A NEW TECHNIQUE FOR WOUND DEBRIDEMENT

Annals of Burns and Fire Disasters - vol. IX - n. 3 - September 1996

A NEW TECHNIQUE FOR WOUND DEBRIDEMENT

Midon Miguez 1, Valero Gasalla J., Pousa Real F, Martelo Villar F.J.

Servicio de Cirugia Plastica, Hospital Juan Canalejo, La Coruha, Spain

SUMMARY. A new technique is presented for wound debridement, based on the use of metallic swabs. The technique's simplicity and rapidity and the limited damage caused to healthy tissue surrounding the wound make it particularly useful in the debridement of partialthickness wounds.

Introduction
Tangential excision, described by Janzekovic,' is the most commonly used method for the debridement of burns and lesions with hypertrophic granulated tissue.
However, the dermatome can be difficult to use in lesions with irregular edges, in small or multiple wounds, and in those situated in concavities, with the risk of damage to surrounding healthy tissue.
We here describe a new technique that is suitable for such conditions.

Description of the technique

Debridement with a metallic swab (Fig. 1) is simple to perform, consisting of energetic rubbing of the wound with the swab until all necrotic tissue or granulation is eliminated, in order to obtain a bleeding surface suitable for receiving the skin graft (Figs. 2a,b).

	Fig. 1 - The metallic swab

Fig. 2a - Lesions in buttock surface before swab debridement.	Fig. 2b - Lesions in buttock surface after swab debridement.

Advantages and disadvantages

Among the advantages offered by this technique, we would like to emphasize the following points:

metallic swabs are cheap and easy to obtain
they can be reused and are simple to sterilize
they do not damage healthy tissue surrounding the lesion
they adapt to surfaces of all types: smooth, concave and convex

The disadvantages which we have found are as follows: incomplete debridement of necrotic tissue on some occasions, although this is not an obstacle for graft acceptance. This phenomenon was demonstrated by Jackson,' who showed that grafts are accepted in zones with incomplete debridement, owing to to plasmatic diffusion through them the technique is not useful in full-thickness lesions
We recommend the application of this new technique in the debridement of partial-thickness burns or in lesions with considerable granulation which present irregular edges, are small or multiple, or are situated in concavities.

RESUME. Les Auteurs décrivent une nouvelle technique pour le débridement des lésions basée sur l'emploi de tampons métalliques. La simplicité et la rapidité de la technique, comme aussi les dommages limités causés au tissu sain autour de la lésion, la rendent particulièrement utile dans le débridement del lésions d'épaisseur moyenne.

BIBLIOGRAPHY

Janzekovic Z.: "Present clinical aspects of burns: A symposium".Derganc M. Maribor, Yugoslavia, 1968.
Jackson D.M.: Second thoughts on the bum wound. J. Trauma, 9:839-62, 1969.

This paper was received on 15 February 1996.

Address correspondence to: Dr Josd Mid6n Mfguez, C/ Mendndez Pelayo 4-6, 9' C, 15.005 La Corufla, Spain.

G. WHITAKER INTERNATIONAL BURNS PRIZE
PALERMO (ITALY)
under the patronage of the Authorities of the Sicilian Region for 1997

By law n' 57 of June 14th 1983 the Sicilian Regional Assembly authorized the President of the Region to grant the "Giuseppe Whitaker Foundation", a non-profit-making organization under the patronage of the Accademia dei Lincei with seat in Palermo, an annual contribution for the establishment of the "G. Whitaker International Burns Prize" aimed at recognizing the activity of the most qualified experts from all countries in the field of burns pathology and treatment.
The amount of the prize is fixed at twenty million Italian lire. The prize is awarded each year by the month of June in Palermo at the seat of the G. Whitaker Foundation.
The Adjudicating Committee is composed of the President of the Foundation, the President of the Sicilian Region, the Representative of the Accademia dei Lincei within the G. Whitaker Foundation, the Dean of the Faculty of Medicine and Surgery of Palermo University, three experts in the field of prevention, pathology, therapy and functional recovery of burns, the winner of the prize awarded the previous year, and a legal expert nominated in agreement with the President of the Sicilian Region as a guarantee of the respect for the scientific purposes which the legislators intended when establishing the prize.
All persons who consider themselves to be qualified to compete for the award are invited to send their detailed curriculum no later than 3 1 st January 1997 to Michele Masellis M.D., Secretary-Member of the Scientific Committee, G. Whitaker Foundation, Via Dante 167, 90141 Palermo, Italy.