- 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.
- 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).
- 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.
- 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 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.
Assessment and Management of Pressure Injuries for the Interprofessional Team, Third Edition
Point of Care Resources