Treatment Approaches Debridement & Cell Therapy

Debridement

Debridement is a surgical procedure used to remove all dead (necrotic) and infected tissue from the wound site. Removing dead tissue decreases the bacterial burden, stimulating the wound to contract and heal. Debridement does not radically heal the wound right away. Multiple debridements may be required in order to promote faster healing.

Debridement may occur during a clinical visit or in the operating room. A debridement performed in the office is a small procedure, allowing the patient to return home on the same day. Local anesthesia is used in order to ensure that the patient does not feel any pain.

Often a more extensive debridement is needed to remove all infected tissue and possible scar tissue. These procedures are preformed in the operating room and local, general, or regional anesthesia may be used.

Tissue collected during the debridement is sent to pathology for analysis. The results will reveal if there is a infection, dead tissue, scar tissue, or tumor. These findings will help to inform a tailored treatment plan.

Cell Therapy

Cell therapy is an important component of wound healing. Apligraf®, which has been called a human skin equivalent, may be placed on the wound site. It has keratinocytes and fibroblasts, which stimulate cells and tissue to heal. It was first developed, unsuccessfully, in the 1980s to replace human skin. In randomized trials in the 1990s, Apligraf was found to accelerate closure of both diabetic foot and vein ulcers. It is the only topical treatment that has been proven effective in helping to heal multiple types of chronic wounds.

At the Columbia Wound Healing Center, we apply it as if we were applying a skin graft. You may only need one treatment of Apligraf applied to your wound. However, often wounds require several applications, as the biological effect from the cell therapy lasts only up to six weeks.