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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.