Debridement

Optimizing

Controlling

importance of Optimizing and controlling the wound bed environment

A wound management plan should include a thorough wound assessment and selection of products 

capable of addressing the specific needs of the wound.  Setting goal oriented strategies to gain control 

over the wound environment will help get the wound back on track towards healing.  Appropriate goals 

such as maintaining the physiologic wound environment (e.g., debridement, cleansing, prevention/

management of infection)

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 and providing systemic support (e.g., edema reduction, nutrition, hydration) 

are the foundation to the process.

When necrotic tissue is present, there are a number of related factors that could be the root cause of 

delayed healing: 

 

n

  Non-resolving inflammation

 

n

 

Bacterial infection or 10

6

 organisms per gram of wound tissue

 

n

 

Elevated levels of proteases

 

n

 

Impaired perfusion and decreased tissue oxygenation or oxidative stress

Removal of necrotic tissue is therefore fundamental to allowing the wound to progress and has many 

beneficial effects.  Proper debridement removes and reduces the barriers that impede the healing process 

and provides an environment that stimulates the growth of healthy tissue needed for wound healing.

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