Debridement
Formal Definition
The removal of devitalized, contaminated, or foreign tissue from a wound to promote healing and reduce infection risk; can be surgical (sharp excision), mechanical (wet-to-dry dressings, irrigation), enzymatic (collagenase), biological (maggot therapy), or autolytic (moisture-retentive dressings allowing endogenous enzymes to liquefy necrotic tissue).
How It's Used on the Ward
"Debride the wound" or "needs wound debridement" — cleaning out the dead tissue so the wound can actually heal.
Example
""Diabetic foot ulcer with black eschar and surrounding cellulitis: sharp debridement at bedside removing necrotic tissue down to bleeding margins. Culture of debrided tissue sent. Wound base now shows healthy granulation tissue. Starting wound care protocol with moist dressings; vascular surgery reviewing for revascularization candidacy.""
Clinical Context
Wound bed preparation (TIME acronym): Tissue debridement, Infection control, Moisture balance, Edge stimulation. Debridement is the first step — a wound cannot heal over necrotic tissue. Surgical debridement: fastest and most complete. Enzymatic debridement (collagenase): selective, slower, used when sharp debridement not tolerated. Autolytic: slowest, uses body's own enzymes under occlusive dressing. Diabetic foot: neuropathy obscures pain — patients may have extensive necrosis without symptoms. Wagner wound classification guides surgical decision-making.