By Laurie Swezey RN, BSN, CWOCN, CWS, FACCWS
There are four main varieties of debridement: mechanical, autolytic, enzymatic, and also surgical. Each has actually its own benefits and disadvantages. Let’s take it a look in ~ each technique individually:
Mechanical debridement is among the oldest develops of wound debridement. This method uses a procession of moist to wet dressings, which are then manually removed. This reasons non-selective debridement of necrotic tissue and slough (and sometimes healthy tissue together well). Hydrotherapy and also irrigation methods are likewise considered creates of mechanical debridement.
Mechanical debridement is finest suited come wounds with huge amounts the necrotic debris. A recent development in mechanically wound debridement gadgets is the use of a monofilament fiber pad. This pad is designed to bind v slough, hyperkeratotic debris and dried exudate because that removal from the wound bed.
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AdvantagesDressing changes are an easy so the patient deserve to be teach to change their own dressing
DisadvantagesMay remove healthy (healing) tissue and devitalized tissueTime-consuming together the dressings should be adjusted often (or the patient have to spend a many time in the whirlpool bathtub to achieve the desired goal)Can be fairly painful for the patientInfection is a risk when whirlpools are used because of waterborne contamination
Autolytic debridement supplies the body’s own processes (enzymes and moisture) to breakdown tough eschar and also slough. It does not damage healthy skin, but breaks under dead and devitalized tissue gradually quite effectively. The idea behind autolytic debridement is to save wound fluids in continuous contact with the wound. This is accomplished with the usage of semi-occlusive or occlusive dressings such together transparent films, hydrogels and hydrocolloids. This technique can be supplied on phase ll or lll wounds that room not greatly exudative.
AdvantagesNo damage to surrounding skin; is selective for necrotic tissueThe process is safe since it provides the body’s natural processes to rid the wound the necrotic tissueEasy come performVery effectiveNot painful for the patient
DisadvantagesThe procedure takes time (may take days to weeks)The wound should be on regular basis monitored for indications of infectionAnaerobic growth may occur when an occlusive dressing is chosen
Enzymatic debridement utilizes chemical agents to malfunction necrotic tissue. They space most useful for debriding wounds with a large amount the necrotic or eschar formation.
AdvantagesWorks faster than autolytic debridementIf effectively applied, there is tiny risk to healthy tissue
DisadvantagesThe patience must have actually the chemical agent prescribed and it might be relatively expensiveCare have to be required to ensure healthy tissue does not come in call with the chemistry agentA second dressing may be compelled to absorb exudateChemical debridement may reason some uncomfortable to the patient (i.e., burning sensation, raised wound pain)
Surgical debridement provides sharp instruments (such together a scalpel) or a laser to eliminate necrotic tissue from the wound bed, one of two people at the patient’s bedside or in an operating room under basic anesthesia. This method is best for very large wounds v a many necrotic material and also infected material.
AdvantagesExcellent control over what and how much tissue is removedFastest way to achieve a clean wound bedCan speed the healing process
DisadvantagesNot cost-effective if an operation room is requiredGeneral anesthesia tote its very own risksPainful because that the patient
Other instrument of Wound Debridement
A fifth kind of wound debridement is biological debridement using maggots that have been grown in a sterile environment. The maggots eat just necrotic tissue, for this reason this kind of therapy can be thought of as selective. This method is gaining in popularity, however some patients find the technique somewhat painful and also their tardy of maggots might stand in the means of using this an approach of debridement.
These techniques are the typical methods the debridement available today. In deciding which method is ideal for her patient, a cautious weighing of benefits and flaw is necessary. Almost every one of these methods can be painful, as such pain manage should likewise be factored in to her decision.
Editor\"s Note: This write-up was initially published on august 19, 2013 and has been updated for accuracy and comprehension.
Sources:Moore, Zena (2012). The important role of debridement in wound bed preparation. Wounds International, volume 2 worry 2. Easily accessible at: http://www.woundsinternational.com/pdf/content_10389.pdfStrohal R, Dissemond J, Jordan O\"Brien J, et al. EWMA Document: Debridement. An update overview and clarification of the principle role of debridement. Easily accessible at: http://ewma.org/fileadmin/user_upload/EWMA/pdf/EWMA_Projects/Debridement...
About The AuthorLaurie Swezey RN, BSN, CWOCN, CWS, FACCWS is a Certified Wound Therapist and also enterostomal therapist, founder and also president of WoundEducators.com, and advocate of incorporating digital and also computer an innovation into the field of wound care.
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