Deterioration of texture integrity for any reasons is called a wound. The purpose in the treatment of all wounds, irrespective of type, is to heal the wounded tissue within the shortest time and before any complications emerge. The process of removing contaminated tissues that have lost their vitality and foreign substances on and around the perimeter of wounds is named debridement. The necrotic tissues in the wound prevent the normal wound healing process, and create a culture medium that is compatible for bacterial growth.Debridement plays an important part in the wound healing process; it reduces the bacterial load, enables infection control and prevention, and allows to see the wound wall and live tissues. Although surgical debridement is accepted as the fastest and the most effective debridement method, it may not be possible to apply this sometimes. One of the most frequently used debridement methods under such circumstances is autolytic debridement. Collagenase and protease, which breakdown proteins, are produced by macrophages and allow for debridement to be achieved as a result. Moist wound conditions facilitate debridement because they have the water and enzymes necessary for the elimination of dead tissues.
Case
M.K 28 years’ old male patient. The wound site was dressed on a daily basis for the patient on whom fasciotomy was applied in the form of a skin incision as a consequence of the compartment syndrome that developed in the thigh of the left leg as associated with a gun wound. Evisceration started to develop on the 3rd day on the top side of the wound, the lips of which were sutured following limited debridement in the operating room on the 12th day. HydroClean application was planned for autolytic debridement, flushing and absorption purposes on the wound of 8*12cm in diameter, with running, necrotic areas and 1 cm cavity. The wound was flushed with Physiological Saline. A cream with barrier features was applied on the surrounding tissues for protection purposes. HydroClean was placed in the wound bed and fixation was ensured by a covering pad. This procedure was repeated on a daily basis for 6 days. Whitening was observed on the wound perimeter during this period. The area that was thought to be maceration was eliminated with the vaporization of the ringer solution when the treatment was ended. The patient did not complain of any pain during dressing changes. Starting with the 7th day, it was observed that the cavity area in the wound was filled in, the wound diameter receded to 10*6cm, the exudate was reduced, the necrotic tissues disappeared, granulation was increased, and epithelization started , and the treatment was ended. Wound care was continued with wound dressing with moisturizing and absorbent features.
Conclusion
The necrotic tissues and uncontrolled exudate in the wound prevent wound healing and offer an environment compatible for bacterial reproduction. The use of a product that accelerates wound healing with effective wound cleaning and debridement features, fights with bacteria, is absorbent, increases granulation and stimulates epithelization is an important and effective approach in wound treatment. The time and costs savings in the application of the product on the patient are also very important. Autolytic debridement is a very effective an advantageous method in necrotic and exudative ulcers because it s painless and has a selective character.
