Chapter 5 - Role of debridement and its biocompatibility in antimicrobial wound dressings

Abstract

A wound is a breach or damage to skin tissue that results in non-functionality. Sometimes the epidermis, dermis, or muscle tissues are damaged. Skin tissue has strong self-healing abilities. However, some wounds take longer to heal or do not heal on their own, necessitating the use of an assisted healing factor. Diabetes, stroke, spinal cord injury, burns, and chronic infection are all conditions that can result in such wounds. Wound dressing is required to promote healing and protect such wounds. In general, devitalized and necrotic tissue is present at the wound site, which promotes microbial growth, inhibits wound contraction, impedes proliferation, and brings the overall wound healing cascade to a halt. Debridement is introduced in this context as a technique for removing necrotic tissue in addition to the bacterial burden present over the wound. Debridement has become a critical step in wound care. Debridement methods such as autolytic, surgical, enzymatic, mechanical, hydrosurgery, biological, and ultrasound debridement have been used for many years. Debridement in chronic wounds follows the three-dimensional principle of drainage, disruption, and division. The debridement technique should be biocompatible, simple to use, and painless. We discussed the pros and cons of the currently used tissue debridement techniques in this chapter, as well as some novel methods in the pipeline for pursuing better performing and low-risk tissue debridement.