after injury vary among athletic trainers and are often based on ritualistic practices. An understanding of cleansing, debridement, and dressing techniques; clinical features of infection and adverse reactions; and monitoring of acute skin trauma is critical for certified athletic trainers and other allied health and medical professionals to create a local wound environment that promotes healing and lessens the risk of complications.Recommendations: These guidelines are intended to provide the certified athletic trainer and others participating in athletic health care with specific knowledge about and recommendations for the management of acute skin trauma.Key Words: abrasions, avulsions, blisters, incisions, lacerations, punctures, cleansing, debridement, nonocclusive dressings, occlusive dressings, infection, adverse reactions T raumatic injury to the skin is common among athletes participating in all sports.1 The exact frequencies of abrasions, avulsions, blisters, incisions, lacerations, and punctures are difficult to calculate because many patients do not seek medical attention after injury; for others, their activity level is initially unaffected, and the injury is not recorded on surveillance reports. Unreported skin trauma and inappropriate wound management can result in delayed healing, cross-contamination, bacterial colonization, and infection, adversely affecting the overall health and playing status of the patient. Managing acute skin trauma through appropriate cleansing, debridement, and dressing techniques can create an environment conducive to healing and lessen the risk of complications. 2,3Wound-management techniques have undergone drastic changes over the last 50 years, and other allied health care professions, organizations, and facilities have developed guidelines that serve as standards of care. [4][5][6] However, guidelines for the management of acute skin trauma by athletic trainers (ATs) are limited in the literature.1,7 The development and implementation of cleansing, debridement, and dressing techniques for acute skin trauma are critical for ATs to successfully deliver health care services to patients. The following review and recommendations provide information on the management of acute skin trauma and guidelines for ATs and other allied health and medical professionals who care for patients. RECOMMENDATIONSThis position statement is based on current research and literature with regard to the cleansing, debridement, dressing, and monitoring of acute skin trauma. We independently categorized the studies and literature using the Strength of Recommendation Taxonomy (SORT) developed by the American Academy of Family Physicians. 8 The taxonomy grades the quality of the data from the literature (level of evidence) and p...

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“…Foams, hydrofibers, crystalline sodium chloride gauze, calcium alginates, hydrogel and hydrocolloids are some of the traditional materials used for occlusive dressing and management of exudates in chronic wounds [10]. Occlusive dressings allow accumulation of homeostatic biomolecules at wound site to promote healing.…”

Section: Occlusive Dressing Materialsmentioning

confidence: 99%

Nanomaterials: New Generation Therapeutics in Wound Healing and Tissue Repair

Singh¹,

A.S

Gade³

et al. 2010

CNANO

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Wound healing and ulcer management is a vast topic that stimulated clinical research due to its major socio economic impact on clinical practices. Last decade of research in clinical science has seen materials at microscale developments which significantly contributed to ulcer management and wound healing with their merits and limitations. The present review outlines the new materials at nanoscale that have been designed and manufactured to address the existing problems in wound care but comparatively less familiar to clinicians for tissue repair and ulcer management. Development in tissue engineering practices spanning from micro-to nano-dimension provided superior materials over traditional wound dressing materials mimicking tissue in vivo. Recent advances in material sciences and polymer chemistry have yielded an entire class of new nanomaterials, ranging from bioactive tissue scaffold to novel electrospun polymer and hydrogel for tissue repair and wound management. Nanoscale materials with biodegradable chemistries and molecular compositions assist wound healing as adhesive and bandages in specialized wound care. Moreover, new class of materials gives opportunity to engineer tissue substrate in vitro to support bio-responsive nanomedicine for wound healing. Soft nanomaterial design technology involving hydrogel and bio-scaffold revolutionized the wound management supplementing biophysical and biochemical considerations of tissue regeneration. In addition, this review addresses the immediate challenges and opportunities provided by nanoscale tissue engineering in designing synthetic biomaterials as instructive extracellular matrix (ECM) for tissue remodeling and morphogenesis.

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Understanding wound bed preparation and wound debridement

Cited by 24 publications

References 10 publications

Analgesic efficacy of equimolar 50% nitrous oxide/oxygen gas premix (Kalinox®) as compared with a 5% eutectic mixture of lidocaine/prilocaine (EMLA®) in chronic leg ulcer debridement

Analgesic efficacy of equimolar 50% nitrous oxide/oxygen gas premix (Kalinox®) as compared with a 5% eutectic mixture of lidocaine/prilocaine (EMLA®) in chronic leg ulcer debridement

National Athletic Trainers' Association Position Statement: Management of Acute Skin Trauma

Nanomaterials: New Generation Therapeutics in Wound Healing and Tissue Repair

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