Description
In a comprehensive presentation on orthopedic debridement, Rhidian Morgan-Jones begins by reflecting on the excellent debates in the previous session, hoping for a less controversial discussion this time. He emphasizes the critical importance of surgical debridement in managing orthopedic infections, noting that the success of other treatment measures, including antibiotic use, is contingent upon the quality of debridement performed. He defines debridement as the surgical removal of foreign material and necrotic tissue, explaining its historical context and the need for clear definitions in surgical practice.
Morgan-Jones provides a detailed outline of the six methods of debridement: surgical, mechanical, chemical, autolytic, enzymatic, and biological, highlighting that currently, only the first three are widely available to surgeons. He advocated for a thorough surgical approach, including the removal of infected tissue, metalwork, and any membranes or biofilms.
Throughout his talk, he explains the processes of mechanical debridement, such as reaming and curettage, and the use of techniques like pulse lavage and hydrogen peroxide for effective cleaning. He also touches upon the use of acetic acid as a chemical debridement method, advocating for a balanced approach using inexpensive alternatives while acknowledging the complexity of infections.
Morgan-Jones stresses the need for a systematic and reproducible approach to debridement, urging practitioners to define their techniques clearly rather than relying on subjective descriptors. The presentation concludes with an affirmation of the importance of separating debridement from reconstruction, advocating for a methodical and rigorous approach to ensuring optimal surgical outcomes.