What are the débridement procedures used in the treatment of pressure injuries (pressure ulcers)?

Updated: Mar 26, 2020
  • Author: Christian N Kirman, MD; Chief Editor: John Geibel, MD, MSc, DSc, AGAF  more...
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Answer

The purpose of wound débridement is to remove all materials that promote infection, delay granulation, and impede healing, including necrotic tissue, eschar, and slough (ie, the stringy yellow, green, or gray nonviable debris in an ulcer). Accurate injury staging cannot be accomplished until necrotic tissue is removed. [124] The following three débridement procedures are commonly used:

  • Enzymatic débridement - This uses various chemical agents (proteolytic enzymes) that act by attacking collagen and liquefying necrotic wound debris without damaging granulation tissue [10, 76]
  • Mechanical nonselective débridement - In this approach, necrotic tissue is loosened and removed is accomplished by means of whirlpool treatments, forceful irrigation, or the use of wet-to-dry dressings
  • Sharp débridement - This consists of surgical removal of the eschar and any devitalized tissue within it (see Surgical Debridement); it is indiscriminate in the removal of vital and devitalized tissue and thus requires a great deal of clinical skill and judgment [125, 126]

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