Wound Debridement

What is wound debridement?

A wound is damage to body tissues that may be caused by pressure, injury, or surgery. Wounds may be bruises, scrapes, scratches, cuts, burns, pressure sores (pressure ulcers), or surgery cuts. To allow healthy tissue to heal and prevent more damage or infection, infected or damaged wound tissue is removed in a procedure called wound debridement. Wound debridement can be done by several different methods. They include surgical, chemical, mechanical, autolytic tissue removal, or maggot debridement therapy.

How is wound debridement done?

Before the procedure:

• Your healthcare provider will ask you to sign a consent form for wound debridement. The consent form will state the reason you are having the procedure, what happens during the procedure, and what you may expect afterward.
• There is risk with every treatment or procedure. Talk to your healthcare provider for complete information about whether any of these risks apply to you:
  • Anesthesia problems
  • Bleeding
  • Blood clots
  • Infection
• Tell your healthcare provider if you have any food, medicine, or other allergies such as latex.
• Tell your healthcare provider if you are taking any medicines, including nonprescription drugs, herbal remedies, or recreational or illegal drugs.
• You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow medicine to be given directly into your blood and to give you fluids, if needed.

During the procedure:

• A cardiac (heart) monitor may be used to keep track of your heart rate and rhythm.
• Your blood oxygen level may be monitored by a sensor that is attached to your finger or earlobe.
• You may be given a sedative through your IV to help you to relax.
• You will be given medicine called anesthesia to keep you from feeling pain during the procedure. You may have:
  • Local anesthesia, which numbs the area where the debridement will be done.
  • Regional anesthesia, which numbs a larger area of your body. Depending on the medicine, you may be awake or asleep during the procedure.
  • General anesthesia relaxes your muscles and puts you into a deep sleep. It also keeps you from remembering the operation. While you are asleep, you will have a tube in your throat to help you breath and to make sure you are getting enough oxygen. The tube may be removed before you wake up after the surgery.
• The surgeon will choose the best debridement procedure for your wound.
  • Surgical: The damaged tissue is removed with a sharp surgery tool or laser.
  • Chemical: Medicine, usually an ointment, is put on the wound and covered with a dressing to keep the ointment off healthy tissue. The medicine helps remove the damaged tissue.
  • Mechanical:
    • Wet to dry dressings: A wet dressing is put on the wound and allowed to dry. Damaged tissue attaches to the dressing as it dries and is removed when the dressing is changed.
    • Hydrotherapy: Pressure from a stream of water is used to remove the damaged tissue.
  • Autolytic: A wet or moist dressing is put on the damaged tissue to keep the tissue moist and allow your body to get rid of the damaged tissue on its own as it grows new, healthy tissue underneath it.
  • Maggot debridement: Disinfected fly larvae are put in the wound to remove infected tissue, kill bacteria, and encourage healing.

After the procedure:

You may stay in the hospital for a few hours or several days to recover, depending on your condition.

• While you are in the hospital:
  • You will be checked often by nursing staff.
  • There will be a dressing on the debridement area. The dressing will be checked and changed by your provider or the nursing staff as needed.
• Your provider may prescribe medicine to:
  • Treat pain
  • Treat or prevent an infection
  • Treat other medical conditions that may be preventing your wound from healing
• Your provider may recommend other types of therapy to help relieve pain, other symptoms, or side effects of treatment.

What can I do to help?

• You will need to tell your healthcare team if you have new or worsening:
  • Bluish color of the skin below your debridement site
• Symptoms of dehydration, which may include dry mouth or eyes, weakness, little to no urine output
• Depression
• Redness, swelling, pain, warmth, or drainage from your surgical wound
• Fever, chills, or muscle aches

Ask questions about any medicine, treatment, or information that you do not understand.

How long will I be in the hospital?

How long you stay the hospital depends on many factors. Whatever has caused the wound, such as a burn, and the severity of that cause will determine the average amount of time to stay in the hospital. Your hospital stay may be a few days to several weeks.

If your wound is severe and you have complications, you may stay in the hospital longer. Wound healing may take many weeks or months. You may need to continue a wound care or rehabilitation (rehab) program after you leave the hospital to continue treating your wound or to help you adjust to tissue, bone, or limb loss.