Wound Debridement

Wound debridement is a procedure used to remove dead tissue and contaminated substances from a wound. A wound must be clean to heal. It also must get a good supply of blood. Anything that is stopping this must be taken out of the wound. This could be dead tissue, scar tissue, fluid buildup, or debris from outside of the body. Wounds that are not cleaned by debridement heal slowly or not at all. They can become infected. Any infection in the tissue can also spread to nearby areas or to other parts of the body through the blood. Wound debridement can be done through a surgical procedure or various other methods.

Debridement is sometimes done to get a sample of tissue from the wound. The tissue can be checked under a microscope or sent to a lab for testing.

LET YOUR CAREGIVER KNOW ABOUT:

  • Any allergies you have.

  • All medicines you are taking, including vitamins, steroids, herbs, eyedrops, and over-the-counter medicines and creams.  

  • Previous problems you or members of your family have had with the use of anesthetics.  

  • Any blood disorders you have had.  

  • Previous surgeries you have had.  

  • Other health problems you have.  

RISKS AND COMPLICATIONS

Generally, wound debridement is a safe procedure. However, as with any medical procedure, complications can occur. Possible complications include:

  • Bleeding that does not stop.  

  • Infection.  

  • Damage to nerves, blood vessels, or healthy tissue inside the wound.  

  • Pain.  

  • Lack of healing.

BEFORE THE PROCEDURE

  • The caregiver will check the wound for signs of healing or infection. A measurement of the wound will be taken, including how deep it is. A metal tool (probe) may be used. Blood tests may be done to check for infection.  

  • If you will be given medicine to make you sleep through the procedure (general anesthetic), do not eat or drink anything for at least 6 hours before the procedure. Ask your caregiver if it is okay to have a sip of water with any needed medicine.  

  • Make plans to have someone drive you home after the procedure. Also, make sure someone can stay with you for a few days.  

PROCEDURE

The following methods may be used alone or in combination.

Surgical debridement:

  • Small monitors may be placed on your body. They are used to check your heart, blood pressure, and oxygen level.  

  • You may be given medicine through an intravenous (IV) access tube in your hand or arm.  

  • You might be given medicine to help you relax (sedative).  

  • You may be given medicine to numb the area around the wound (local anesthetic). If the wound is deep or wide, you may be given general anesthetic to make you sleep through the procedure.  

  • Once you are asleep or the wound area is numb, the wound may be washed with a sterile saltwater solution.  

  • Scissors, surgical knives (scalpels), and surgical tweezers (forceps) will be used to remove dead or dying tissue. Any other material that should not be in the wound will also be taken out.  

  • After the tissue and other material have been removed from the wound, the wound will be washed again.  

  • A bandage (dressing) may be placed over the wound.  

Mechanical debridement:

Mechanical debridement may involve various techniques:

  • A dressing may be used to pull off dead tissue. A moist dressing is placed over the wound. It is left in place until it is dry. When the dressing is lifted off, this lifts away the dead tissue.  

  • Whirlpool baths may be used to flush the wound with forceful streams of hot water.  

  • The wound may be flushed with sterile solution.

  • Surgical instruments that use water under high pressure may be used to clean the wound.

Chemical debridement: 

  • A chemical medicine is put on the wound. The aim is to dissolve dead or dying tissue. Ointments may also be used.

Autolytic debridement: 

  • A special dressing is used to trap moisture inside the wound. The goal is for the wound to heal naturally under the dressing. Healing takes longer with this treatment.

AFTER THE PROCEDURE

  • If a local anesthetic is used, you will be allowed to go home as soon as you are ready. If a general anesthetic is used, you will be taken to a recovery area until you are stable. Your blood pressure and pulse will be checked often. You may continue to get fluids through the IV tube for a while. Once you are stable, you may be able to go home, or you may need to stay in the hospital overnight. Your caregiver will decide when you can go home.  

  • You may feel some pain. You will likely be given medicine for pain.

  • Before you go home, make sure you know how to care for the wound. This includes knowing when the dressing should be changed and how to change it.  

  • Set up a follow-up appointment before leaving.