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.