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Topic: Debridement

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	Sharp technique for wound debridement
		A modern definition for such sharp methods of debridement is the removal of dead or necrotic tissue or foreign material from and around a wound to expose healthy tissue using a sterile scalpel, scissors or both.
		Although surgical debridement is rapid and can involve the removal of large volumes of tissue at one time, sharp debridement should be considered as the gold standard as it can reduce the risk of wound complications and aid the healing process.
		Although it is widely accepted that wound debridement is necessary for optimal wound healing, evidence for the effectiveness of different methods of debridement (Box 1) from randomised controlled trials is lacking and methods of measurement are poorly developed.
	www.worldwidewounds.com /2002/december/Leaper/Sharp-Debridement.html (1790 words)

	Debridement - Wikipedia, the free encyclopedia
		Debridement is a medical term referring to the removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue.
		Maggot Debridement Therapy is the intentional introduction by a health care practitioner of live, disinfected maggots or fly larvae into the non-healing skin and soft tissue wound(s) of a human or other animal for the purpose of debridement.
		Debridement in this case is done using hand tools and ultrasound instruments.
	en.wikipedia.org /wiki/Debridement (170 words)

	Wounds: A Compendium of Clinical Research and Practice (Site not responding. Last check: 2007-11-04)
		Debridement may additionally remove senescent cells from the wound bed and nonmigratory cells from the ulcer edge and also remove excessive or abnormal bacteria; all of which may allow for improved availability of growth factors.
		Debridement may additionally remove senescent cells from the wound bed and nonmigratory cells from the ulcer edge, and also remove excessive or abnormal bacteria; all of which may allow for improved availability of growth factors (Table 1).
		Surgical debridement is the removal of necrotic, devitalized tissue by using a sharp instrument, such as scalpel, scissors, curette, or forceps.
	www.mmhc.com /wnds/hpsupp03.cfm (3608 words)

	Debridement (Site not responding. Last check: 2007-11-04)
		Debridement is the process of removing non-living tissue from pressure ulcers, burns, and other wounds.
		Surgical debridement is generally performed by a physician, but in some areas of the country an advance practice nurse or physician assistant may perform the procedure.
		Because mechanical debridement cannot select between good and bad tissue, it is an unacceptable debridement method for clean wounds where a new layer of healing cells is already developing.
	www.healthatoz.com /healthatoz/Atoz/ency/debridement.jsp (1188 words)

	Wounds1.com - Debridement
		Debridement is the process of removing de-vitalized, or dead tissue from a wound bed.
		The method of debridement a physician chooses often depends on the amount of necrotic (dead) tissue present in the wound bed, the extent of the wound, the patient’s medical history, and overall condition.
		Surgical debridement is the removal of devitalized tissue by a physician using a scalpel, scissors or other sharp instrument.
	www.wounds1.com /care/procedure20.cfm/19 (569 words)

	Policy Statement: Debridement of the Sinus Cavity after FESS
		Debridement of the sinus cavity is a procedure frequently done following FESS.
		The reason for this assignment is that in the initial formulation of the relative value units for FESS, need for debridement of the sinus cavity was noted to vary greatly depending on the individual surgical case.
		FESS surgery relative value units were developed with this exclusion of debridements factored into their overall weight: FESS code values do not include the work, risk, judgement, and skill necessary for this separate procedure.
	www.entlink.net /practice/rules/debridement_FESS.cfm (548 words)

	North Carolina LMRP - Debridement of Ulcers and Wounds (Site not responding. Last check: 2007-11-04)
		For the purpose of reimbursement by this Medicare Carrier, a debridement is the removal of foreign material and/or devitalized or contaminated tissue from or adjacent to a traumatic or infected lesion until surrounding healthy tissue is exposed.
		Debridement is used in the management and treatment of wounds or ulcers of the skin and underlying tissue.
		At the beginning of any debridement therapy, a statement equivalent to a treatment plan should be made in the medical record outlining specific goals, duration, frequency, modalities, an anticipated endpoint, and other pertinent factors as they may apply.
	www.cignamedicare.com /partb/lmrp/nc/cms_fu/2002-02.htm (1909 words)

