Debridement and Infection Management

1. Debridement

Debridement is the removal of nonviable tissue, foreign material, and biofilm from a wound to create an optimal healing environment.

Goals of Debridement

• Reduce bacterial load and biofilm

• Stimulate wound healing

• Improve effectiveness of topical therapies

• Allow accurate wound assessment

Types of Debridement

1. Sharp/Surgical Debridement

• Performed with scalpel, scissors, or curette

• Fastest and most effective method

• Indicated for infected, necrotic, or rapidly deteriorating wounds

• Requires trained clinician and appropriate pain control

2. Mechanical Debridement

• Wet-to-dry dressings, wound irrigation

• Non-selective (removes healthy tissue as well)

• Less commonly recommended today

3. Autolytic Debridement

• Uses moisture-retentive dressings (hydrocolloids, hydrogels)

• Selective and painless

• Best for stable, non-infected wounds

4. Enzymatic Debridement

• Topical enzymes (e.g., collagenase)

• Selective and useful when sharp debridement is not appropriate

5. Biological Debridement

• Medical-grade maggots

• Highly selective and effective for resistant necrotic tissue