wound debridement advancements

    wound debridement advancements

    Wound care of the foot and ankle today has come a long ways from years back of wet to dry dressings. With the growth of wound care centers and limb preservation programs we are able to heal wounds quicker than ever before. As well the need for amputations of toes , feet and legs are going down with proper treatment. One of the methods to heal wounds is debridement. This is just on part of the treatment and not the only thing that will heal a wound. One must remember that good blood flow and a environment free of infection and a deformity free foot are also important. healing wounds takes a multiple specialty approach that includes podiatry infectious disease specialists and vascular specialists.

    wound debridement advancement

    Wound debridement is the removal of non viable tissue from the bed of the wound. Many wounds that are slow to heal have overgrowth of tissue in it that slows down and prevents new skin to cover the wound. I compare it to a garden , how do you get a garden to grow grass you need to

    Heel wound with gangrene

    Heel wound with gangrene


    remove the weeds (debride the wound) water the grass (good vasculature and good circulation) and make sure there are no aphids and fungi growing ( remove bioburden such as infection).


    wound debridement advancements

    How does one remove the bad tissue from wounds?  Years ago the doctor would put a wet dressing on it and then it would dry and when it dried out the doctor would tear it off and along came with it the bad tissue. That was called a wet to dry dressing. We have moved away from that to much better techniques. Yes there is the classic method of using a scalpel , which works great. However the drawback to the scalpel method is that it inevitably removed healthy tissue along with it. Today there are 2 excellent water systems that remove the dead tissue one is the versajet

    The other is called Misonix

    this is myself performing a debridement with misonix

    Misonix tissue debridement











    These methods give an accurate way of removing dead tissue while maintaining the live tissue.

    One other method for which i have had tremendous success is the use of Santyl ointment http://www.santyl.com/  this is an ointment that removed the bad tissue and KEEPS the healthy tissue via enzymatic debridement. It uses collagenase to remove the unwanted tissue  and promote the growth of new skin tissue. So if you are going week after week to a wound care center for a foot wound or a diabetic foot wound or even a wound on your foot and leg from an injury of a surgery incision that has not healed  make sure to learn about these methods and see if they are right for you.

    Wound testimonial from a patient of Dr Wrotslavsky  (reprinted with patient permission)  ” Dear Dr Wrotslavsky, Thank you for caring for me and closing my wound. I was going to a wound care center for 6 months and my wound was not getting smaller. You were able to diagnose the underlying issue and took me straight to the operating room and cleaned it up. You then put a skin graft on it and now my wound is closed. I am so happy to be back in shoes , thank you”  Joan M.  La Jolla San diego.