Advances in wound debridement techniques
Dead and devitalised tissue interferes with the process of wound healing. Debridement is a natural process that occurs in all wounds and is crucial to healing; it reduces the bacterial burden in a wound and promotes effective inflammatory responses that encourage the formation of healthy granulation tissue.7 Wound care should be part of holistic patient care. Recent advances in debridement techniques include: biosurgery, hydrosurgery, mechanical debridement, and ultrasound. Biosurgery and mechanical debridement can be practiced by nonspecialist nurses and can be provided in a patient's home, thus increasing the patient's access to debridement therapy and accelerating wound healing.
Debridement is ‘the removal of nonviable tissue from the wound bed to encourage wound healing.1 Debridement removes damaged and dead tissue, debris and bacteria from the wound. This minimises infection risk and encourages healing.2 Chronic wounds often contain necrotic or sloughy tissue. This dead, devitalised tissue inhibits healing and can harbour bacteria, which can increase the risk of infection and further inhibit healing.3
Any decision regarding wound debridement should be part of a holistic patient assessment. This assessment should consider the person's general condition, prognosis, health, and wishes. If, for example, the person is receiving palliative care and has limited life expectancy, the nurse should determine the costs and benefits of debridement. Some people may find certain debridement methods more or less acceptable than others. Hence, a comprehensive wound assessment should be carried out before a decision to debride is considered.4,5
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