Debridement

Debridement is the cleaning of a wound by taking away material that will not heal and that holds healing back: dead (necrotic) tissue, the yellowish film called slough, crusts, pus, blood clots and foreign matter such as dirt, glass or bone fragments. The aim is to expose healthy, bleeding tissue. It is a routine part of treating burns, contaminated injuries and chronic wounds such as diabetic foot ulcers, pressure ulcers and leg ulcers.

Dead tissue gets in the way of repair: it feeds bacteria, shelters biofilms, keeps the wound inflamed and hides the true depth of the damage. Clinicians choose among several methods. Sharp or surgical debridement with a scalpel, scissors or curette is the quickest and suits large amounts of dead tissue. Mechanical methods scrub, irrigate or use pressurized fluid jets. Autolytic debridement relies on moist dressings such as hydrogels, letting the body's own enzymes soften and liquefy dead material, which is gentle but slow. Enzymatic debridement applies enzymes such as collagenase, and biological debridement uses sterile fly larvae (maggots), which eat dead tissue while leaving living tissue largely alone.

Methods differ in speed, pain, bleeding risk and how selectively they remove only dead tissue, and debridement often has to be repeated as a wound changes.