Debridement is a valuable tool used in wound care to remove dead, necrotic, or foreign material from a wound and to help transform a chronic wound into an acute wound to expedite healing. This guide provides health care and wound care professionals with fundamental information on skin anatomy and wound healing, as well as evidence-based recommendations on the use of debridement in chronic wound care.

When managing chronic wounds, health care professionals often turn to debridement to manage the necrotic tissue that impedes wound healing. But with a variety of debridement techniques available, it is sometimes hard to know which technique is the best for your patient and your setting. This webinar will review the different types of debridement, how to combine them for best results, and assessment techniques to ensure you are always making patient-centered decisions. Presented by Pamela Scarborough, PT, DPT, MS, CDE, CWS, CEEAA.

Download A Fact A Day – Debridement and Chronic Wounds and share it within your facility. This two-page fact sheet was created to support staff education on debridement methods and chronic wounds. The print-friendly format is perfect for posting on the bulletin board or distributing to your nursing staff at in-service.

How much do you know about wound debridement? Take our 10-question quiz to find out!

Calciphylaxis: A disorder, generally found in end stage renal disease, but not limited to renal patients, with widespread calcification of small and medium sized vessels, that leads to occlusion, thrombosis, and tissue necrosis. Extreme cases can be life-threatening.

Enzymatic debridement: Removal of devitalized tissue from the wound base through an externally applied chemical or enzyme. Debridement may be selective or nonselective, depending on the chemical or enzyme used.

Epibole: The upper edges of the epidermis roll to envelop the basement membrane, or lower edges of the epidermis, so that epithelial migration does not occur at wound edges.

Why Debride? The Benefits of Effective Wound Debridement

Debridement is essential to promote healing and prevent infection. There are five main types of debridement methods. BEAMS is the common mnemonic to remember all types: biological, enzymatic, autolytic, mechanical, and surgical. In recent years, new types of debridement technology have been introduced, such as fluid jet technology, ultrasound debridement therapy, hydrosurgery, and monofilament polyester fiber pad debridement.

The Healing Trajectory: The Process of Wound Healing

There are four stages of wound healing. This systematic process moves in a linear direction. The four stages of wound healing are: hemostasis, inflammation, proliferation, and maturation. It is imperative to remember that wound healing is not linear. It is possible for a patient to move forward or backward through the wound healing phases due to intrinsic and extrinsic forces.

Chronic Wound Management: Types of Wound Tissue

To witness the normal wound healing process is extraordinary. However, the systematic process of healing is not always perfect. Chronic wounds are complex and present an immense burden in health care. Identifying the wound etiology is important, but an accurate wound assessment is just as important. The color, consistency, and texture of wound tissue will lead you to the most appropriate wound management plan.

Wound Debridement Options: The 5 Major Methods

There are five types of non-selective and selective debridement methods, but many factors determine what method will be most effective for your patient.1 Determining the debridement method is based not only on the wound presentation and evaluation, but also on the patient’s history and physical examination. Looking at the “whole patient, not only the hole in the patient,” is a valuable quote to live by as a wound care clinician. Ask yourself or your patient these few questions: Has the patient had a previous chronic wound history? Is your patient compliant with the plan of care? Who will be performing the dressing changes? Are there economic factors that affect the treatment plan? Take the answers to these questions into consideration when deciding on debridement methods.