References

Vowden K, Vowden P Debridement made easy. Wounds UK. 2011; 7:(4)1-4

Strohal R, Apelqvist J, Dissemond J EWMA document: debridement. J Wound Care. 2013; 22:S1-S52

White R, Cutting C. Critical colonisation of chronic wounds: microbial mechanisms. Wounds UK. 2008; 4:(1)70-78

Ousey K, Cook L. Wound assessment made easy. Wounds UK. 2012; 8

Brown A. The role of debridement in the healing process. Nurs Times. 2013; 109:(40)16-19

Gray D, Acton C, Chadwick P Consensus guidance for the use of debridement techniques in the UK. Wounds UK. 2011; 7:(1)77-84

Wolcott RD, Kennedy JP, Dowd SE. Regular debridement is the main tool for maintaining a healthy wound bed in most chronic wounds. J Wound Care. 2009; 18:(2)54-56

Nigam Y, Bexfield A, Thomas S, Ratcliffe NA. Maggot therapy: the science and implication for CAM part I - history and bacterial resistance. Evid Based Complement Alternat Med. 2006; 3:(2)223-227

Thomas S, Jones M, Shutler S Using larvae in modern wound management. J Wound Care. 1996; 5:(2)60-69

Thomas S, Jones M. Maggots can benefit patients with MRSA. Practice Nurse. 2000; 20:(2)101-104

Schultz GS, Sibbald RG, Falanga V Wound bed preparation: a systematic approach to wound management. Wound Repair Regen. 2003; 11:1-28

Allan N, Olson M, Nagel D, Martin R. The impact of VERSAJET hydrosurgical debridement on wounds containing bacterial biofilms. Wound Repair Reg. 2010; 18

Gray D, Stang D. Ultrasound-assisted wound debridement device. Wounds UK. 2010; 6:(4)156-162

Bahr S, Mustafi N, Hättig P Clinical efficacy of a new monofilament fibre-containing wound debridement product. J Wound Care. 2011; 205:(5)242-248

Downe A. How wound cleaning and debridement aids management and healing. J Community Nurs. 2014; 28:(4)33-37

Hard-to-heal wounds

Advances in wound debridement techniques

02 July 2019
Practice
02 July 2019
Volume 3 · Issue 3

Abstract

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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Debridement
Holistic nursing
Treatment