Archive for the ‘Debridement’ Category

Maggot Debridement Therapy and Leech Therapy Are Viable Options

Wednesday, May 13th, 2020
maggot debridement therapy

Using maggots and leeches in the healthcare setting can make many people cringe, including seasoned wound care clinicians.

But the age-old treatments of maggot debridement therapy and leech therapy are relatively inexpensive and fairly effective.

“Maggot therapy can save a limb in approximately 40% to 60% of patients scheduled for amputation,” said Ronald Sherman, MD, MSc, DTM&H, director at BioTherapuetics, Education & Research (BTER) Foundation, co-founder.

Sherman also works as the laboratory director at Monarch Labs and a practicing physician in Orange County, Calif.

(more…)

Sharp Debridement: Cutting Through the Confusion

Wednesday, November 13th, 2019
Tools to perform sharp debridement rest on a surgical tray.

I have been training wound care clinicians in sharp debridement for more than 16 years, yet questions and confusion still abound about this practice.

Many clinicians have either received no education or incorrect education regarding sharp debridement and its use in wound care. 

This often leads to infrequent use of sharp debridement or worse, the inappropriate use of the practice. This is a skilled procedure and one should be properly trained before engaging in it.

My hope is to cut through the confusion and offer a solid explanation of this highly effective treatment for managing wounds.

(more…)

Disappointed by Debridement

Friday, March 3rd, 2017

Nancy Collins, PhD, RDN, LD, FAPWCA, FAND

Plaintiffs often express shock and disbelief after eschar is removed, which often leaves a wound larger than the original size of the eschar.

Disappointed by Debridement

Wound photo: “Stage 4 decubitus displaying the Gluteus medius muscle attached to the crest of the ilium” by Bobjgalindo is licensed under CC BY 2.0

“We were in shock and couldn’t believe our eyes. It was like half her foot was gone.”

“My husband and I were horrified when we saw what they did.”

“My sister and I looked at each other, and I just kept asking why?”

“I had to leave the room and go the bathroom to cry when I saw what they did to my mother.”

You might think these quotes are from people who have witnessed a shocking crime or some sort of violence, but they are not. These are quotes from family members, now plaintiffs, who are suing for poor medical care related to a chronic wound. Their shock all had one thing in common—it came after seeing a wound that was surgically debrided.

(more…)

Wound Care Minute: What’s the Difference Between Excoriation and Denuded Skin?

Saturday, December 24th, 2016

Excoriation vs. Denuded: WCEI co-founder Nancy Morgan discusses these often-confused wound care terms

(more…)

Wound Care Myths: 5 More Debunked

Friday, November 25th, 2016

Whether it involves heel protectors, anti-embolism stockings, or letting wounds “breathe,” there are still plenty of wound-care myths circulating out there. Ready for the truth? You can handle it.

Wound Care Myths: 5 More Debunked

Do you use wet-to-dry dressings in order to save money? Have you administered oral antibiotics to treat infected wounds? And do you follow physicians’ orders for wound treatments even though you know they’re inappropriate?

If you answered yes to any of these questions, then you are not alone. You are among a host of other professionals who have believed or participated in some of the most common wound care myths. In an earlier post, we revealed why these and other wound care myths simply need to go away. But wait! Here are five more myths that run counter to the evidence and wound care standards that guide our clinical practice.

(more…)

Wound Care and Debridement: Know the BEAMS

Friday, August 26th, 2016

These five major debridement methods for wound clinicians are easy to remember (hint: BEAMS), and key to the wound healing process.

Wound Care and Debridement: Know the BEAMS

When it comes to healing chronic wounds, clinicians are all about Wound Bed Preparation, which is the process of removing local barriers to wound healing. A key to this process is debridement – the removal of necrotic, dead tissues from the wound bed.

In order to provide the best care possible for your patients, it’s important to know the differences between the two main categories and five major methods of debridement.

(more…)

Maggots and Wound Care: The Not-So-Odd Couple

Monday, May 23rd, 2016

The use of maggots in wound care is making a comeback – in the form of maggot debridement therapy – and wound clinicians can’t wait to talk about it.

Maggots and Wound Care

Most people don’t get too excited about maggots. In fact, the mere mention of legless larvae surely triggers gag responses and/or skin crawling in millions of non-healthcare citizens everywhere. But that’s definitely not the case for those of us in wound care.

(more…)

Debridement Basics. How Many Methods Are There?

Monday, December 1st, 2014

debridementDebridement is the removal of necrotic, dead tissue from the wound bed. It also plays a vital role in the tissue management concept of Wound Bed Preparation. Wound Bed Preparation is the comprehensive approach we use to get our chronic wounds to heal. There are two main categories of debridement: selective and non- selective. Selective methods are where only necrotic, non-viable tissue is removed from the wound bed. Non-selective methods remove both necrotic tissue and viable living tissue.

There are 5 major debridement methods. They are known by the acronym BEAMS. The Selective methods include: Biological, Enzymatic and Autolytic. The non-selective methods are Mechanical and Sharp .

Biological debridement is also known as maggot debridement using sterile medical maggots to remove necrotic tissue. These sterile maggots debride necrotic tissue by liquefying and digesting it, they also kill and ingest bacteria while stimulating wound healing.

Enzymatic debridement is the use of collagenase ointment (Santyl) once daily to the wound bed. The ointment works from the bottom up to loosen the collagen that holds the necrotic material to the wound bed. It is a faster method than autolytic debridement, but slower than sharp debridement.

Autolytic Debridement is the slowest type. It uses the body’s own enzymes to assist in breaking down the necrotic tissue. This is achieved by using products that maintain a moist wound environment. This type of debridement is not appropriate for large amounts of necrotic tissue or infected wounds.

Mechanical debridement is a method that uses an external force to separate the necrotic tissue from the wound bed. This may be painful and removes non-viable as well as viable tissue. Methods include wet to dry dressings, scrubbing, whirlpool and irrigation. Contraindications for mechanical debridement would be epithelializing and granulating wounds.

The fastest method of debridement is the Sharp method. There are 2 types, Sharp surgical (done by a surgeon, physician or podiatrist) or sharp conservative (done at bedside by a trained clinician). It involves the use of scalpels, scissors, curettes or forceps. Sharp surgical is a major procedure that sacrifices some viable tissue where sharp conservative is a minor procedure done at the bedside that removes non-viable tissue.

The debridement method used will be chosen on a variety of factors including the wound characteristics, amount of necrotic tissue in wound, efficiency and selectivity of the debridement method itself, pain management for your patient, the cost of the procedure, exudate levels of the wound, presence of or risk of infection, the patients care setting, and the patients overall medical condition all need to be taken into account.

It is also important to remember not every patient with necrotic tissue will always be a candidate for debridement. Be sure that you understand indications and contraindications for each method when you are selecting the one for your patient.

Click Here for FREE WEBINAR