Debridement 

is the medical removal of a patient's dead, damaged, or infected tissue to improve the

healing potential of the remaining healthy tissue. Removal may be surgical, mechanical,
chemical, autolytic (self-digestion), and by maggot therapy, where certain species of
live maggots selectively eat only necrotic tissue.

VAC

A dressing, containing a drainage tube, is fitted to the contours of a deep or irregularly-shaped wound and
sealed with a transparent film. The tube is connected to avacuum source, turning an open wound into a
controlled, closed wound while removing excess fluid from the wound bed to enhance circulation and
remove waste from the lymphatic system. The technique is usually used with chronic wounds or wounds
that are expected to present difficulties while healing (such as those associated with diabetes or when
the veins and arteries are unable to provide or remove blood adequately).

Gait Patterns – Summary According to Various Sources

 
Two-point gait:  one crutch and opposite extremity move together followed by the opposite
crutch and extremity; requires use of two assistive devices (canes or crutches); allows for natural
arm and leg motion during gait, good support and stability from two opposing points of contact. 
 
Three-point gait:  both crutches and involved leg are advanced together, then uninvolved leg is
advanced forward; requires use of two assistive devices (crutches or canes) or a walker; indicated
for use with involvement of one extremity , e.g. lower extremity fracture.
 
Four-point gait:  a slow gait pattern in which one crutch is advanced forward and placed on the
floor, followed by advancement of the opposite leg; then the remaining crutch is advanced
forward followed by the opposite remaining leg; requires the use of two assistive devices
(crutches or canes); provides maximum stability with three points of support while one limb is
moving.
 
Swing-to gait:  both crutches are advanced forward together; weight is shifted onto hands for
support and both legs are then swung forward to meet the crutches; requires the use of two
crutches or a walker; indicated for individuals with limited use of both lower extremities and
trunk instability.
 
Swing-through gait: both crutches are advanced forward together; weight is shifted onto the
hands for support and both legs which are swung forward beyond the point of crutch placement;
requires the use of two crutches; both swing-to and swing-through gaits are used for bilateral
lower extremity involvement, and trunk instability, e.g. patient with paraplegia, spina bifida.  Not
as safe as swing-to gait.