During the process of wound healing, the cells and tissue in the affected area can die, resulting in necrotic tissue. This can be due to an insufficient supply of blood, bacterial infection, or a traumatic injury. Wound debridement describes the process of removing the dead tissue to promote wound healing.
If the dead skin is not removed, healthy new tissue is prevented from developing. In addition, dead skin can hide obvious signs of infection, allowing the bacteria to thrive. When struggling with a non-healing wound, wound debridement is an important part of the healing process as it removes the dead tissue (along with its odors) and speeds up the development of healthy tissue.
How Does Wound Debridement Work?
While the body has the ability to shed dead skin itself at times, there are other times when a medical procedure is required to assist. There are five primary types of wound debridement.
Also known as larval therapy, biological debridement uses maggot, or their larvae, on the wound to eat and remove the dead skin. These maggots are sterilized and applied to the wound along with a dressing to contain the maggots within a certain area. The healthy skin is left behind to generate further and improve the wound healing.
This method involves the application of a topical agent with certain enzymes that dissolve and consume the necrotic tissue. Enzymatic debridement is often used in conjunction with surgical and sharp debridement.
This category of wound debridement uses hydrocolloids and hydrogels which are applied to the affected area. This adds moisture to the area and contributes to the degrading of the tissues so that the body can get rid of the dead tissue. Autolytic debridement is the slowest of all methods, and results in zero pain. Through the maintenance of a level of moisture, the body’s own enzymes are used to get rid of the dead tissue.
Mechanical debridement is done through a number of procedures such as irrigation, hydrotherapy, wet-to-dry dressings and an abraded technique. This technique is typically the most cost-effective, but poses a risk to the healthy tissue and can be quite painful.
Surgical and Sharp Debridement
During surgical debridement, the necrotic material is removed with medical tools such as scalpel and forceps. This results in a bleeding wound bed which improves the oxygen supply for healthy tissue to generate. Sharp debridement works in a similar way to surgical debridement. The main difference being that surgical scissors are used to remove the necrotic material.
In many instances, a combination of various debridement methods is used to remove dead tissue and improve the generation of healthy tissue.
Professional Wound Debridement
Consulting a medical expert for a consultation will give you the best indication as to whether wound debridement is a necessary procedure. Not all wounds are suited for wound debridement. For example, acute wounds do not often need debridement, but it can be an important part of chronic wound care when necrotic material has built up over time.
Wounds that need debridement are ones that have dead tissue trapping bacteria which can led to a wound infection. Dead tissue prevents new tissue from growing and can hide pockets of pus (which can also lead to infection).
If you find that your wound does not heal in an expected amount of time (approximately 2 – 3 weeks), then it may have developed into a chronic wound. Chronic wounds are more at risk of dead tissue building up, preventing healthy tissue from growing and delaying the healing process. It is best to consult an advanced wound care specialist for their expert medical advice and treatment prescription.