Surgical debridement

Abstract

Surgical debridement in chronic wounds plays pivotal roles. Debridement is considered to fasten the wound healing rate and time and reduce the wound area by removing necrotic wound bed, wound edge tissue like hyperkeratotic epidermis, necrotic dermis, foreign debris, and bacterial pathogens, which bring inhibitory effects on wound healing [1]. There is marked cytoplasmic reduction and localization of epidermal growth factor receptor (EGFR) in the epidermis by microarray analysis, which indicates that the nonhealing keratinocytes have attenuated capacity to respond to EGF. Along with epidermal and keratinocyte inhibition, fibroblasts derived from nonhealing wounds demonstrate slower migration [2]. All these information with molecular analysis suggest that proper surgical debridement may be a reasonable solution to overcome this problem. Surgical debridement is considered one of the essential choices in accelerating and optimizing the wound healing; however, the evidences of this technique and rationale should be further discussed in each pathologic condition such as leg and diabetic foot ulcer.