Debridement of a Wound, Infection, or Burn
Definition
Debridement is the removal of unhealthy tissue from a wound. It will improve wound healing. There are different ways to do debridement.
Reasons for Procedure
Debridement may be done to:
- Remove infected areas or dead cells, or clean away crust, dirt or debris.
- Create a neat wound edge to decrease scarring.
- Help very severe burns or pressure sores heal.
- Get a sample of tissue for testing.
Possible Complications
Problems from the procedure are rare, but all procedures have some risk. Your doctor will talk to you about possible problems such as:
- Pain
- Bleeding
- Infection
- Delayed healing
- Loss of healthy tissue
Things that may increase the chance of problems include:
- Infection in the area
- Having other medical problems
- Smoking
- Diabetes
- Use of steroid or other medicine that suppress the immune system
- Poor nutrition
- Poor circulation
- Immune system problems
What to Expect
Prior to Procedure
Arrange for a ride to and from the procedure. You may need to avoid food or drink the night before if you will have anesthesia.
Pain medicine may be given before the procedure.
Anesthesia
Anesthesia may be used for deep wounds. Local anesthesia will numb the area. General anesthesia will block pain and you will be asleep.
Description of Procedure
The area will be cleaned and prepared. There are different types of debridement. The treatment plan will often include more than one step. Methods may be surgical or non-surgical.
In surgery, tools will be used to cut away areas of dead tissue. It may be used on large, deep, or painful wounds. Some wounds may need help to close after tissue is removed. An area of skin will be removed from another area of the body and placed on the wound. It can help the wound heal closed.
Non-surgical methods will use medicine or water to remove dead tissue. Medical whirlpool or syringes may be used to brush away dead skin. Wet to dry dressing is another option. A wet dressing is packed in the wound and left until it is dry. When the dry dressing is pulled away it will take dead tissue with it.
A medicine may also be used over the wound. It will help to dissolve dead tissue. It can also help your body heal the wound itself. All methods may need to be repeated several times.
Immediately After Procedure
Samples of removed tissue may be sent to a lab.
How Long Will It Take?
Surgical debridement is the quickest method. Nonsurgical debridement may take 2 to 6 weeks or longer.
How Much Will It Hurt?
General anesthesia will block pain during surgery. Some still report discomfort with local anesthesia. There is often soreness in recovery. Pain medicine may be given to help ease pain.
Other types of debridement often cause pain. Medicine can be given before changing the dressing to help ease pain.
Average Hospital Stay
You may be able to go home on the same day. If you are already in the hospital, it should not make your stay longer.
Post-procedure Care
At Home
It may take the wound many weeks to heal. Wound care will need to be continued at home.
Call Your Doctor
Contact your doctor if your recovery is not going as you expect or you have problems such as:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge at the wound site
- Chalky white, blue, or black appearance to tissue around wound
- If general anesthesia was used—cough, shortness of breath, chest pain, or severe nausea or vomiting
- Pain that you cannot control with the medications you were given
If you think you have an emergency, call for emergency medical services right away.
RESOURCES:
VNAA—Visiting Nurse Associations of America
http://www.vnaa.org
Wound Ostomy and Continence Nurses Society
http://www.wocn.org
REFERENCES:
Golinko MS,Joffe R, Maggi J, et al. Operative debridement of diabetic foot ulcers. J Am Coll Surg. 2008;207(6):e1-e6.
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.
Steed DL. Debridement. Am J Surg. 2004;187(5A):71S-74S.
Wong CH,Yam AK, Tan AB, Song C. Approach to debridement in necrotizing fasciitis. Am J Surg. 2008;196(3):e19-e24.
Last reviewed November 2018 by EBSCO Medical Review Board Marcin Chwistek, MD Last Updated: 12/20/2014