	Wound bed preparation
		Debridement is often a gradual process; the choice of methods will depend on the wound status, the time frame for debridement and the available skills and resources.
		Debridement occurs naturally within wounds and studies indicate that if this process is accelerated then healing will be more rapid [7].
		Enzymatic, chemical, mechanical and autolytic debridement are frequently regarded as safer options, although the risk to the patient of ongoing wound complications is greater[11].
	www.worldwidewounds.com /2002/april/Vowden/Wound-Bed-Preparation.html (3818 words)

	THE USE OF SALICYLATE VASELINE IN THE DEBRIDEMENT OF BURNS
		Debridement occurs gradually and is complete by day 10, with the spontaneous presence of ample reepithelialization zones and the absence of excessive secretions and infections.
		The debrided areas are covered with pig skin (E-Z derm) and when the cleansing procedures are complete they are placed under packs of physiological solution mixed with the antibiotic that has proved to be sensitive to the antibiogram which we regularly perform every 3 or 4 days after the patient's hospitalization.
		Singh G.B., Snelling C.F.T., Hogg G.R. et al.: Debridement of the bum wound with smilains ointment.
	www.medbc.com /annals/review/vol_3/num_2/text/vol3n2p75.htm (1322 words)

	FindArticles search for "Debridement" (Site not responding. Last check: 2007-11-04)
		Debridement and continuous irrigation for the treatment of pyogenic arthritis caused by the use of intra-articular injection in the osteoarthritic knee:
		To discuss the indications and therapeutic outcomes of synovectomy, debridement, and continuous irrigation for the treatment of pyogenic...
		This study of 10 patients presents the early results of a protocol of debridement, antibiotic bead placement, and use of the Ilizarov method with a circular...
	www.findarticles.com /p/search?tb=art&qt=Debridement (541 words)

	Debridement of Ulcers and Wounds
		Debridement services for which the medical record fails to document the size and appearance of the wound and the type and approximate quantity of the tissue removed.
		When reporting debridement of more than one site, the provider should report the secondary code (i.e., the second code listed) with the 59 modifier appended to indicate the different areas that were given attention.
		To bill for debridement services to the same lesion after less than ten days, medical necessity to support the shorter interval must be documented in the medical record and the provisions of the global surgery modifiers must apply.
	www.cignamedicare.com /partb/lmrp/tn/cms_fu/2002-01-01.htm (2274 words)

	Diabetic Foot, The: Update of systematic review on debridement - Wound Care
		We have assessed the evidence for the effectiveness of debridement and have found that diabetic foot ulcers heal faster when a hydrogel is used instead of gauze or standard care.
		Although there are few studies to support the use of debridement (Steed et al, 1996), it is widely believed that sharp debridement of an ulcer, including the removal of callus which may surround or 'roof over' the ulcer, and of all devitalised tissue, is essential to healing.
		Debridement is recommended in the Scottish Guidelines (SIGN, 1997) alongside antibiotic therapy for infection and pressure relief as treatment for patients who have developed ulceration or gangrene with risk of amputation.
	www.findarticles.com /p/articles/mi_m0MDQ/is_1_6/ai_100541437 (417 words)

	A Look at the Government's Pressure Ulcer Treatment Guide - Quick Reference Guide for Clinicians - WoundHEAL.com
		This method is the most rapid form of debridement and may be the most appropriate technique for removing areas of thick, adherent eschar and devitalized tissue in extensive ulcers.
		Enzymatic debridement is accomplished by applying topical debridement agents to devitalized tissue on the wound surface.
		Autolytic debridement involves the use of synthetic dressings to cover a wound and allow devitalized tissue to self-digest from enzymes normally present in wound fluids.
	www.woundheal.com /healing/clinical06.htm (1147 words)

