Traumatizace rány při chirurgickém débridementu – experimentální studie
Authors:
Jan Stryja
Authors‘ workplace:
Vzdělávací a výzkumný institut AGEL, o. p. s., Třinec
; Komplexní kardiovaskulární centrum, Nemocnice Podlesí a. s., Třinec.
Published in:
Hojení ran 8, č. 1: 37-42, 2014
Category:
Debridement
Overview
Surgical debridement is included in many guidelines and clinical standards. The meaning of surgical debridement is to remove necrotic parts of tissue, coatings, foreign bodies, stuck remains of dressings and senescent cells without any ability to reproduce. We can assume different techniques of surgical debridement bring about different grade of local tissue trauma. This experiment is objectifying the soft tissue trauma degree on experimental wound model during sharp debridement procedure and comparing the tissue sample trauma degrees (n=128). We tested debridement realized by surgical scissors, scalpel, electrocautery and hydrosurgery (Versajet device). The analysis of the obtained experimental data gave appealing information hydrosurgery method has reconcilable lower levels of wound surface damage and clinical efficiency related to wound healing than scissors and electrocauthery (p=0.00013, p=0.00145). There was no difference (p=0.17775 ) in tissue trauma degree spread between scalpel and hydrosurgery. Surgical scissors cause more serious wound bed trauma, they are unselective and increase the incidence of secondary necrosis at the wound bed.
Key words:
sharp debridement, tissue trauma, scalpel, scissors, electrocautery, hydrosurgery
Sources
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Lebrun, E., Tomic-Canic, M., Kirsner, R. S. The role of surgical débridement in healing of diabetic foot ulcers. Wound Repair Regen 18, 5: 433–438, 2010.
National Institute for Clinical Excellence. Guidance for the use of debriding agents for difficult to heal surgical wounds. London: NICE, 2001. (NICE 2001)
Stryja, J. How to rate the wound débridement trauma? Journal Eur Wound Management Association (EWMA) 12, 1: 7–12, 2012.
Tenenhaus, M., Bhavsar, D., Rennekampff, H. O. Treatment of deep partial thickness and indeterminate depth facial burn wounds with water-jet débridement and a biosynthetic dressing. Injury 38, Suppl 5: S38–S45, 2007.
Labels
Surgery Nurse Home nurseArticle was published in
Wound Healing
2014 Issue 1
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