Debridement of the Diabetic Foot and Leg

Abstract

Debridement is the excision of foreign, dead, dying, damaged, or infected tissues in order to optimize the healing potential of the remaining healthy and viable tissues. It is a time honored and vital step in wound bed preparation performed in a myriad of ways in preparation for soft tissue closure within the steps of the plastic and reconstructive ladder. Debridement is truly the foundation of and perhaps the single most important component in the wound management cascade but a thoughtful understanding and careful consideration of the patient, the wound, and possible methods of debridement are still vital to a successful outcome. Various modes of debridement exist and although most are readily available regardless of clinical setting, individual choice of debridement mode to undertake may depend on clinician and patient access to resources and the logistical feasibility of its implementation. The surgeon must adapt to the wound as it presents and evolves and cater treatment modalities to the patient and the environment in which they are treated. Regardless of the exact setting, it is preferred that the multidisciplinary approach be pursued and utilized.