SURGICAL DEBRIDEMENT

REQUIREMENTS: Written Informed Consent, Sterile gauze pieces, Saline, Sterile working surface (A plastic drape is generally spread over the table), Syringe with local anaesthesia, Scalpel with 15 no. blade with toothed forceps   (or a sharp curette), Sterile gauze pieces and dressing 1)    Local anesthesia (may not be required for diabetic ulcer as it is painless) 2)    Use saline/ antiseptic solution to irrigate the wound (betadine solution is better avoided as it hampers wound healing) 3)    Using all aseptic precautions remove the dead tissue using 15 no. blade and toothed forceps 4)    Use short even strokes with minimal pressure (swapping movements) to avoid injury to underlying structures and minimize any bleeding that might occur. -All devitalized tissue must be excised until bleeding occurs -Muscle that is pale or dark in colour, does not contract on pinching and does not bleed on cutting must be removed -Try to scrape superficially at the edge of ulcer as this is where the healthy tissue grows 5)    The wound is covered up with either wet or dry dressing 6)    Advice to patient:  No weight bearing on the wound Reassess and dress as required Tetanus immunization and antibiotics as indicated Written by our guest author Pratik Mundada #Ae(ONE)INTERN