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Debridement is the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. [2] [3] Removal may be surgical, mechanical, chemical, autolytic (self-digestion), or by maggot therapy.
Mechanical debridement: Achieved through use of mechanical force to remove devitalized tissue (e.g. wet-to-dry dressing, pressurized wound irrigation, pulse-lavage); however, this process will remove both healthy and non-healthy tissue and is therefore considered a non-selective debridement method.
Timing is important to wound healing. Critically, the timing of wound re-epithelialization can decide the outcome of the healing. [11] If the epithelization of tissue over a denuded area is slow, a scar will form over many weeks, or months; [12] [13] If the epithelization of a wounded area is fast, the healing will result in regeneration.
An open wound after debridement. Debridement is an essential element of effective wound care. [7] Although this view is deeply rooted in practice it is nonetheless based on empirical observation. Bradley et al. have stated that it is "unclear whether wound debridement is a beneficial process that expedites healing". [8]
Debridement and drainage of wound fluid are an especially important part of the treatment for diabetic ulcers, which may create the need for amputation if infection gets out of control. Mechanical removal of bacteria and devitalized tissue is also the idea behind wound irrigation, which is accomplished using pulsed lavage. [14]
Mechanical debridement, is the use of debriding dressings, whirlpool or ultrasound for slough in a stable wound. Surgical debridement, or sharp debridement, is the fastest method, as it allows a surgeon to quickly remove dead tissue.
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In a major injury, if epithelial cell migration and tissue contraction cannot cover the wound, suturing the edges of the injured skin together, or even replacement of lost skin with skin grafts, may be required to restore the skin. As epithelial cells continue to migrate around the scab, the dermis is repaired by the activity of stem cells.
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