Debridement is an essential part of wound management.
For wounds to adequately heal, the wound bed must be properly prepared to achieve optimum results and ultimately, for the wound to close the right way.
There are five different debridement methods to choose from but identifying what’s best for a certain type of wound depends on a lot of factors.
The wound presentation is one factor but so is the evaluation, the patient’s history, and who will perform the debridement itself.
Economic factors may also come into play which is why it’s crucial to understand how each method is done and what it entails so you can determine the best option according to your patient’s overall condition.
5 Methods of Debridement
1. Biological Debridement
Biological debridement is the type of debridement that uses the help of maggots, also known as Lucilia sericata or green bottle fly. These maggots are grown in a clean and sterile environment where they digest pathogens and dead tissues.
The procedure is done by placing the maggots on top of the wound bed using a dressing that will help confine them to the wound.
2. Autolytic Debridement
Considered the slowest among all methods, autolytic debridement is most commonly used in a long-term care setting. This method is painless and uses the body’s enzyme and moisture under the dressing, liquefying the non-viable tissue in the process.
The key to this method is to keep moisture balanced. It is also essential to change the dressing frequently and for the dressing to have good absorbency. Some of the dressing types you can use for this method are hydrogels as well as transparent films.
3. Enzymatic Debridement
Enzymatic debridement is performed by applying a topical agent that chemically liquefies dead or necrotic tissues with the use of enzymes. What these enzymes do then is dissolve devitalized tissue.
It’s important to note that it is not recommended to use antimicrobial agents and collagenase together because they can reduce the effectiveness of this debridement method.
The method can be used with surgical and sharp debridement, however, but it can also get expensive depending on the insurance source. It is also commonly used in long-term care settings with the help of a nurse who can do it daily.
4. Mechanical Debridement
There are a lot of considerations when it comes to this method which uses irrigation, hydrotherapy, wet-to-dry dressings, and an abraded technique.
While it is considered cost-effective, this method can damage healthy tissue and can cause a tremendous amount of pain. Deep wounds with tunneling should be packed loosely because the wound may close to form a pocket and not heal at all which can lead to abscess and infection.
5. Surgical Sharp and Conservative Sharp Debridement
Last but not least is the surgical sharp debridement method which is performed by a skilled practitioner primarily because it requires the use of surgical instruments like scalpels, rongeurs, and forceps.
This method of debridement promotes wound healing through biofilm and devitalized tissue removal. Considered the most aggressive among debridement methods, surgical sharp debridement is performed inside a surgical operating room while a sharp conservative debridement can be done inside a clinic using sterile instruments.
Conclusion
Wound debridement isn’t a one-size-fits-all solution. As mentioned, there are several factors to consider to determine which debridement method is ideal for the kind of wound you’re facing. By knowing and understanding how each method is done, you’d be able to treat wounds more effectively and help them heal at a faster rate.
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