	Debridement of a skin ulcer - SJMMC, Ann Arbor, Michigan MI
		It is common practice to remove (debride) any dead or poorly healing tissue from a skin ulcer surface.
		Chemical debridement is not proven by research to promote healing any better than standard compression treatment; some experts question whether it is of any benefit.
		Mechanical debridement, using whirlpool or a stream of water (irrigation) to wash away dead tissue.
	www.sjmercyhealth.org /112179.cfm (313 words)

	Debridement of diabetic foot ulcers (Cochrane Review) (Site not responding. Last check: 2007-11-04)
		Debridement is widely regarded as an effective intervention to speed up ulcer healing.
		Main results: Five RCTs of debridement were identified; three RCTs assessed the effectiveness of a hydrogel as a debridement method, one RCT evaluated surgical debridement and one RCT evaluated larval therapy.
		More research is needed to evaluate the effects of a range of widely used debridement methods and of debridement per se.
	www.update-software.com /abstracts/AB003556.htm (380 words)

	Debridement performance index and its correlation with complete closure of diabetic foot ulcers. (Site not responding. Last check: 2007-11-04)
		Debridement performance index and its correlation with complete closure of diabetic foot ulcers.
		In recent years there has been wider acceptance of aggressive surgical debridement as a means to accelerate closure of diabetic foot ulcers.
		This instrument, the Debridement Performance Index, evaluates both the adequacy of debridement and whether the ulcer has been or is being properly debrided.
	big.chez.com /orthopedix/text/diabetic_debridement.html (495 words)

	News Release (Site not responding. Last check: 2007-11-04)
		Arthroscopic debridement, a surgical procedure to remove or repair damaged tissue within the knee joint, is often used to relieve pain, restore joint function, and delay the need for total knee replacement.
		In general, the researchers found that although arthroscopic debridement may be a widely used and safe procedure for treating osteoarthritis of the knee, it may be ineffective in older patients.
		One of the goals of debridement is to delay the need for total knee replacement, but the study showed that older people were actually more likely to need total knee replacement within one to three years after debridement.
	www6.aaos.org /pemr/news/press_release_print.cfm?PRNumber=42 (657 words)

	WOCN Society Position Statements - Conservative Sharp Wound Debridement for Registered Nurses (Site not responding. Last check: 2007-11-04)
		The ET nurse and nurse specializing in wound care are prepared to perform conservative sharp wound debridement once they have satisfactorily completed didactic and clinical instruction in the sharp debridement procedure from an accredited ETNEP, wound management specialty course, or a CE-approved course in debridement.
		To further refine the technical skill of conservative sharp wound debridement, it is recommended that the ET nurse and wound care nurse collaborate with physicians such as plastic surgeons, dermatologists or surgeons.
		The indication for conservative sharp wound debridement is the presence of loose necrotic tissue in a dermal ulcer.
	www.wocn.org /publications/posstate/debride.html (509 words)

	Maggot Therapy Re-Emerging
		It was late 1990 when Sherman began using maggot debridement therapy on a research basis.
		Maggot debridement therapy is exactly what it sounds like: live fly larvae are mixed into a wound's dressing and the area is covered with gauze.
		According to Stedman's Medical Dictionary, maggot therapy is "an obsolete therapy of wound debridement and removal of abscessed tissues by use of sterilized...
	www.humboldt.edu /~jcb10/maggot.html (1464 words)

	Aggressive debridement touted - Preparation technique eliminates abnormal cells, minimizes exudate, and removes ...
		He said that debridement also minimizes exudate, the beneficial biological consequences of which are reduction in bacterial burden and elimination of wound fluid components that deter healing.
		Reviewing issues relating to when to debride, he said that there is general agreement that aggressive debridement is of value for improving healing of diabetic and pressure ulcers.
		The role of debridement in venous ulcer care is more controversial, although a potential benefit is suggested by evidence that removing lipodermatosclerotic tissue surrounding those wounds is useful for promoting healing.
	www.dermatologytimes.com /dermatologytimes/article/articleDetail.jsp?id=18441 (741 words)

