Types of Debridement
- Surgical debridement is the fastest method, allowing selective removal of tissue.
- Autolytic debridement uses the body's own enzymes to liquefy necrotic tissue.
- Enzymatic debridement involves the use of chemical enzymes to slough off necrotic tissue.
- Mechanical debridement can be achieved through directed wound irrigation or therapeutic irrigation with suction.
- Maggot therapy uses small maggots to consume necrotic tissue in a precise manner.
Surgical Debridement
- Surgical or sharp debridement is performed under anesthesia and allows for complete control over tissue removal.
- It can be done in the operating room or bedside, depending on the extent of necrotic material.
- Tissue is debrided back to viability based on appearance and blood flow in healthy tissue.
- It is commonly used in the treatment of burns, serious wounds, and certain snake and spider bites.
- Surgeons may debride surrounding healthy tissue to ensure complete removal of tumors.
Autolytic Debridement
- Autolysis uses the body's own enzymes and moisture to soften and liquefy necrotic tissue.
- It is a selective and virtually painless method for the patient.
- Occlusive or semi-occlusive dressings can maintain wound fluid in contact with the necrotic tissue.
- Hydrocolloids, hydrogels, and transparent films are commonly used for autolytic debridement.
- It is suitable for wounds with limited dead tissue and no infection.
Enzymatic Debridement
- Chemical enzymes derived from micro-organisms or plants are used to slough off necrotic tissue.
- Some enzymatic debriders are selective, while others are not.
- This method is effective for wounds with a large amount of necrotic debris or eschar formation.
- However, its effectiveness is variable, and it is not considered a standard of care for burn treatments.
- The use of enzymatic debridement is limited and requires further research.
Mechanical Debridement
- Hydrotherapy, such as directed wound irrigation, can be used for selective mechanical debridement.
- Whirlpool baths should not be used as they can damage all tissue and increase the risk of infection.
- Hydrosurgery utilizes a high-pressure, water-based jet system to remove burnt skin.
- This method aims to leave behind healthy skin and requires more research for its effectiveness.
- Non-selective debridement can be achieved by allowing a dressing to proceed from moist to dry and manually removing it.
This article needs additional citations for verification. (May 2013) |
Debridement is the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. Removal may be surgical, mechanical, chemical, autolytic (self-digestion), and by maggot therapy.
| Debridement | |
|---|---|
 Necrotic tissue from the left leg is being surgically debrided in a patient with necrotizing fasciitis. | |
| Pronunciation | /dɪˈbriːdmənt/ |
| ICD-10-PCS | 0?D |
| MeSH | D003646 |
In podiatry, practitioners such as chiropodists, podiatrists and foot health practitioners remove conditions such as calluses and verrucas.
Debridement is an important part of the healing process for burns and other serious wounds; it is also used for treating some kinds of snake and spider bites.
Sometimes the boundaries of the problem tissue may not be clearly defined. For example, when excising a tumor, there may be micrometastases along the edges of the tumor that are too small to be detected, but if not removed, could cause a relapse. In such circumstances, a surgeon may opt to debride a portion of the surrounding healthy tissue to ensure that the tumor is completely removed.
Borrowed from French débridement.
debridement (countable and uncountable, plural debridements)
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