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What is Wound Debridement?

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  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 10 November 2016
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Wound care may require additional steps to promote healing. Sticking a bandage on a wound isn’t always enough. One of these steps is called wound debridement, which may be executed through a number of methods. It helps take off tissue that is dead or diseased, leaving behind healthy tissue that is likely to heal better in the absence of undesirable tissue. As mentioned, a number of different wound debridement strategies exist, and these progress from very little actual manual tissue removal, to significant tissue removal that can be exceptionally precise.

One type of wound debridement is called wet to dry packing or autolytic. This involves placing wet dressing like gauze on the wound so it stays moist. Several wet packs could be applied before beginning dry dressing that may seal in moisture. This sealed environment takes advantage of the body’s own ability to heal by producing a variety of healing bodily chemicals. Autolytic wound debridement is typically called the most preferred method, since the body sloughs off dead tissue naturally. On the other hand, this is not appropriate in all circumstances and is very unlikely to be preferred if the wound has infectious matter in it.

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Another approach is removing dead tissue with gauze. A wound will be covered with piece of gauze soaked in a special solution, and when this dries it is pulled off. The procedure, called mechanical wound debridement, is something like beauty waxing. Healthy and dead skin cells get removed, and many people criticize this form because it takes off more healthy skin cells than is necessary.

An alternative is chemical wound debridement. Certain chemicals that contain enzymes are placed on the wound, and these may destroy necrotic tissue instead of healthy tissue. One variant of this is larval or biological wound debridement, which uses maggots that eat away dead tissue while leaving healthy tissue in its place. As stomach curdling as this sounds, this form of debridement can be fairly successful.

Sometimes a wound infection is so severe, much greater precision is needed immediately. In these instances, doctors may turn to surgical wound debridement, which can occur at bedside for some people or may need to happen in an operating room. Using a variety of techniques a surgeon can precisely remove infected or dead tissue in order to give live healthy tissue a chance to heal. Wounds might also be stitched closed in some procedures.

For patients who might hear the term debridement, it’s clear this can mean many different types of care, all designed to promote the healing of wounds. It certainly makes sense to talk to doctors about the type of debridement they plan and why they think that particular type is most advantageous. Many of these wound treatments may be accompanied with local anesthetic if the injured area is very painful, and surgical debridement may require general anesthesia.

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