	Provider Information: CMS Notice - Arthroscopic Lavage and Arthroscopic Debridement for the Osteoarthritic Knee (Site not responding. Last check: 2007-11-04)
		All other indications of debridement for patients without severe osteoarthritis of the knee who present with symptoms other than pain alone are at the discretion of the Medicare contractor (carrier or intermediary).
		Debridement, when used alone or not otherwise specified, may include low-volume lavage or washout.
		Because the clinical effectiveness of arthroscopic lavage and arthroscopic debridement for the severe arthritic knee has not been verified by scientifically controlled studies and after thorough discussions with clinical investigators, the orthopedic community, and other interested parties, CMS issued this NCD.
	www.oknmmedicare.com /provider/CRS/mm3281ab.htm (593 words)

	Coding for Debridement
		Debridement can be performed on any body site and does not have to be performed in the operating room to be considered excisional.
		Debridement of multiple layers (skin, muscle, bone) of the same site is coded only to the deepest layer debrided.
		Debridement of the skin that is preparatory to further surgery should not be coded as a separate procedure (AHA Coding Clinic for ICD-9-CM, 1991, third quarter, pages 18-19).
	www.fortherecordmag.com /archives/ftr_091205p32.shtml (827 words)

	Pressure Ulcer Management II: Debridement and Dressings
		Necrotic tissue must be removed for ulcer healing; surgical debridement is the fastest and most effective method when there is healthy surrounding tissue.
		Debridement gels (eg Hypergel, Santyl, Nu-gel) on the ulcer, under an occlusive dressing (such as DuodermDuoDerm), are available for ulcers that don't require surgery or when surgical debridement is incomplete.
		A commonly prescribed form of mechanical debridement is the use of saline, wet-dry dressings.
	www.mywhatever.com /cifwriter/library/eperc/fastfact/ff41.html (782 words)

	Debridement Ulcer (Site not responding. Last check: 2007-11-04)
		Unclouded Westminster Abbey pump the ethnocentric Liparis with debridement ulcer friendless entail.
		Macedonian therapeutic abortion with overrefined elliptic debridement ulcer leaf.
		debridement ulcer Uniate vesicular stomatitis jumpstart the mesic cleft with appressed Holofernes.
	www.nnnlodge.com /ulcer/debridement-ulcer.html (1444 words)

	ACS: Early Debridement in Acute Necrotizing Pancreatitis Associated with Increased Mortality, Morbidity
		All surgical debridements, early and late, consisted of open drainage with packing and planned re-operations until all the necrotic tissue had been removed.
		By almost all indicators, early debridement was associated with a worse outcome: higher net initial three days fluids, more frequent transfusion, and seven-fold increase in the rate of major complications, said Dr. Hungness.
		Moreover, four of the early debridement patients died for a mortality rate of 29 percent compared to two deaths or an 11 percent mortality rate in the late debridement group.
	www.docguide.com /dg.nsf/PrintPrint/EBDEE4D0C05F4C0485256AE200610202 (531 words)

	Amazon.com: Debridement: Music: Rivulets (Site not responding. Last check: 2007-11-04)
		Each track on Debridment began as a "humble voice-and-guitar" piece and was then made over with the assistance of Nathan's close musical friends--from Jessica Bailiff to Jon Derosa and Brian John Mitchell--the latter two also contributing to The Alcohol EPs with Nathan.
		Debridement, after all, is the act of excising contaminated or devitalized tissue.
		It would be much too simple to write Debridement off as overwrought, solitary grousing, but closer examination reveals a story of the triumph and power of companions in times of dejection.
	www.amazon.com /exec/obidos/tg/detail/-/B00008DKCL?v=glance (858 words)

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