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At least 19 recordsLinked to original sources
PubMed2025

Application of Perioperative Real-Time Fluorescence Imaging to Achieve High-Quality Debridement: A Randomized Control Trial.

OBJECTIVE: To investigate the effectiveness of real-time fluorescence imaging (RTFI)-assisted debridement in managing chronic wounds compared with standard surgical debridement. APPROACH: This study was a patient-blinded, randomized clinical trial conducted from February 17, 2021, to July 30, 2021, on patients with chronic wounds. Patients were randomized to an RTFI group (M group) or conventional group (C group). The primary outcomes were as follows: percentage of residual bacterial area (preoperative and postoperative), number of debridements, high-quality debridement ratio, operation duration, and wound healing duration. RESULTS: A total of 100 patients were enrolled in both groups. No significant difference in the percentage of preoperative residual bacterial area or high-quality debridement ratio was seen. The M group underwent debridement an average of 2.6 times and had a significantly longer duration of operation (33.5 &#xb1; 12.7 min) than the C group (29.9 &#xb1; 10.4 min; p = 0.031). The postoperative residual bacterial area was significantly lower in the M than in the C group (6.83% &#xb1; 1.39% vs. 30.0% &#xb1; 12.37%, respectively; p < 0.001). The M group required significantly fewer wound healing days (49.2 &#xb1; 25.3 vs. 63.0 &#xb1; 27.9, p < 0.001). Secondary outcomes also demonstrated statistically significant differences in total hospitalized days (17.5 &#xb1; 9.3 vs. 21.5 &#xb1; 12.5, p < 0.01), days of antibiotic use (15.5 &#xb1; 8.7 vs. 18.7 &#xb1; 6.7, p < 0.01), and reinfection rates (4 of 100 vs. 22 of 100, p < 0.001). INNOVATION: RTFI can detect signals from normal skin components and bacterial metabolites. Therefore, interpretation of RTFI results should be correlated with the clinical condition. RTFI is associated with high-quality debridement. This technique can also be applied in targeted biopsy and in training young staff to mature debridement procedures. CONCLUSION: RTFI in debridement is associated with favorable clinical outcomes and may have a positive influence on chronic wound healing.

Humans↗
PubMed1979

The extent of muscle tissue damage following missile trauma one, six and twelve hours after the infliction of trauma, studied by the current method of debridement.

Spherical missiles with velocities around 1000 m/s were used to inflict missile trauma to one thigh of pigs. The determination of the impact and exit velocities made it possible to calculate the extent of energy transferred to the tissue. About one third of the pigs were treated surgically within one hour after the trauma, one third after a delay of 6 hours and one third after 12 hours. The surgical procedure consisted of debriding muscle tissue which showed impaired contractility and/or consistency and discoloration and/or lack of capillary bleeding - the current criteria of non-viability. The amount of debrided muscle tissue from each wound was weighed and the amount of debrided muscle tissue per joule transferred to the tissue was calculated. As compared to operations performed within one hour the average of the debrided muscle tissue per joule was greater after 6 hours delay and even still greater after 12 hours. However, the difference between the averages after 6 and 12 hours were not statistically significant.

Animals↗
PubMed1978

The extent of tissue damage in missile wounds one and six hours after the infliction of trauma studied by the current method of debridement.

Spherical missiles with velocities around 1000 m/s were used to inflict simultaneously missile trauma to both thighs of pigs. The determination of the impact and exit velocity enabled the extent of energy transferred to the tissues to be calculated. One thigh of each pig was treated surgically within one hour and the other one after a delay of 6 hours after trauma. The surgical procedure consisted of debriding muscle tissue which showed impaired contractility, consistency, discoloration or lack of capillary bleeding--current criteria of non-viability. The amount of debrided muscle tissue at the first operation showed a linear regression versus the extent of energy transfer, whereas after 6 hours no relation could be found between the amount of debrided tissue and energy transfer. There was no significant difference between the amount of debrided tissue per joule of transferred energy when the results of the two operations on each pig were compared.

Animals↗
PubMed1978

Role of debridement and interferon in the treatment of dendritic keratitis.

In a controlled clinical study, 42 patients with dendritic keratitis were treated either with thermocautery plus human leukocyte interferon (HLI) or with minimal wiping debridement plus HLI. The results show that the efficiency with which primary debridement was carried out, determined the success of further therapy using interferon. We conclude that interferon works basically as a prophylactic agent and needs the support of further antiviral measures to be effective against dendritic keratitis.

