Surgical debridement is defined as the removal of nonviable tissue, foreign material, and bacteria from a wound using sharp surgical instruments. This fast and specific debridement method is an essential component of preparing the wound bed, preventing infection, and promoting physiological healing. This technique also offers adjunctive benefits, such as the opportunity to thoroughly assess the wound and implement surgical planning. Surgical debridement has become an integral aspect of management in virtually all wound types, including acute traumatic injuries, burns, cutaneous infections, and chronic wounds, such as diabetic and pressure ulcers. Multiple classification schemes have been developed in order to guide wound debridement. Fluency in surgical debridement as it relates to wound physiology, infection, and operative technique is a fundamental skill for all practitioners of wound management.
KeywordsSurgical debridement Debridement Wound stages Wound healing Wound infection Wound bed preparation Chronic wound Biofilm Burn Acute wound
Surgical debridement. Preoperative planning: flap markings; Doppler sonography for assessment of vessel patency; local anesthesia; surgical site preparation with povidone-iodine; sterile field; staining with methylene blue for guided debridement). Surgical debridement: wound edge incision; removal of stained tissue using electrocautery; removal of residual stained tissues using curette; rongeur-assisted bone biopsy; fluid irrigation via pulsatile jet device. Postoperative: debrided wound (MP4 167740 kb)
- 4.Schultz GS, Sibbald RG, Falanga V, Ayello EA, Dowsett C, Harding K, et al. Wound bed preparation: a systematic approach to wound management. Wound Repair and Rregen. 2003;11(Suppl 1):S1–28.Google Scholar
- 8.Webb LX, Smith TL, Morykwas MJ. Wound debridement: a comparison of two techniques for particle clearance. HydroCision Doc. No. 1000–1161, Rev. A09/03. www.wounds.Smith-Nephew.com
- 9.Department of Health and Human Services. Medicare Payments for surgical debridement services in 2004. 2007. OEI-02-05-00390.Google Scholar
- 11.Robson MC, Heggers JP. Quantitative bacteriology and inflammatory mediators in soft tissue. Soft and hard tissue repair. New York: Praeger; 1984. p. 484–507.Google Scholar
- 18.Panel for the Prediction and Prevention of Pressure Ulcers in Adults. Pressure ulcers in adults: prediction and prevention. Clinical practice guideline, 3. Rockville: Agency for Healthcare Policy and Research, Public Health Service, US Department of Health and Human Services, 1992 May: HCPR Publication No. 92–0047.Google Scholar