General Principles of Surgical Débridement



General Principles of Surgical Débridement


Lawrence X. Webb, MD, MBA

Henry J. Dolch, DO


Dr. Webb or an immediate family member is a member of a speakers’ bureau or has made paid presentations on behalf of the Musculoskeletal Transplant Foundation; serves as a paid consultant to or is an employee of Biocomposites; has received nonincome support (such as equipment or services), commercially derived honoraria, or other non-research-related funding (such as paid travel) from Kinetic Concepts, Doctors Group, Smith & Nephew, Stryker, and Synthes; and serves as a board member, owner, officer, or committee member of the Orthopaedic Trauma Association Southeastern Fracture Consortium Foundation. Neither Dr. Dolch nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this chapter.



INTRODUCTION

A wound characterized by tissue that is contaminated and/or devitalized is best managed with surgical débridement; that is, removal of contaminants as well as the devitalized tissue.1 The goal of this process is to alter the wound environment, so that healing can occur readily and free of infection. The surgeon must carefully assess the nature of the wound. If surgical extensions are needed to better evaluate and débride the wound, then they should be incorporated. Bone stabilization should be done with an aim to provide stability. It should be accomplished in such a way as to minimize the likelihood for osteonecrosis which in turn potentiates infection. Stable soft-tissue coverage is needed to thwart necrosis of dessication-prone tissue such as exposed bone, joint or tendon devoid of paratenon.

image VIDEO 68.1 Surgical Débridement. Lawrence X. Webb, MD; Henry J. Dolch, DO (6 min)



Feb 2, 2020 | Posted by in ORTHOPEDIC | Comments Off on General Principles of Surgical Débridement
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