Non-selective Methods Of Debridement

What is debridement?

Debridement is the removal of foreign bodies, necrotic (dead) tissues, and poorly healing tissues from a wound. It is usually done to help a wound begin to heal. It is also done to check for infection or unwanted tunnels under the skin. Bone and other deep tissue infections may also be found when doing debridement. With debridement, dead tissues, and sometimes even normal healthy tissues, are removed slowly and little by little from the wound. As the healing process starts and the wound improves, you may need to return for more wound debridement. In severe (very bad) cases, wounds may take years to show improvement and healing, or may not even heal at all.

Why is wound debridement needed?

Wound debridement is needed when certain factors, such as foreign bodies and dead tissues, delay the healing process. These factors may also cause the wound to be infected with germs, and healing may take even longer. Removing tissues or foreign body materials lets caregivers look more closely at your wound. This helps them plan the best treatment for the wound.

What are non-selective methods of wound debridement?

Non-selective methods of wound debridement remove the necrotic tissue and may also remove nearby healthy tissue. The wound may look bigger after debridement. You may have any of the following:

  • Chemical method: This method uses chemical solutions to soften the dead tissues on your wound.

    • Hydrogen peroxide: This solution kills germs on the wound. You may see foam or bubbles forming on the wound surface. This method may irritate your skin near the wound edges, making the skin look red. It is used for small or large wounds and may help remove a bad smell from the wound.

    • Hypochlorite: This solution helps remove the dead tissue slowly, and may cause irritation on the wound and the skin around it.

    • Iodine: This solution may help quickly dry up the dead tissues. Caregivers may use a special knife to cut off and remove the dead tissues before the solution is used. Iodine is safe for the cells but may irritate and stain your skin. It may be used for any size of wounds. Tell your caregiver if you have thyroid disease and will be having this treatment.

  • Mechanical methods:

    • Pulsed lavage method: This is used for people who are not able to move well. You may be given medicines to control the pain while this method is being used. This method uses a special device that allows pulsating saline (salt solution) to touch the wound surface. The tissue debris (wastes) is removed when a suction tube is used on the wound. You may feel some pressure and pain as debris and some healthy tissue around the wound are suctioned.

    • Wet-to-dry dressings: This method uses moist saline gauze placed in the wound and allowed to dry. The dead tissue comes out with the gauze when removed. It may be used in those with large wounds that have large areas of dead tissue. Your caregiver may need to use this method more than once.

    • High-pressure fluid irrigation method: This is also called whirlpool method. You are placed in a bath where warm, fast-moving water will soften and remove the dead tissue. This method is best used to clean both the wound and the tissue around it. It also increases blood flow at the wound surface. People with diabetes (high sugar level in the blood) and other conditions may need this method.

What factors decrease the ability of my wound to heal?

  • Age: Young people have more elastic skin and stronger connective tissues. These factors allow skin to heal faster. Elderly people have loose skin, decreased fat, and weak collagen (protein that strengthens tissues) which makes their skin easily damaged.

  • Chronic disease: This includes diseases, such as diabetes and atherosclerosis (blocked arteries). These conditions cause less blood flow to the arms or legs. Poor blood flow carries less oxygen and nutrients to wounds, causing them to heal slowly.

  • Medicines: Medicines used for treating inflammation (swelling) may delay healing by decreasing the immune (defense) system of the body. Steroid medicines block the natural process of carrying white blood cells to wounds. White blood cells help wounds heal. People who use steroids are also at higher risk of wound infection. Long-term use of antibiotics increases your risk of super infection. If you have a super infection, stronger and larger amounts of antibiotics are needed to treat it.

What can I do to help my wound heal?

Wound protection, a moist wound, and enough oxygen helps wounds heal faster. Do the following to help your wound heal:

  • Avoid smoking: Smoking cigars, pipes and cigarettes may decrease the ability of new blood vessels to form on the wound site. It may also decrease the action of hemoglobin (part of the blood carrying oxygen) and delay healing.

  • Avoid stress: Stress causes the blood vessels to constrict (get small). This may lead to less oxygen supply to the tissues and delay healing.

  • Drink enough liquid: Men 19 years old and older should drink about 3.0 Liters of liquid each day (close to 13 eight-ounce cups). Women 19 years old and older should drink about 2.2 Liters of liquid each day (close to 9 eight-ounce cups). Follow your caregiver's advice if you must change the amount of liquid you drink. For most people, healthy liquids to drink are water, juices, and milk. Drinking enough liquids keeps wounds moist, helping them heal faster.

  • Eat a healthy diet: Foods rich in protein, such as meat, eggs and dairy products, help repair tissue. Carbohydrate-rich foods, such as bread and cereals, are needed for cell growth, and help decrease wound infection. Eating foods with high calories and rich in zinc, such as meats, seafood (especially oysters), and liver, may also help healing. Taking vitamins A and C help collagen formation and increase scar tissue strength. Avoid caffeine. Caffeine causes blood vessels to constrict (get small). This results in less oxygen getting to tissues, and delays healing. Caffeine may be found in coffee, tea, soda, and sports foods and drinks. Ask your caregiver for more information about foods that may help wound healing.

  • Exercise regularly: Regular exercise improves blood flow to the body. This causes more oxygen to go to body cells. When cells have enough oxygen, wounds heal faster.

What are the risks of having wound debridement?

  • Having any of the non-selective methods for wound debridement may carry certain risks. You may have more bleeding or pain than expected. High-pressure irrigation may cause trauma to the wound bed, and increase your risk of getting an infection. Pulsed lavage may push harmful germs deeper into the tissue. Iodine may not only stain but also irritate the skin. Healthy tissue and the skin around the wound may also be removed causing more pain. You may worry about the wound which may get bigger after it is debrided.

  • If you choose not to have your wound debrided, your wound may not start to heal for a long time. The longer you have your wound, the higher your risk for infection and tissue damage. The pain or other symptoms that you have may worsen. Contact your caregiver if you have concerns or questions about your wound, medicine or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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