What Is The Role of Wound Debridement

If you have a wound that’s not healing properly, your doctor may suggest one of several procedures known as wound debridement. These treatments remove dead or infected tissue so that your wound can heal properly.

Here’s what you need to know about wound debridement and why it’s important to the healing process.

What Is Wound Debridement?

Wound debridement is the removal of dead tissue, infected tissue, or debris from a wound so that it can heal properly. Doctors may remove the tissue or debris from a wound with surgical or non-surgical methods. It can be a single treatment or multiple treatments.

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Why Is Wound Debridement Necessary?

Usually, a wound will heal on its own as part of your body’s immune system response. But sometimes a wound doesn’t get better on its own. It may have become infected, or there may be a piece of foreign debris lodged in the wound.

Dead tissue in a wound can also delay healing and prevent the formation of healthy tissue. It creates an inviting environment for bacteria, increasing the risk of infection. A severe infection can lead to a life-threatening condition known as sepsis, when you go into shock and your organs stop working.

Types of Wound Debridement

There are several different ways of removing dead tissue or infected tissue, including surgery or the application of special dressings. The treatment will depend on the size and severity of the wound. Your doctor may use more than one method of removing dead tissue or infected tissue from your wound.

Your doctor will talk to you about the best method for your condition. Your treatment may take place in a hospital bed or your doctor’s office. It can also happen in a wound care center or in a hospital operating room.

Some treatment options for wound debridement are:

Autolytic debridement

This is the most conservative type of debridement. It uses your body’s own enzymes and natural fluids to break down dead tissue. Your doctor will apply a dressing to the wound to help seal in moisture.

The increased moisture around the wound speeds up the process of separating dead from healthy tissue. This treatment is best for small wounds that aren’t infected. Doctors sometimes use it in tandem with other debridement treatments.

Enzymatic debridement

This is another conservative approach to wound debridement. Doctors apply chemical enzymes to the wound through an ointment or gel, then cover it with a dressing. The enzymes may be from an animal, plant, or bacteria.

The enzymes produce more moisture, which helps break down dead tissue. Doctors don’t use this method in wounds that are heavily infected.

Mechanical debridement

This type of debridement involves removing dead tissue with some type of gentle pressure. It might be lightly scrubbing the wound with a soft pad to remove debris. Another method is to use hydrotherapy, or a stream of sterile saline solution, to wash away dead tissue or debris.

Biological debridement

It sounds strange, but another method of wound debridement is using the sterile, live larvae of the common greenbottle fly. The larvae eat only the dead tissue and produce chemicals that speed up the healing process. They don’t eat healthy tissue.

Your doctor will place the larvae directly on the wound or in a mesh bag kept on with a dressing. They stay on for a few days at a time.

Surgical debridement

This type of debridement is done when the doctor uses a scalpel, scissors, or other surgical instrument to cut dead tissue from the wound.

Patients may require local anesthesia near the surgical site, and some might need general anesthesia (asleep) if a major clean-up is needed.

Recovering From Wound Debridement

Recovery time after wound debridement may vary, depending on how severe the wound was, its location, and the type of debridement method used. Most methods may only generate some mild discomfort upon dressing removal while chronic wounds could need repeat procedures to ensure that the wound heals in a timely manner.

It may also take longer to recover if you have health issues (like diabetes) that slow healing.

You might experience pain after wound debridement, especially if you had surgery. Your doctor will give you instructions on how to care for your wound.

You should call your doctor if you have any questions or concerns after wound debridement or if you experience any signs of infection such as:

  • Redness.
  • Swelling.
  • A bad odor.
  • Fever.
  • Nausea.
  • Chills.
  • Vomiting.
  • Increasing pain.
  • Bleeding or discharge around the wound.
Sources

American College of Surgeons Division of Education, Non-Healing Wounds, Link

National Library of Medicine, Wound Debridement, Link

MyHealth.Alberta.ca, What is wound debridement? Link

MyHealth.Alberta.ca, Wound debridement: What to expect at home, Link

Nursing Times, The principles of maggot therapy and its role in contemporary wound care, Link

JAMA Dermatology, Frequency of Debridements and Time to Heal, Link

About UPMC

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