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Treating Pressure Ulcers/Injuries: Debridement

The goal of treatment is to create a healing environment. This may require debridement (removing unhealthy or dead tissue) so new healthy tissue can form. Various types of debridement are available. These are performed by physicians and certified specialists. Your healthcare provider may give you medicine to help control pain during the treatment.

Cross section of skin showing pressure ulcer with scar material in center. Arrow is going through scar tissue showing part of tissue being removed.
Dead tissue must be removed for the wound to heal properly.

Sharp debridement. This method removes dead tissue with a scalpel, curette, scissors, or other sharp instrument. Extensive removal may require surgery. Sharp debridement allows for precise removal of tissue. This is the preferred method if you have an active infection. Keep in mind this technique can be painful without topical or local anesthesia.

Enzymatic debridement. This method uses topical agents containing enzymes to dissolve dead tissue. Tiny cuts may need to be made before applying the enzymes to help them get absorbed.

Autolytic debridement. This method uses the body’s own enzymes to break down dead tissue. Special dressings are used to keep the wound moist. This allows the dead skin to slowly separate from healthy tissue. The treatment can take up to several weeks, but it is less painful than other methods. It’s also selective in the tissue it removes. This method should not be used if you have active infection.

Mechanical debridement. This method may be used to remove debris and dead tissue. It may be done in several methods. Strong scrubbing of the wound or rubbing a dry gauze may be done in some cases, if it the dead tissue is loosely attached and superficial. However, this method may be painful unless the patient is neuropathic or has had pain medicine. Wet-to-dry dressings involve putting a piece of gauze moistened with saline to the wound and letting it dry. The dried gauze is then removed, taking tissue and debris with it. This is not a favored method because it may remove healthy tissue as well as dead tissue. Wet-to-dry debridement can be very painful. The use of monofilament fiber pads may also be used to effectively remove dead tissue from open wounds. This can be much less painful than scrubbing with regular gauze or using wet-to-dry dressings.  

Biological debridement. This method may be used to remove dead tissue and bacteria. It is done using medicinal maggots of the green bottle fly. Live sterilized larvae are placed in the wound bed. The larvae secrete enzymes that liquefy dead tissue. Healthy tissue is not harmed by the enzymes. Larvae are replaced every 3 to 4 days, and are covered with a breathable dressing.  

To learn more

For more information, go to the Pressure Ulcer/Injury Resource mobile app.

Author: StayWell Custom Communications
Last Annual Review Date: 8/1/2018
Copyright © The StayWell Company, LLC. except where otherwise noted.
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