Debridement↗
PubMed1977

One-stage debridement and plastic repair of compound comminuted depressed skull fractures with methyl methacrylate.

A one-stage technique is described for repair and debridement of compound, comminuted depressed skull fractures using methyl methacrylate, which appears to be simple, effective, and safe, provided that the paranasal sinuses are not involved. If so, a two-stage debridement and repair are recommended. In the series reported, of 25 patients, only one developed infection, which was successfully treated with further operative repair and antibiotics.

Adolescent↗
PubMed1978

A comparison of postsurgical healing following debridement by ultrasonic or hand instruments.

Subjects for the study were 15 patients requiring periodontal surgery in the maxillary posterior quadrants. A split mouth technique with assignment of quadrants by random alternation was used. Assessments were carried out at given time intervals using the Gingival Index, crevicular fluid measurement, Plaque Index and Retention Index. Pain experience following surgery was also noted. Approximately 8 weeks after the initial assessment, periodontal flap surgery was carried out. On the one side debridement was carried out using an ultrasonic scaler, on the other side, hand instrumentation only was used. On the side receiving ultrasonic debridement during surgery, there was an increased rate of healing as measured by the Gingival Index and crevicular fluid. There was no difference in postoperative pain experience, Plaque Index or Retention Index.

Adult↗
PubMed1978

Debridement: an essential component of traumatic wound care.

The harmful influences of devitalized tissue on wound defenses are documented and the importance of wound debridement in the care of the traumatic wound is stressed. All devitalized soft tissues damaged the host's defenses and encouraged the development of infection. The capacity of divitalized muscle, fat, and skin to enhance infection was comparable. The infection-potentiating effect of skin was enhanced by exposing it to a dry thermal injury. The mechanisms by which devitalized soft tissue enhanced infection are several. The devitalized soft tissue acts as a culture medium promoting bacterial growth. In addition, the devitalized tissue inhibits leukocyte phagocytosis of bacteria and subsequent kill. Finally, the anaerobic environment within the devitalized tissue may also limit leukocyte function.

Debridement↗
PubMed1979

[Debridement of burns with proteolytic enzymes from Bacillus subtilis].

50 patients with burns received an enzymatic debridement with bacillus subtilis (Protease-ointment = Travase. Symmetrical control sites were treated without Protease-ointment simultaneously. With the help of Protease-ointment early eschar removal was achieved in deep dermal burns. In full thickness burns the success of the treatment was dependent on the depths of the tissue damage and the early application of Protease-ointment, which allowed the removal of the dermal elements of the eschar whereas fat remained unaffected. In our experience Protease-ointment can be considered a valuable method of eschar removal in addition to surgical measures.

Bacillus subtilis↗
PubMed1979

A preliminary report of the efficacy of Debrisan (dextranomer) in the debridement of cutaneous ulcers.

A randomized trial involving 50 patients has demonstrated that a new type of debriding agent, cross-linked dextran beads with the trade name Debrisan (dextranomer, Pharmacia, Inc.), will produce rapid healing of cutaneous ulcers which have been resistant to conventional therapy over the long-term. Evaluation in terms of a number of therapeutic parameters, including rate of healing, dehydration, sterilization, loss of symptoms, and improvement in physiology, is included in this preliminary study.

Administration, Topical↗
PubMed1978

Early laminar excision: improved control of burn wound sepsis by partial dermatome debridement.

The large mass of devitalized tissue that comprises the burn eschar is gradually becoming recognized as the principal source of complications in the burn patient. Clinical observations suggest that the topical agent silver sulfadiazine does not penetrate the eschar sufficiently to prevent bacterial infection from becoming established in the deeper levels of the wound but does penetrate to a depth of approximately 1.5 mm in bactericidal concentrations. A new technique that takes advantage of this fact, early laminar excision, has been developed at the Children's Hospital of Michigan Burn Center. The eschar is excised layer by layer with the electric dermatome under general anesthesia within the first 72 hr post burn, and the thickness of the devitalized tissue is reduced to a remnant of less than 1 mm. This is less than the depth to which silver sulfadiazine is capable of penetrating in bactericidal concentrations, and greatly enhanced control of burn wound sepsis is achieved. Early laminar excision of the eschar, combined with silver sulfadiazine dressings, aggressive resurfacing of the wound, and increased emphasis on nutrition, is an approach to management of the victims of thermal trauma that should significantly improve survival in patients with burn injuries greater than 60% body surface area.

Adolescent↗