Definition & Overview
Debridement of extensive eczematous or infected skin refers to a medical procedure that removes dead, damaged, or infected tissue due to extensive eczema and severe skin infections. Debridement is a common treatment used for a range of skin wounds and disorders as skin healing necessitates the removal of damaged tissues.
Who Should Undergo and Expected Results
As mentioned above, the procedure is recommended for patients with:
- Extensive eczema
- Severe infection
Eczema, also known as eczematous dermatitis, is a medical condition that causes inflammation, itching, and bleeding of some parts of the skin. Although usually attributed to an autoimmune reaction or irritation, the disease occurs, in most cases, without an obvious cause. Most dermatologists, therefore, consider eczema as a result of a combination of various factors, which may include:
- Compromised or weakened immune system
- Immune system disorders
- Environmental factors, such as pollution or colder climates
- Defects in the skin barrier
Severe infections of the skin, on the other hand, come in various forms and can be caused by bacteria, fungus, or yeast infections. Some cases of severe infections that are not promptly treated or do not respond properly to treatment lead to the death of skin tissues (necrosis), which causes the development of abscesses, or pockets of pus. If left untreated, necrosis and abscesses can lead to amputations or even death if the infection further spreads.
Debridement of extensive eczematous or infected skin is expected to remove all dead and severely damaged parts of the skin allowing doctors to easily and more effectively evaluate and treat the underlying skin disorder. The procedure also prevents the infection from spreading further to the surrounding healthy skin and generally speeds up the healing process.
How is the Procedure Performed?
Debridement of extensive eczematous and infected skin can be performed using various methods, including:
Surgical debridement – Also known as sharp debridement, this procedure removes extremely damaged skin due to eczema or severely infected skin by cutting dead tissues away. This is considered as the easiest and most efficient method, especially for the treatment of inflammatory conditions. The procedure involves the application of saline solution and aesthetic gel to the wound to minimise pain and discomfort. The dead tissue is then held using forceps and cut way piece by piece using surgical scissors or a scalpel.
Mechanical debridement – This method is performed by simply leaving a saline-moistened dressing over the wound overnight. The prolonged contact between the dressing and the wound causes the dead or damaged tissue to stick to dressing when it is removed. This method can be very painful and can accidentally remove healthy living tissue.
Chemical debridement – In this method, the dead tissue is dissolved using enzymes and other compounds before a moist dressing is applied to the affected area.
Possible Risks and Complications
Just like any other medical procedure, debridement of extensive eczematous or infected skin also comes with risks. There is a possibility that the tendons, blood vessels, or other structures near the wound will get damaged during the process.
Also, there is a risk that any bacteria thriving on the surface of the eczematous or infected skin may be introduced deeper into the body during the procedure. This may cause another infection to develop after the debridement process.
Katelaris CH, Peake JE. “Allergy and the skin: eczema and chronic urticarial.” Med J Aust 2006; 185(9): 517-522. https://www.mja.com.au/journal/2006/185/9/5-allergy-and-skin-eczema-and-chronic-urticaria
Stevens DL, Bisno AL, Chambers HF, et al. “Practice guidelines for the diagnosis and management of skin and soft-tissue infections.” Oxford Journals, Clinical Infectious Diseases. 41(10):1373-1406. http://cid.oxfordjournals.org/content/41/10/1373.full