Provider Prepared’s Weekly Pearl of Wound Wisdom #5 -A case for debridement
A 23 year old male presents to the Emergency Department after being involved in a motorcycle accident. He has extensive laceration to the left forearm. The accident occurred within a couple hours of the street having new ‘chip seal’ applied to the road surface. The laceration is heavily contaminated with rock, dirt, and dust; all secured to the subcutaneous tissues by a layer of fresh tar.
With a wound that is heavily contaminated with foreign material that can not be cleansed with irrigation, sharp excisional debridement is an appropriate option. Debridement of the epidermal and dermal layers should be completed using a scalpel, rather than scissors. This prevents the crimping of these tissues which can cause vascular compromise to the wound edge, and thus delayed healing. Subcutaneous adipose tissue is appropriately debrided with scissors. The crimping action of scissors at this level does not affect wound healing.
Roberts, JA et al. Clinical Procedures in Emergency Medicine 2010. 571-572
After multiple valiant attempts of vigorous irrigation, the tar within the forearm laceration remains intact. Sharp debridement utilizing a #15 blade effectively removed the contaminated tissue allowing proper wound cleansing. Tackle all of your wound debridement tasks with Provider Prepared Laceration kits equipped with a scalpel and sharp scissors!
Provider Prepared
Nathan Whittaker, MD
With a wound that is heavily contaminated with foreign material that can not be cleansed with irrigation, sharp excisional debridement is an appropriate option. Debridement of the epidermal and dermal layers should be completed using a scalpel, rather than scissors. This prevents the crimping of these tissues which can cause vascular compromise to the wound edge, and thus delayed healing. Subcutaneous adipose tissue is appropriately debrided with scissors. The crimping action of scissors at this level does not affect wound healing.
Roberts, JA et al. Clinical Procedures in Emergency Medicine 2010. 571-572
After multiple valiant attempts of vigorous irrigation, the tar within the forearm laceration remains intact. Sharp debridement utilizing a #15 blade effectively removed the contaminated tissue allowing proper wound cleansing. Tackle all of your wound debridement tasks with Provider Prepared Laceration kits equipped with a scalpel and sharp scissors!
Provider Prepared
Nathan Whittaker, MD
- Dr. Nate Whittaker, MD Emergency Medicine Specialist
Comments 0