Debridement procedure for wound cleansing
Analyzing color, odor, weight and distribution of fluid on the used wound dressing allows one to draw conclusions on the wound healing process. This makes it easier to choose the right wound dressing.
Surgical debridement
Excision/removal of necroses and fibrin coatings with the aid of a scalpel, scissors, sharp curette or laser, under surgical conditions or as an outpatient depending on the wound condition. Is regarded as the fastest and most effective debridement method because everything which blocks healing is removed out of the wound “abruptly“. It is mandatory for controlling severe infections.
Outpatient surgical debridement
Outpatient surgical debridement carried out e.g. at the sick bed should not simply entail “snipping“ at the wound but should be similar to a well prepared surgical procedure with patient education and the patient’s informed consent. In particular sufficient pain reduction must be ensured, e.g. by applying locally anesthetizing creams, note contact time!
Enzymatic debridement
Removal of fibrin coatings and thin necrotic layers (or of closed necroses to a lesser extent) through enzyme preparations with diverse ranges of effect; can e.g. be used as a ”fine cleansing" after surgical debridement. Note the indications and manufacturers’ application notes exactly because side effects are possible when applied incorrectly.
Autolytic debridement
Softening and removal of necroses and fibrin coatings through suitable wound dressings (e.g. foam materials, hydrogels, TenderWet) which support the body's own wound cleansing processes. The cleansing effect can be substantial; the method is also cell-preserving due to the moist wound environment, safe and free from side effects, causes minor pain and is easy to use – also in domestic wound treatment.
Wound rinsing
Wound rinsing during every dressing change supports wound cleansing with the aid of wound dressings effectively. Ringer’s solution is recommendable as irrigation; when applied briefly, a physiological saline solution can also be used. Compared to saline solution, the preferable Ringer’s solution contains potassium and calcium ions. As a result, electrolyte shifts in the wound area are marginal and proliferation of cells is also promoted.
Bio-surgery with maggots
Grubs of the fly species Lucilia sericata grown especially for this purpose are placed on the wound and begin their mode of ”debridement": they release enzymes into their surroundings and within a short period of time "eat" necrotic tissue, including pus and existing germs, also deep in the wound. Healthy tissue remains untouched because the grubs can distinguish between live and dead tissue.
