000 02992nam a22003737a 4500
008 170411s20162016 xxu||||| |||| 00| 0 eng d
022 _a0032-1052
040 _aOvid MEDLINE(R)
099 _a27556779
245 _aCurrent Concepts in Debridement: Science and Strategies.
251 _aPlastic & Reconstructive Surgery. 138(3 Suppl):82S-93S, 2016 Sep
252 _aPlast Reconstr Surg. 138(3 Suppl):82S-93S, 2016 Sep
253 _aPlastic and reconstructive surgery
260 _c2016
260 _fFY2017
266 _d2017-04-11
520 _aBACKGROUND: The establishment of a healthy wound bed through adequate debridement of infected, senescent, and/or devitalized tissue is central to the progression of normal wound healing. Although a variety of surgical and nonsurgical strategies have been proposed, none have proven completely effective in all settings. This review focuses on the principles and techniques of modern debridement practices employed in the management of complex wounds.
520 _aCONCLUSION: Optimal management requires a multimodal approach that centers around operative debridement and incorporates the use of adjunctive measures to facilitate the removal of infected tissue, biofilm, and/or senescent cells that impede the progression of normal wound healing.
520 _aMETHODS: A comprehensive review of the PubMed/Medline and Ovid databases was performed to identify basic science and clinical studies using key words most relevant to biofilm, debridement, and wound healing. English language articles that were peer reviewed and that met the standard of evidence-based medicine were included. Level of evidence for various debridement approaches was rated utilizing the American Society of Plastic Surgeons Rating Levels of Evidence and Grading Recommendations.
520 _aRESULTS: The value of both operative and nonoperative debridement techniques, their indications, and limitations are described. With an emphasis placed on surgical debridement, this review highlights technical adjuncts that can be used to optimize wound bed preparation, including preoperative topical staining of the wound, as well as the use of color-guided endpoints to prevent removal of excess healthy tissue. The indications for using temporizing measures for wound control such as negative pressure wound therapy with and without installation are also discussed.
546 _aEnglish
650 _a*Debridement/mt [Methods]
650 _a*Wound Healing
650 _a*Wound Infection/pc [Prevention & Control]
650 _aHumans
650 _aSurgical Wound/th [Therapy]
651 _aMedStar Washington Hospital Center
656 _aSurgery/Plastic Surgery
657 _aJournal Article
700 _aDeFazio, Michael V
790 _aAnghel EL, Attinger CE, Barker JC, DeFazio MV, Janis JE
856 _uhttps://dx.doi.org/10.1097/PRS.0000000000002651
_zhttps://dx.doi.org/10.1097/PRS.0000000000002651
942 _cART
_dArticle
999 _c2219
_d2219