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indications for surfactant debridement stagnant wounds, local wound infections, burns
benefits of surfactant debridement cleanses wound without the use of cytogenic agents,
reduces inflammation, reduces biofilm, allows for daily visualization of wound
disadvantages of surfactant debridement can be expensive, dressing must be changed
daily
contraindications for surfactant debridement sensitivity to chemical properties
enzymatic debridement a type of non-instrumental debridement that uses collagenase to
dissolve collagen anchors between necrotic tissue and the wound bed
benefits of enzymatic debridement faster than autolysis, good option for those at high
risk for bleeding, safe in infected wounds
,disadvantages of enzymatic debridement costly, daily application, can sting, takes longer
than sharp or mechanical debridement
contraindications of enzymatic debridement not compatible with metal products, some
antiseptic cleansers reduce its activity/effectiveness
chemical debridement by sodium hypochlorite a type of non-instrumental debridement
using sodium hypochlorite (diluted bleach) to dissolve collagen anchors between necrotic tissue
and the wound bed
indications for chemical debridement by sodium hypochlorite grossly necrotic or infected
wounds
benefits of chemical debridement by sodium hypochlorite reduces wound odor, cheap,
non-cytotoxic
disadvantages of chemical debridement by sodium hypochlorite use is controversial, is
cytotoxic to fibroblasts
,contraindications of chemical debridement by sodium hypochlorite do not use in clean
wounds
chemical debridement by silver nitrate a type of non-instrumental debridement using
silver nitrate to reduce fibroblast proliferation and overgrowth
*silver nitrate is a non-selective, caustic, chemical which burns and contacted tissues
benefits of chemical debridement by silver nitrate removes excess granulation tissue,
removes necrotic tissue, can open up epibole, reduces bioburden
disadvantages of chemical debridement by silver nitrate use is controversial, painful, can
stain skin, absorption of toxic silver is possible
contraindications of chemical debridement by silver nitrate avoid use in pediatric
patients as it can cause silver toxicity and is painful
, biosurgical debridement a type of non-instrumental debridement using medical grade
maggots to liquify necrotic tissue through proteolytic enzymes
disadvantages of biosurgical debridement distasteful to most patients/caregivers,
bleeding, pain, crawling sensation
contraindications or biosurgical debridement poorly perfused wounds, exposed blood
vessels, necrotic bones, limb-threatening infections
mechanical debridement by wet-to-dry dressing a type of non-instrumental debridement
done by using damp gauze in the wound bed that is allowed to dry out to trap tissue which is
then pulled off during dressing changes
benefits of mechanical debridement by wet-to-dry dressing cheap, dressing change is
easy to perform, use in heavily necrotic or infected wounds without granulation tissue
disadvantages of mechanical debridement by wet-to-dry dressing painful, non-selective
(will pull off healing tissue with necrotic tissue), time consuming (multiple dressing changes
daily for weeks)