Scarring commonly develops in pressure ulcers, which are the result of prolonged pressure on the skin, limiting blood flow and causing tissue damage. The bedsore in pressure ulcers can hinder healing and requires specific care to prevent infection and promote recovery. Preserving scarring in wounds could reduce inflammation and negatively modulate myofibroblasts by inhibiting the polarization and infiltration of M2 macrophages, which would prevent excessive wound contraction and collagen deposition. There are several factors that influence the decision to eliminate the bedsore, such as the size, location and depth of the wound, as well as the underlying infection or necrotic tissue.
In situations where scarring obstructs the visualization of the wound or prevents the application of topical treatments, debridement may be justified to facilitate the healing process. In addition, the removal of scarring may be indicated in wounds where the patient is at risk of developing complications, such as infection or impaired blood circulation. However, the elimination of sores must be carefully weighed taking into account the potential risks and benefits, taking into account the patient's general health status, the characteristics of the wound and the objectives of the treatment. A bedsore of this type is said to be God's band-aid, as it is intact and prevents external contaminants from entering the tissue.
underlying. In the case of an inadequate blood supply for healing, removing the necrotic tissue will only lead to a larger wound that will not heal. This reinforces the standard of care, which states that the evaluation of any injury below the knee should include a vascular exam. The primary goal of debridement is to remove all devitalized tissue from the wound bed to promote wound healing.
Debridement is also used to eliminate biofilm, biological burden and senescent cells, and it is suggested to do so at every encounter. Proper management and removal of bedsores plays a crucial role in starting the healing process, which can take weeks or months to fully recover. Often recognized as a dry, dark, or leathery coating that covers a wound, is a protective barrier that results from tissue necrosis. After removal or treatment of the bedsore, diligent wound care and continuous monitoring are essential to prevent infection, promote granulation tissue formation and minimize the risk of recurrence.
The preservation of scarlet fever inhibits collagen expression in proteins associated with contraction (actin and vimentin of smooth muscle α), collagen expression, inflammatory cytokines (IL-1beta, IL-10, TFN-α and IL-) and macrophage infiltration M2. The escar reserve downregulated the gene expression of the inflammatory factors IL-6, IL-10, TNF- and IL-4.The treatment of bedsore depends on several factors, including the patient's etiology, size, depth, and general condition of the wound. Escarectomy followed by replacement with a skin graft is a conventional treatment4 for patients with deep burns, which is beneficial in reducing the infection rate5 and reducing inflammation. Addressing underlying risk factors, such as optimizing vascular perfusion and treating comorbidities, is crucial to prevent future scarring and promote overall wound healing. A number of factors contribute to the formation of sores, such as trauma, burns, pressure injuries, arterial or venous insufficiency, and certain medical conditions, such as diabetes or peripheral vascular diseases.
Contraindications include, depending on the mechanical debridement modality used, the presence of granulation tissue in a larger amount than devitalized tissue, the inability to control pain, patients with poor perfusion and an intact escara without clear clinical evidence of an underlying infection. Whether the wound has formed a crust or scaly tissue, one way to help prevent infection and heal the wound is to keep the surrounding skin clean and free of infection. The bedsore is usually firm and adheres firmly to the underlying skin, forming a protective barrier against future infections and injuries. Two of these protective mechanisms, scabs and bedsores, are common in many types of wounds and they are often confused.
In addition, high levels of multiple inflammatory factors were detected in the elimination group, including proinflammatory factors (IL-6 and TNF-α) secreted by M1 macrophages and anti-inflammatory factors (IL) secreted by M2 macrophages, which were likely triggered by secondary inflammation following the removal of the scare. In addition, bedsores normally require debridement or extraction to facilitate wound healing, while scars may require interventions such as scar massage or the application of silicone gel to improve appearance and flexibility.
