ABSTRACT
Acute wound healing generally follows an overlapping four-step process: coagulation, inflammation, proliferation/matrix repair, and remodeling/epithelialization. Nonhealing or chronic wounds become “stuck” in one of these stages. They are characterized by defective remodeling of the extracellular matrix, a failure to re-epithelialize, and prolonged inflammation (1–3). The concept of wound bed preparation is a method to systematically approach and treat chronic wounds. Debridement is often the focus of wound bed preparation, but the broad goals are to remove necrotic and/or fibrinous tissue from the wound bed, decrease bacterial burden, increase the amount of granulation tissue, decrease exudates and edema, and reduce the number of abnormal or senescent cells within the wound or at the wound edge Staging systems have been developed to compare the efficacy of interventions, taking into account wound bed appearance and the amount of wound exudates In this chapter, we will review the goals of wound bed preparation with a focus on debridement.
