Debridement, which can also be known as debridement, is a procedure performed to remove dead, infected, necrotic tissue from wounds, improving healing and preventing the infection from spreading to other parts of the body. It can also be done to remove foreign materials from inside the wound, such as pieces of glass, for example.
The procedure is performed by a doctor, general practitioner or vascular, in the operating room or by a trained nurse, in an outpatient clinic or clinic and different types can be indicated, depending on the characteristics of the wound and the person's health conditions.
What is it for
Debridement is a very important procedure for the treatment of a wound with necrotic and infected tissue, since the removal of this dead tissue improves healing, decreases secretions, such as exudate, reduces the action of microorganisms and improves the absorption of ointments with antibiotics..
Surgical debridement, for example, is widely used in cases of people with diabetic foot wounds, as this procedure reduces inflammation and releases substances that help the growth of healthy tissue within the wound. Learn how to care for and treat diabetic foot wounds.
Main types of debridement
There are different types of debridement that are indicated by the doctor according to the characteristics of the wound such as size, depth, location, amount of secretion and whether you have infection or not, and they can be:
- Autolytic: it is performed by the body itself naturally, through processes similar to healing, promoted by the defense cells, the leukocytes. To improve the effects of this type of debridement, it is necessary to keep the wound moist with saline and dressings with hydrogel, essential fatty acids (AGE) and calcium alginate; Surgical: consists of surgery to remove dead tissue from a wound and is done in cases where the wounds are large. This procedure can only be performed by a doctor, in a surgical center, under local or general anesthesia; Instrumental: it can be done by a trained nurse, in a dressing room, and is based on the removal of dead tissue and infected skin with the aid of a scalpel and tweezers. Generally, several sessions should be performed for the gradual removal of necrotic tissue and it does not cause pain, as this dead tissue has no cells that lead to the sensation of pain; Enzymatic or chemical: consists of the application of substances, like ointments, directly on the wound so that the dead tissue is removed. Some of these substances have enzymes that eliminate necrosis, such as collagenase and fibrinolysins; Mechanical: involves the removal of dead tissue through friction and irrigation with saline, however, it is not widely used because it requires specific care so that bleeding does not occur in the wound.
In addition, there is a technique used called biological debridement that uses sterile larvae of the species Lucilia sericata , of the common green fly, to eat dead tissue and bacteria from the wound, controlling infection and improving healing. The larvae are placed on the wound with a dressing that must be replaced twice a week.
How is done
Before performing the procedure, the doctor or nurse will examine the wound, checking the extent of sites with necrosis and will also analyze health conditions in general, as people with clotting problems, such as idiopathic thrombocytopenic purpura, may have difficulty healing, in addition to having a higher risk of bleeding during debridement.
The location and duration of the procedure depends on the debridement technique to be used, and can be done in a surgical center of a hospital or an outpatient clinic with a dressing room. Therefore, before the procedure, the doctor or nurse will explain the procedure to be performed and make specific recommendations, which should be followed as instructed.
After the procedure, it is necessary to take some precautions such as keeping the dressing clean and dry, avoiding swimming in the pool or the sea and not applying pressure to the wound site.
Possible complications
The most common complications of debridement can be bleeding from the wound, irritation of the surrounding skin, pain after the procedure and allergic reaction to the products used, however, the benefits are greater and should be considered a priority, because in some cases, a wound it cannot heal without debridement.
Still, if symptoms such as fever, swelling, bleeding and severe pain appear after debridement, it is necessary to seek medical attention quickly so that the most appropriate treatment is recommended.
