What is the slough on the wound?

What is wound slough?

During the wound healing process, yellow or grayish-white soft tissue sometimes appears, commonly known as slough. Its appearance also indicates that wound healing is impaired . Slough is usually a mixture of necrotic cells, fibrin, white blood cells, and bacteria. It is usually yellow or grayish-white in appearance, soft and moist in texture, and sometimes stringy or sticky. Unlike healthy granulation tissue, slough does not bleed, is soft to the touch, and is not noticeably painful. The presence of slough hinders the migration and proliferation of new epithelial cells, delaying the wound healing process. It also provides a favorable environment for bacterial reproduction and increases the risk of infection.

What are the causes of carrion formation?

Insufficient local blood supply is one of the main causes of slough formation. When the wound is locally ischemic, the tissue cannot obtain enough oxygen and nutrients, leading to cell death. Wound infection can also promote the formation of slough. The toxins produced by bacteria can destroy healthy tissue, trigger an inflammatory response, and form necrotic tissue. Certain systemic diseases, such as diabetes and peripheral vascular disease, can affect microcirculation and increase the risk of slough formation. Malnutrition, especially protein deficiency, reduces the ability of tissue repair and makes necrotic tissue more likely to form. Excessive external pressure or improper wound care, such as inappropriate dressing selection or untimely replacement, can also lead to slough.

How to distinguish slough from other wound tissue?

Slough tissue must be distinguished from other types of wound tissue. Healthy granulation tissue is bright red, granular, easily bleeds, and is mildly painful, a sign of wound healing. Necrotic tissue is typically black or brown, hard and dry, clearly demarcated from surrounding tissue, and requires debridement and removal. Slough tissue, on the other hand, is yellow or off-white, soft and moist, does not bleed, and is poorly demarcated from surrounding tissue. Accurately identifying wound tissue type is crucial for taking appropriate treatment measures.

How to deal with wound slough?

Debridement is the primary method for managing slough. Mechanical debridement uses sterile instruments to directly remove slough and is suitable for small amounts of slough and healthy surrounding tissue. Autolytic debridement utilizes enzymes in the wound's own exudate to soften the slough. Hydrocolloid or hydrogel dressings are used to keep the wound moist and promote autologous debridement. Enzymatic debridement uses exogenous enzymes such as collagenase and papain to break down necrotic tissue. Biological debridement utilizes medical maggots to selectively engulf necrotic tissue, preserving healthy tissue. For large amounts of slough or deep necrotic tissue, surgical debridement may be required.

How to promote wound healing after debridement?

After debridement, a favorable environment for healing needs to be created. Keep the wound moderately moist and use appropriate dressings such as foam dressings and alginate dressings. Control infection by using silver dressings or antibiotic ointments as appropriate. Improve local blood circulation by massaging the surrounding skin and engaging in appropriate activities. Provide adequate nutritional support and ensure adequate intake of protein, vitamins, and trace elements. For chronic wounds, advanced treatments such as negative pressure wound therapy or growth factors may be considered.

How to prevent slough formation?

Preventing slough formation requires a multifaceted approach. Keep the wound clean, change the dressing regularly, and avoid infection. Reduce local pressure on the wound, especially in areas like the sacrum or heel for bedridden patients. Manage underlying medical conditions, control blood sugar, and improve circulation. Provide adequate nutritional support, especially protein and vitamin supplements.

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Editor: kiki Jia