Chemical debridement

Chemical debridement involves the use of topical enzymatic gels and solutions to dissolve and remove necrotic tissue from the wound. Different... 

Among the lesser-used biological media studied as Pb-exposure markers are those with characteristics such as noninvasive accessibility that would appear to offer a simpler, inexpensive alternative. Mushak (1992) described the relative advantages and limitations of hair sampling as a Pb-exposure biomarker. Hair collection is noninvasive and offers an indefinitely stable medium. But hair is also a very problematic matrix for external surface contamination. Of most concern is the extreme difficulty of chemically debriding hair surfaces of any external Pb without simultaneously removing Pb from internal deposits in hair. Despite claims of effective contamination removal protocols, it remains to be established that the current state of the measurement art encourages hair Pb analyses (Barbosa et al., 2005 U.S. EPA, 2006). 

The nonpharmacologic treatment of diabetic foot ulcers may include off-loading, chemical or surgical debridement of necrotic tissue, wound dressings, hyperbaric oxygen, vascular or orthopedic surgery, and the use of human skin equivalents.30... 

The wound should be debrided and excised as usual, maintaining a no-touch technique. Removed fragments of tissue should be dropped into a container of 5% to 10% hypochlorite. Bulky tissue such as an amputated limb should be placed in a plastic or rubber bag (chemical proof), which is then sealed.14... 

There are a variety of methods that can be used to debride a wound, including autolytic, chemical, mechanical, and surgical. Autolytic debridement utilises the body s own enzymes and moisture to dissolve and clean the wound of necrotic tissue. This method has the advantage of being virtually painless for the patient, but can take many weeks to achieve. A moist wound environment is the key factor to autolytic debridement, and is obtained by using occlusive or semi-occlusive wound dressings. 

Of the bum injury patients admitted to a specialized Regional Bum Center in Toronto, Ontario, Canada, over an 8-year period, the 24 chemically injured patients made up 2.6 % of the total [29], Occupationally related chemical exposures accounted for 75 % of these injuries, and the involved chanicals included hydrofluoric acid, sulfuric add, black liquor (a heated mixture of sodium carbonate, sodium hydroxide, sodium sulfide, sodium thiosulfate, and sodium sulfate), lyes (alkaline corrosives), phenol, and potassium permanganate. Complications were seen in 58 % of chemically injured patients, including chemical ocular injuries, wound infections, tendon exposures, toe amputation, and systemic toxicity. Of these 24 patients, 14 required extensive surgical debridement and skin grafting. One patient with a 98 % TBSA chemical skin injury died. Of those patients who had typical decontamination measures such as removal of contaminated clothing... 

Following lavage and debridement of blisters, chemical insults will be treated with the same principles as for thermal injuries the lesions can be covered with the same creams or dressings as these for bum lesions (treatment with silver sulfadiazine will protect against dehydration and provides an antimicrobial effect against a broad... 

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