Debridement is a medical procedure which involves removing necrotic tissue, made up from metabolic waste and dead tissue from a wound. This material needs to be removed in order for a patients body to resume the natural healing process. Necrotic tissue hinders progress because it starves the wound of free radicals and cells which aid healing. It can also hide wound complications which are underneath it, such as an abscess or build up of fluid, and increase the risk of infection caused by bacterial growth and sepsis.
There are several different methods of debridement, and although some surgeons prefer certain ones personally, there’s not been a great deal of studies to help the medical profession decide which is the best. The method of debridement used for any particular wound will depend on the wound itself, and the skill of the surgeon involved.
~ Mechanical debridement
Mechanical debridement involves wet to dry dressings, and the use of wound irrigation. With a wet to dry dressing a piece of damp gauze is used to cover a wound. As it dries it picks up necrotic tissue, which comes away as the dressings removed. Unfortunately this method can induce pain, and so often isn’t used as much as other methods, some of which are virtually pain free.
Wound irrigation is applied by a system known as pulsed lavage, which lets medical practitioners cleanse a wound using irrigation pressure at regular intervals over a period of days.
~ Sharp debridement
Sharp debridement is only carried out by highly skilled surgeons, and involves using surgical instruments, such as a scalpel or laser to cut away necrotic tissue. This method of debridement is generally used in emergency situations.
~ Chemical debridement
With chemical debridement an enzymatic agent, in solution or gel form, is applied to necrotic tissue in order to dissolve it. Application has to be carefully limited to the affected area, otherwise healthy tissue is also dissolved along with unhealthy tissue.
~ Autolytic debridement
Topical dressings are used to promote debridement through moisture. Necrotic tissue is then cleared by cells and enzymes which digest the material by a process known as liquefaction.
~ Maggot debridement
Fly larvae, otherwise refered to as maggots, are used to dissolved necrotic tissue when applied to a wound. Although many people associate maggots with germs and dirt, the opposite is true of them when used in debridement, as they cleanse a wound by killing bacteria, and speed up the healing process.
The different debridement methods used can be extremely effective when applied correctly, stimulating a patients natural healing process while lessening the chances of infection and fatality.
Sources
medical edu.com
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