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Today's VeTerinary PracTice | July/august 2015 | tvpjournal.com MoisT Wound Healing: THe neW sTandard of care Peer reviewed 32 The needs of wounds differ as they progress through the healing process, and all wounds beneft from a properly moist environment that supports normal cell function. With just a few different moisture-retentive dressings (MRDs), the clinician can work synergistically with the cells to support microscopically precise debridement and repair for a wide variety of wounds, while providing the patient with a faster, healthier, and more comfortable healing experience. WOUND DEBRIDEMENT The frst step of wound care, whether from the viewpoint of white blood cells (WBCs) or the clinician, is debridement—that is, removing all contaminants, such as foreign material and bacteria, and damaged tissue from the wound. 1 Debridement can be: • Selective: Removal of unhealthy tissue while healthy tissue is spared • Nonselective: Removal of both healthy and unhealthy tissues. Forms of debridement include: • Autolytic debridement: Performed by WBCs during the frst 3 to 5 days after the wound occurs (infammatory/debridement phase) (Figures 1 to 4). This form of debridement is the most selective because it spares healthy cells and intact matrix molecules while removing damaged cells and matrix with microscopic precision. 2 • Surgical debridement: Tissue removed by surgeon according to characteristics, such as color, texture, vascular supply, and temperature; selective on a macroscopic level. • Mechanical debridement: Physical removal of tissue adhered to a dried-on dressing; nonselective and, thus, the least desirable form of debridement. The New STaNdard of Care Moist Wound Healing Bonnie Grambow Campbell, DVM, PhD, Diplomate ACVS Washington State University FIGURE 1. Several days after being hit and pinned under a car, this mixed-breed dog developed an eschar on its left side that ultimately sloughed, leaving a large wound. Surgical intervention was limited due to the client's fnancial restrictions. Because this dog was treated before my exposure to moist wound healing practices, healing time was long. The boxed area shows the location of the wound. FIGURE 2. Patient from Figure 1; day 7 after injury: Necrotic tissue and an eschar (asterisk) remain after a large section of skin had sloughed. Microscopically, WBCs are selectively debriding the diseased tissue. Surgical debridement and lavage were performed after this photograph was taken.