Why Wounds Need to Be Débrided

Abstract

A number of factors are responsible for the great advances in burn care over the past 25 years. Aggressive fluid resuscitation followed by eschar excision and rapid wound closure are the clinical principles of modern burn care. The physiological state of burn patients improves rapidly after debridement and wound closure. Also, in the long run, the severity of scarring is reduced with early grafting. The disruption of the remodeling phase of wound repair seems to be related to the proliferative phase of repair and the cause for hypertrophic scarring. A therapy which optimizes the acute inflammatory response after burns promotes optimal wound closure and repair. The elimination of devitalized tissue in the wound bed creates an opportunity for the optimal inflammatory response to continue the promotion of the proliferate phase. Especially in patients with severe burn wounds, the removal of eschar by enzymatic debridement to promote rapid wound closure is cost-effective and reduces the added trauma of a surgical procedure and blood transfusions.