Wound Care and Debridement

A wound that hasn't healed in four to six weeks is telling you something. On the foot of someone with diabetes, it may have started as a blister from new chappals or a crack in the heel that went unnoticed because the foot has lost feeling. On the back or hips of a bedridden parent, it may be a bedsore that began as a patch of red skin. Slow wounds are often painless, and that's exactly why they get worse quietly.

Wounds stall because of dead tissue, infection, poor blood supply, constant pressure, high blood sugar or poor nutrition, often several at once. Wound care and debridement deals with each. Debridement means removing dead, infected or contaminated tissue (the yellow slough or black crust on the wound) so the healthy tissue underneath can grow. Small amounts are removed in the dressing room, and deep wounds are cleaned in the operation theatre. Regular dressings, pressure relief and treatment of the cause follow.

Healing is slow. A diabetic foot ulcer often takes 2 to 4 months to close, and a deep bedsore longer. Starting early matters most for diabetic feet, because most amputations in diabetes begin with a foot ulcer that got worse.

Wound debridement and wound management are part of the regular work of our general surgery department, and operation theatres are available round the clock for severe infections. Wounds that need a graft or flap are planned with our plastic surgeon. Between hospital visits, our home care plan can send trained staff to do dressings at home.

Any wound that isn't clearly getting smaller after two weeks, or hasn't healed in four to six, needs a proper assessment.

We measure the wound at each visit. One that stops shrinking for two weeks means the plan needs to change.