Debridement and Amputation
Debridement
What is debridement?
Debridement is a procedure done to remove necrotic (dead) or infected skin tissue to help a wound heal. Debridement is normally recommended for wounds that are not healing properly. Debridement is also recommended to remove foreign material from the tissue. Wound debridement helps healthy tissue grow, minimize scarring and reduce complications of infections.
What does debridement involve?
Preparation of getting a wound debridement depends on the wound and medical health condition. The wound will first be examined, and the following procedures may be used to remove dead tissue:
- Autolytic debridement This procedure involves the use of a moist wound dressing, supporting the body’s ability to break down dead tissue.
- Sharp debridement This involves the surgeon removing dead tissue with the use of a sharp instrument. A dressing will then be applied to help control bleeding.
- Enzymatic debridement This procedure is also called chemical debridement. It involves the use of medication to break down dead tissue in the wound.
- Mechanical debridement Involves a pulse lavage or wet to dry saline dressing being used to remove dead tissue.
Normally, a debridement procedure may be repeated until the wound heals, and the procedure may be different depending on the wound.
Amputation
What is an amputation?
Amputation is a surgical procedure which involves the removal of a limb due to an injury, disease or surgery. Amputations may be recommended if:
- One has a blood vessel disease called peripheral vascular disease, diabetes, blood clots, or an infection that occurs in the bones called osteomyelitis.
- There is an injury, especially in the arms. Most upper extremity amputations are due to trauma.
- Surgery is needed to remove tumours from bones and muscles.
Please note: Amputation is always done as a last resort when limb salvage is not possible or where keeping the limb may lead to severe complications or death.
What does an amputation involve?
An amputation may vary depending on the type of amputation and the condition. This procedure may be done under general anaesthetic, meaning the patient will be asleep throughout the procedure, or while awake under spinal anaesthesia. During this procedure, an intravenous line will be inserted in the arm or hand, and the heart and blood pressure will be monitored.
The vascular surgeon will first examine the joint near the diseased limb, and an incision will be made on the site of the diseased limb. The limb will be removed, and the wound will be closed with sutures. Usually, a drain is inserted after a major amputation.
After amputation, the patient will be referred to a psychologist, physiotherapist and orthotist to start with rehabilitation focused on self-sufficiency. The patient will also be evaluated for a prosthetic limb if indicated. A multi-disciplinary approach is used to ensure the highest success rate.
