The Hip: Preservation, Replacement and Revision

Wound Debridement

- Discussion:
   - avoid tourniquet when possible
   - wound debridement:
           - begins at the periphery;
        - skin:
                - must extend lacerations proximally and distally inorder to extend the entire trauma zone;
                - excise at least 2 mm of skin edge back to tissue that exhibits bleeding;
                - remove all non viable and crushed skin;
                - leave sharp margins;
                - maintain skin bridges if they appear viable;
        - deep tissues:
                - contaminated subcutaneous tissue, fascia and muscle are debrided by to clean viable tissue;
                - blood vessels and nerves are preserved;
        - debridement of muscle
        - bones:
bones devoid of soft tissue attachments are removed;
              - debridement of open tibia fractures
   - pressure irrigation
   - antibiotic beads

 History of the ISS/SIC: Antoine Depage, one of the founders of the ISS/SIC.

 In Flanders fields: the Great War, Antoine Depage, and the resurgence of débridement.

 Historical origins and current concepts of wound debridement.


Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Monday, October 10, 2016 5:24 am