Debridement of bacterial and particulate-contaminated wounds.

Debridement of contaminated wounds is an essential component of uncomplicated wound healing. Efficient techniques should be capable of removing bacteria as well as foreign matter because of the well-known ability of foreign bodies to potentiate infection. We have compared the ability of current debridement techniques with the relatively new ultrasound debridement to clean wounds contaminated with bacteria and particulate matter. In part I, we prepared dorsal wounds on 15 Sprague-Dawley rats, and 20 mg of Montmorillonite clay soil fraction, a well-known infection-potentiating factor, was placed in each wound. Animals were randomly assigned to one of three treatment groups: ultrasound debridement, soaking, and irrigation. The amount of clay removed from each wound was measured. In part II, 48 Sprague-Dawley rats were given a standard wound and inoculated with a subinfective dose of Staphylococcus aureus bacteria and 10 mg of Montmorillonite clay particles. Each rat was randomly assigned to a debridement technique--soaking, scrubbing, high-pressure irrigation, and ultrasound--and was examined after 7 days for inflammatory responses. Results of part I demonstrated that ultrasound debridement and irrigation remove statistically equal amounts of clay (p < 0.05). In part II, we found that high-pressure irrigation and ultrasound debridement effectively treat contaminated wounds (gross infection, p < 0.05; wound induration, p < 0.0001; bacteria counts, p < 0.002). This study presents ultrasound debridement as effective treatment of contaminated wounds.