Wound debridement involves removing necrotic tissue that may present as yellow, moist slough or black, dry eschar. Confirming adequate vascular supply and obtaining patient consent are important steps prior to wound debridement.
Selecting a method of wound debridement for each unique patient’s treatment of care is determined by: the patient’s pain level, available equipment (including analgesia), the clinician’s level of education, scope of practice and supporting policies depending on the clinical setting. Reviewing the risks versus the harm related to each method of debridement should be considered in advance.
- Obtaining and documenting patient consent is important prior to wound debridement for liability
- The need and speed of debridement can determine the type of debridement method chosen
- Clinicians should accurately confirm the wound’s tissue type prior to debridement
- Removing necrotic tissue in a wound bed can facilitate granulation tissue formation and promote faster wound healing
Albaugh, K., & Loehne, H. (2010). General management principles in patients with wounds. In J. M. McCulloch & L. C. Kloth. (4th ed.). F. A. Davis.
Alhajj, M., Bansal, P., & Goyal, A. (2020). Physiology, granulation tissue. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK554402/
Bates-Jensen, B. M., & Serena, T. E. (2012). Management of necrotic and nonviable tissue. In C. Sussman & B. Bates-Jensen. (4th ed.). Wolters Luwer | Lippincott Williams & Wilkins.
Debridement Best Practice Recommendations Quick Reference Guide. Nurses Specialized in Wound, Ostomy and Continence Canada. 2021 http://nswoc.ca/wp-content/uploads/2021/09/Debridement-BPR-Quick-Reference-Guide-copyrighted.pdf
Grey, J. E., Enoch, S., & Harding, K. G. (2006). Wound assessment. British Medical Journal, 332(7536), 285-288. https://doi.org/10.1136/bmj.332.7536.285
Harris, C., Coutts, P., Raizman, R., & Grady, N. (2018). Sharp wound debridement: patient selection and perspectives. Chronic Wound Management and Research, 5, 29-36. https://doi.org/10.2147/CWCMR.S146747
Harris, R. J. (2009). The nursing practice of conservative sharp wound debridement: Promotion, education and proficiency. Wound Care Canada, 7(1), 22-30.
Health Service Executive (HSE). National wound management guideline 2018. https://healthservice.hse.ie/filelibrary/onmsd/hse-national-wound-management-guidelines-2018.pdf
Lukić, M., Pantelić, I., & Savić, S. (2021). Towards optimal pH of the skin and topical formulations: from the current state of the art to tailored products. Cosmetics, 8, 69. https://doi.org/10.3990/cosmetics8030069
Marieb, E. N., & Hoehn, K. (2010). Human anatomy and physiology (8th ed.). Pearson Benjamin Cummings.
McNichol, L., Ratliff, C., & Yates, S. (2021). Wound, Ostomy and Continence Nurses Society Core Curriculum: Wound Management. (2nd ed.). Wolters Kluwer.
Merriam-Webster. (n.d.). Necrosis. Available at: https://www.merriam-webster.com/dictionary/necrosis
Nurses Specialized in Wound, Ostomy and Continence Canada. (2021). Debridement: Canadian Best Practice Recommendations for Nurses. (1st ed.). [internet] http://nswoc.ca/wp-content/uploads/2021/05/NSWOCC-Debridement-Best-Practice-Recommendations-April-2021.pdf
Position Statement: Nurses & Debridement. Nurses Specialized in Wound, Ostomy and Continence Canada. (2021) [internet] http://nswoc.ca/wp-content/uploads/2021/05/NSWOCC-Debridement-Position-Statement-May2021.pdf
Sibbald, R. G., Elliott, J. A., Persaud-Jaimangal, R., Goodman, L., Armstrong, D. G., Harley, C., Coelho, S., Xi, N., Evans, R., Mayer, D. O., Zhao, X., Heil, J., Kotru, B., Delmore, B., LeBlanc, K., Ayello, E. A., Smart, H., Tariq, G., Alavi, A., & Somayaji, R. (2021). Wound Bed Preparation 2021. Advances in Skin & Wound Care, 34(4), 183–195. https://doi.org/10.1097/01.ASW.0000733724.87630.d6
Wound Ostomy and Continence Nursing Society. Wound, Ostomy and Continence Nursing: Scope and Standards of Wound Ostomy Continence Practice, 2nd Edition. An Executive Summary. J Wound Ostomy Continence Nurs. 2018;45(5):369-387. https://doi.org/10.1097/WON.0000000000000438
Wound Source. (2021). Chronic wound management: types of wound tissue. Available at https://www.woundsource.com/blog/chronic-wound-management-types-wound-tissue#:~:text=Unhealthy%20granulation%20is%20dark%2C%20dusky,the%20normal%20wound%20bed%20surface.
Young, T. (2011). Reviewing best practice in wound debridement. Practice Nursing, 22(9), 488-92. https://doi.org/10.12968/pnur.2011.22.9.488
Young, T. (2015). Accurate assessment of different wound tissue types. Wound Essentials, 10(1), 51-54. Retrieved from https://www.woundsme.com/uploads/resources/content_11581.pdf