However, debridement is an important treatment link related to whether the wound can be safely healed and closed. What is debridement? Debridement is a direct treatment for local ulcer wounds, which can remove the rotten tissue of ulcer wounds and reduce the possibility of further spread. For infected wounds, especially those infected with diabetic foot ulcer, controlling infection is the most direct treatment. It can not only reduce the spread of wound infection, but also facilitate the application of topical drugs and promote the growth of new tissues. Although debridement plays an irreplaceable role in the treatment of diabetic foot, if the timing of debridement is not appropriate, it will not only fail to achieve effective therapeutic effect, but may get twice the result with half the effort or lead to the spread of infection and the gradual increase of wound surface. This kind of debridement is meaningless to the patient, and it is also the chief culprit that aggravates the condition.
This is a patient with foot ulcer in Lao Xu from Langfang, Hebei. His feet are swollen and festering. Director Yuan is cleaning and cutting the soles of his feet.
Director Tu Yuan should also evaluate the patient's foot film during debridement to accurately judge the degree of debridement.
Fig. Lao Xu's foot is seriously festered and infected, and a pus cavity has been formed. It must be cut and drained in time. After the incision, those infected tissues under the skin gushed out and the wound surface had a great impact.
Every diabetic foot patient needs debridement, whether it is dry gangrene or wet gangrene. Some patients are really infected, which is unbearable for our naked eyes. However, Director Yuan has been treating this diabetic foot clinically for 20 years, and he has seen all kinds of wound impacts. During this period, many patients' families have seen what secretions and inflammatory tissues flowed out during debridement, which is difficult to look directly at.
Director Yuan has repeatedly emphasized for patients with diabetic foot ulcer and their families that debridement is very important in the whole treatment process of diabetic foot, which is of great significance:
① Thoroughly removing necrotic tissue to reduce the obstacles to the growth of new tissue, and keeping surgical debridement for diabetic foot with rapid growth is the basis of wound healing, and thorough debridement is an important measure to prevent wound infection.
② In some cases of severe infection, it can relieve the high tension of inflammation and edema between tissues;
③ Through thorough debridement, the abscess cavity can be completely opened, which is beneficial to the full drainage of pus and necrotic tissue;
(4) Reducing bacterial load is very important to effectively control infection;
⑤ Reducing the toxin absorption during the decomposition and degradation of necrotic tissue is very important to improve the functional status of patients.
Director Yuan often jokingly said to patients: I know why your foot ulcer is getting worse and worse after long-term treatment. The reason is that there is no professional debridement on your foot, and this debridement is very particular. According to different types, the timing of debridement is different, and the methods of debridement are also different. Early or late debridement, debridement will affect the healing of this late stage more or less.
For patients with severe infection, few doctors are willing to sit here and spend a long time debridement their feet. This requires not only doctors' endurance, but also their patience and sense of responsibility.
Debridement of diabetic foot is really a very important treatment link and a "great" treatment process. After debridement, patients will feel unusually "relaxed" because the infected tissues and secretions under the skin have been cleaned up, just like weeds growing on the ground are suddenly cleaned up. That kind of "brand-new" feeling can only be realized by patients themselves.
Diabetic foot ulcer is not only debridement, but also needs to improve the circulation of lower limbs, nourish nerves, remove necrotic tissue and promote granulation growth. Only the combination of whole and local treatment can effectively control the disease and cure foot ulcer.
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