Debridare

Debridare, known in English as debridement, is the medical removal of nonviable tissue, foreign material, and debris from a wound to promote healing and reduce infection. It is performed by trained clinicians in settings such as hospitals, wound-care clinics, and operating rooms.

Methods include sharp debridement (scalpel or scissors to excise nonviable tissue), mechanical debridement (irrigation, wet-to-dry dressings), enzymatic debridement (proteolytic enzymes), autolytic debridement (moist dressings that support the body’s own enzymes), and biological debridement (maggot therapy).

Indications include necrotic tissue, infection or high bioburden, and non-healing wounds such as diabetic ulcers, venous and pressure ulcers, and post-traumatic wounds. It may also prepare a wound bed for grafting or closure. Contraindications include viable tissue where removal would cause functional loss, significant bleeding risk, or instability that precludes procedures.

The procedure involves local anesthesia, sterile technique, wound assessment, selection of the method, and follow-up care. Aftercare focuses on wound cleansing, dressings, pain control, and monitoring for signs of infection or healing. Some wounds require repeated sessions.

Risks include pain, bleeding, infection, damage to healthy tissue, delayed healing, and scarring. Debridement does not guarantee rapid healing, and in some wounds conservative care may be preferred.

Etymology: the term debridare is related to debridement, deriving from French débridement; it is used in several languages as a cognate.