Debridement

 

 

Debridement is an essential part of the management of many wounds. 1

Debridement is the removal of dead, damaged, or infected tissue that would otherwise impair the healing of a wound.1

  • Due to the underlying pathology of chronic wounds, on-going maintenance debridement is often required to remove the continual build up of necrotic tissue and reduce the bacterial burden.1
  • Traumatic wounds which are dirty will require debridement before treatment can begin.
  • Severe burns are often treated by wholesale excision followed by grafting.

WHEN IS DEBRIDEMENT NOT NECESSARY/REQUIRED FOR WOUND HEALING?

There are some instances where debridement is not appropriate and close monitoring of the wound is essential.2

Debridement is generally not recommended for arterial ulcers and diabetic ulcers with dry eschar or gangrene, without infection, and with an insufficient vascular supply for healing, unless circulation to the area can be improved.3


METHODS OF DEBRIDEMENT

Although several methods for debridement exist, 3 common methods are detailed here:

Surgical: Removal of necrotic tissue by a qualified practitioner may be done by sharp or surgical debridement. The practitioner removes necrotic tissue with the use of sterile instruments including scissors, forceps, and scalpel.5

Autolytic: Selective removal of necrotic tissue by the body's own enzymes (liquefaction of necrotic tissue).1 Moisture-retentive dressings remove necrotic tissue while maintaining a moist wound-healing environment that supports proliferation of granulation tissue and re-epithelialisation.4

Enzymatic: Removal of necrotic tissue through the application of prescription enzymatic debriding agents that break down the tissue through a chemical process.5


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