- avoid tourniquet when possible
- wound debridement:
- begins at the periphery;
- 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 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.