Eschar is necrotic tissue composed of denatured collagen and elastin and protein. Eschar favors wound infection and delay healing. Debridement removes the devitalized tissue and provide a viable base for wound healing and grafting. Debridement can be done with mechanical, enzymatic and surgical. Enzymatic reduce need for surgical debridement.
Disadvantages are increase pain and fluid loss.
Kirscher in archive of dermatology 1975 examined hypertrophic scar with EM and found that hypertrophic scars when pressure-treated appear to mature more quickly. Pressure garments protect fragile maturing wound from trauma, decrease itching, reduce edema, decrease hypertrophic scar, and speed wound healing. Focal nerve compression, Multiple mononeuropathies, Generalized peripheral neuropathies Heterotopic ossification- is more likely to occur the llonger the wound is open. HO can cause loss of ROM, and nerve entrapment mononeuropathies. Microstomia to keep mouth opened.