Debridementet

Debridementet, commonly known as debridement, is the medical procedure of removing nonviable, necrotic, or infected tissue from a wound to promote healing, reduce infection risk, and enable more effective wound care. Debridement helps convert a chronic or contaminated wound into a clean wound bed, supporting granulation and reepithelialization.

Indications include the presence of necrotic tissue (slough or eschar), delayed healing, infection not controlled by antibiotics, burns, ulcers (diabetic, venous, or pressure ulcers), and wounds where necrotic tissue obscures accurate assessment.

Methods vary by setting and wound type. Sharp or surgical debridement uses a scalpel or scissors to excise dead tissue under sterile conditions, often in an operating room or clinic. Mechanical debridement uses physical removal through irrigation or wet-to-dry dressings. Enzymatic debridement employs proteolytic agents to liquefy dead tissue. Autolytic debridement relies on moist dressings to enable the body's own enzymes to dissolve dead tissue. Autolytic methods are typically slower but painless. Biological debridement uses sterile maggots to selectively consume necrotic tissue.

Risks include bleeding, pain, damage to healthy tissue, and transient worsening of infection; debridement may be contraindicated in cases of poor blood supply, severe systemic illness, or when healthy tissue is at undue risk. Debridement is usually part of a broader wound care plan and is followed by cleansing, infection control, and dressings that support a healthy wound bed.