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Types of Wound Debridement
Description:
- Autolysis uses the body's own enzymes and moisture to
re-hydrate, soften and finally liquefy hard eschar and
slough. Autolytic debridement is selective; only necrotic
tissue is liquefied. It is also virtually painless for
the patient. Autolytic debridement can be achieved with
the use of occlusive or semi-occlusive dressings which
maintain wound fluid in contact with the necrotic tissue.
Autolytic debridement can be achieved with hydrocolloids,
hydrogels and transparent films.
Best Uses:
- In stage III or IV wounds with light to moderate exudate
Advantages:
- Very selective, with no damage to surrounding skin.
- The process is safe, using the body's own defense
mechanisms to clean the wound of necrotic debris.
- Effective, versatile and easy to perform
- Little to no pain for the patient
Disadvantages:
- Not as rapid as surgical debridement
- Wound must be monitored closely for signs of infection
- May promote anaerobic growth if an occlusive hydrocolloid
is used
Description:
- Chemical enzymes are fast acting products that produce
slough of necrotic tissue. Some enzymatic debriders are
selective, while some are not.
Best Uses:
- On any wound with a large amount of necrotic debris.
- Eschar formation
Advantages:
- Fast acting
- Minimal or no damage to healthy tissue with proper
application.
Disadvantages:
- Expensive
- Requires a prescription
- Application must be performed carefully only to the
necrotic tissue.
- May require a specific secondary dressing
- Inflammation or discomfort may occur
Description:
- This technique has been used for decades in wound care.
Allowing a dressing to proceed from moist to wet, then
manually removing the dressing causes a form of
non-selective debridement.
- Hydrotherapy is also a type of mechanical debridement.
It's benefits vs. risks are of issue.
Best Uses:
- Wounds with moderate amounts of necrotic debris
Advantages:
- Cost of the actual material (ie. gauze) is low
Disadvantages:
- Non-selective and may traumatize healthy or healing
tissue
- Time consuming
- Can be painful to patient
- Hydrotherapy can cause tissue maceration. Also,
waterborne pathogens may cause contamination or
infection. Disinfecting additives may be cytotoxic.
Description:
- Sharp surgical debridement and laser debridement under
anesthesia are the fastest methods of debridement.
- They are very selective, meaning that the person
performing the debridement has complete control over
which tissue is removed and which is left behind
- Surgical debridement can be performed in the operating
room or at bedside, depending on the extent of the
necrotic material.
Best Uses:
- Wounds with a large amount of necrotic tissue.
- In conjunction with infected tissue.
Advantages:
- Fast and Selective
- Can be extremely effective
Disadvantages:
- Painful to patient
- Costly, especially if an operating room is required
- Requires transport of patient if operating room is
required.
Click here to see our new section on
Maggot Debridement Therapy written by Dr. Ronald Sherman.
These images were supplied by David Janssen, M.D.
Dr. Janssen used to have a very detailed website, but now it's
gone.
Place your mouse over each image for an explanation.
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