Debridement is a common treatment used for lower extremity wound care. This article discusses what debridement is, the types of debridement procedures, when they are used, and the benefits of debridement.
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Debridement is a procedure where a surgeon removes dead (necrotic) or infected skin tissue. This lower extremity wound care procedure is used to help a wound heal. It can also be used to remove foreign material from tissue.
Wounds can get trapped in the first stage of healing in the presence of dead or infected tissue. Debridement restarts the healing process, allowing the wound to heal properly. It can also help reduce scar tissue and minimize complications that arise with infections.
There are several different types of debridement procedures. Your physician will choose the best procedure according to the following factors:
It is common for your physician to use more than one of the following methods:
Sterile maggots are used in biological debridement. This procedure is also known as biosurgery, maggot debridement therapy, and larval therapy.
The maggots aid wound healing by eating the dead tissue in the wound. They also release antibacterial substances and eat harmful bacteria, helping to control infection.
The maggots are secured on the wound with a dressing for 24-72 hours and replaced twice a week. Biological debridement is ideal for large wounds and those infected with bacteria resistant to antibiotics such as MRSA. It may also be indicated if you cannot have surgery.
Chemical debridement (or enzymatic debridement) uses a gel or liquid that contains enzymes to soften unwanted tissue. The enzymes can be sourced from animals, plants, or bacteria. The treatment is applied to the wound once or twice a day and covered with a dressing. The dead tissue is removed along with the dressing when it is removed.
Chemical debridement is often used when patients have bleeding problems, or they have a high risk for complications from surgery. You are not usually recommended for chemical debridement if you have large or severely infected wounds.
Autolytic debridement will soften only necrotic tissue by using your body’s enzymes and natural fluids. A dressing that retains moisture is applied to the wound. The moisture will cause the dead tissue to swell and separate from the wound.
Autolytic debridement is often recommended for non-infected wounds and pressure sores. It can also be used along with another form of debridement if the wound is infected.
The most common type of wound debridement is mechanical debridement. A moving or mechanical force is used to remove unhealthy tissue. There are different types of mechanical debridement. They include:
Mechanical debridement can be used for both non-infected and infected wounds.
Sharp debridement is the removal of unhealthy tissue by cutting it off. Conservative sharp debridement is a minor surgery. Your physician may use scalpels, curettes, or scissors to remove the dead tissue. Your physician will avoid cutting the surrounding healthy tissue.
Surgical debridement, on the other hand, uses surgical instruments. The procedure may involve cutting some of the healthy tissue around the wound. It’s usually performed by a surgeon and requires anesthesia.
Sharp debridement is usually needed if other forms are ineffective or if the need for debridement is urgent. Surgical sharp debridement is generally reserved for large, deep, or very painful wounds.
Not all wounds will need debridement. You may need debridement if:
The use of debridement is a standard treatment in wound management. The benefits of using debridement include the removal of necrotic tissue and bacteria as well as senescent cells. Debridement also stimulates the activity of growth factors.
Most of the debridement procedures can be performed fairly quickly at the bedside. The only exception is surgical sharp debridement, which will take a bit longer because of the use of anesthesia and the need to use the operating room.
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Medically reviewed by Terrence M. Philbin, DO
