As a certified family nurse practitioner at Premier Physicians in Fairview Park, Ohio, Seana Rutherford provides primary care for patients of all ages. Since accepting this position in the summer of 2015, Seana Rutherford has performed a number of debridement procedures for patients with healing wounds.
In the context of wound care, debridement is defined as the removal of dead tissue. Such material often collects in a wound and can halt the healing process, as it can cause infection and interfere with the body’s ability to grow healthy new tissue. The body frequently is able to eliminate this tissue on its own, though surgical or medical removal is often necessary.
Many patients respond to autolytic debridement, which involves the application of a hydrogen or hydrocolloid dressing that breaks down the necrotic (dead) tissue. The procedure is typically painless and does not harm healthy tissue, though it can take a number of weeks to work fully. Enzymatic debridement, which destroys necrotic tissue using a special protein-based substance, may be a faster option.
Patients who require faster treatment may undergo mechanical or surgical debridement. This form forcefully removes necrotic tissue using wet-to-dry dressings, or draws it out using moving water. In general, water-based methods tend to be less painful and less damaging to healthy tissue, though the risk of infection may be higher.
Surgical debridement tends to be the fastest and most effective way of removing necrotic tissue. Performed using surgical or laser instrumentation, it is appropriate for infected as well as non-infected wounds.
Maggot debridement therapy (MDT), also known as larval debridement, is also appropriate for debridement of infected areas. This involves the placement of sterile fly larvae in the wound, where they dissolve the necrotic tissue and eliminate bacteria. Painless and safe, it may cause itchiness in the area.