Burn Wound Care: Hydrotherapy and Debridement

HYDROTHERAPY

Burn wound area are cleansed by immersion, showering or spraying and no more than 30 minutes to prevent increased sodium loss through the burn wound, heat loss, pain, and stress. Client should be premedicated before procedure. Bleeding should be minimize and maintain body temperature during procedure.

Hydrotherapy generally is not use for patients who are unstable or those with ne skin grafts. So if hydrotherapy is not use, burn wound areas are washed and rinsed in bed before the application of antimicrobial agents.

DEBRIDEMENT

Burn Debridement means the excision of devitalized tissue and foreign matter from burn wound area. It can prevent bacterial proliferation and promote wound healing. Debridement may be mechanical, enzymatic, or surgical.

Mechanical:
This mechanical technique uses scissor and forceps to lift and trim away loose eschar. It is a painful procedure and may be bleeding and requires a moist environment to be effective. Dressings are applied directly to the burn wound area: wet-to-dry or wet-to-wet dressing technique.

Enzymatic:
Enzymatic technique means using prepared proteolytic and fibrinolytic topical enzymes that digest necrotic tissue, which facilitates eschar removal.

Surgical:
The eschar area is excised and covered. It may be tangential (shaving of thin layers of eschar until viable tissue is reached) or fascial (used for deep burns and removal of burn tissue and underlying fat down to the fascia).