- Debridement is necessary to remove devitalized tissue and exudate, reduce the risk of infection, prepare the wound bed and promote healing.
- Debridement can be:
- Autolytic, the natural self-clearance of debris in the wound bed by phagocytosis and proteolytic enzymes
- Mechanical, the use of wet-to-dry dressings, hydrotherapy or irrigation with saline solution
- Enzymatic
- Sharp, using a scalpel or scissors
- Select the method of debridement most appropriate to the client’s condition and goals.
- Sharp debridement is a high-risk procedure.
- Debridement with a scalpel should be undertaken with caution and performed by specially trained and experienced healthcare professionals.
- Key factors in deciding method of debridement (1=most desirable, 5=least desirable)
|
|
Surgical |
Enzymatic |
Autolytic |
Biologic |
Mechanical |
|
Speed |
1 |
3 |
5 |
2 |
4 |
|
Tissue selectivity |
3 |
1 |
4 |
2 |
5 |
|
Painful wound |
5 |
2 |
1 |
3 |
4 |
|
Exudate |
1 |
4 |
3 |
5 |
2 |
|
Infection |
1 |
4 |
5 |
2 |
3 |
|
Cost |
5 |
2 |
1 |
3 |
4 |
Clinical Management
Assessment and Management of Venous Leg Ulcers
Point of Care Resources