Wound Debridement Procedures

Wounds are debrided to speed up the healing process. Burns, pressure ulcers and other types of wounds are debrided to remove dead and decaying tissue. These tissues can harbor bacteria, which can lead to inflammation, infection and longer healing time. A wound debridement takes place under the care of a physician, and may be done mechanically, or with the assistance of medical tools.

Autolytic Debridement

• Autolytic debridement takes advantage of the body's immune defenses to break down and separate dead tissue. Keep a wound moist with dressings and ointments. Trapped wound fluid will bond to dying and dead tissue to dissolve it. This type of debridement is done selectively, as wounds that are infected or at risk for becoming infected would only be aggravated by trapped fluid and dead tissue.

Mechanical Debridement

• Mechanical debridement involves the use of a saline-moistened dressing that is allowed to dry and adhere to the wound. Once the dressing has dried, it is removed, which pulls away the dead tissue. Unfortunately, living tissue is also pulled away, and the process can be quite painful. Needless to say, this type of debridement is not used for wounds where new skin has formed.

Chemical Debridement

• Chemical debridement uses enzymes and other tissue-dissolving compounds to debride wounds. The enzymes and compounds are modeled after collagenase, an enzyme the body makes to break down collagen. The synthetic enzymes and compounds are topically applied after the wound has been flushed with saline. A topical antibiotic is then applied to prevent any resulting infection from entering the bloodstream. Finally, a moist dressing is placed over the wound to protect it and to allow the applied enzymes and compounds to penetrate the wound and break down necrotic tissue.

Surgical Debridement

• A physician will use a scapel, a pair of scissors or other surgical instruments to carefully cut away dead tissues. This type of debridement is the quickest and most effective, and is preferred in cases where cellulitis or sepsis are suspected. It can also be performed at a patient's bedside, though in some circumstances it may be appropriate to perform the procedure in an operating room.
  Most physicians prefer to perform surgical debridement, as it is a precise operation that allows dead tissue to be removed without disturbing live tissue, or causing the patient more than minimal pain.

Aftercare

• After any type of debridement, the physician will cover the wound with a dry or moist dressing. It will need to be changed as needed, and antibiotic ointments may also be used to reduce the chance of infection.