Types (Categories) of Debridement

Sharp Debridement

• Best used when the need is urgent, such as with advancing cellulitis or sepsis, increased pain, exudate, and odour.
• Consider using regular sharp debridement to remove biofilm that can impede normal wound healing.
• Must be conducted in an appropriate clinical setting, with sufficient pain management and follow-up by a qualified health-care professional who understands its application and potential complications, and is able to solve problems that may arise during or after treatment.
• Sterile instruments must be used.

Conservative Sharp Wound Debridement

• Used to control infection in non-healable wounds (e.g., persons in palliative care) and to reduce the load of necrotic tissue as part of wound-bed preparation in healable wounds.
• Must only be conducted by a qualified health-care professional who understands its application and potential complications, and can solve problems that may arise during or after treatment.

Autolytic Debridement

• Moisture-retentive dressings, such as hydrocolloids, hydrogels, transparent films, and alginates provide the moist wound environment required for autolytic debridement.
•  The production of exudate may increase.
• It is recommended that the appropriate dressing be chosen to accommodate the increased exudates.
• Should not be used when a wound infection has not been treated or for large pressure injuries (where necrotic tissue exceeds 50 percent).

Enzymatic Debridement

• Products work best in a moist wound environment.
• Follow manufacturers’ instructions prior to using endogenous enzymes, because some products can be deactivated by heavy metals found in wound cleansers, topical dressings, and antimicrobial agents.

 Mechanical Debridement

• Include wound irrigation, wound compressing, and ultrasound.
• Hydrosurgery is also considered to be a form of mechanical debridement; however, because of its cost, the need for specialized training, and the potential for infection control issues, the expert panel does not recommend its use to debride wounds.

Larval Debridement

• Larval debridement involves the application of disinfected maggots to an open wound.
• Maggots release enzymes that break down devitalized tissue.
• The evidence on larval debridement is limited.
• Additional high-quality research is required to determine its effectiveness over other debridement methods.