Key terms
Eschar — A hardened black crust of dead tissue that may form over a wound.
Pressure ulcer — Also known as a decubitus ulcer, pressure ulcers are open wounds that form whenever prolonged pressure is applied to skin covering bony outcrops of the body. Patients who are bedridden are at risk of developing pressure ulcers. Pressure ulcers are commonly known as bedsores.
Sepsis — A severe systemic infection in which bacteria have entered the blood stream.
Preparation
The physician or nurse will begin by assessing the need for debridement. The wound will be examined, frequently by inserting a gloved finger into the wound to estimate the depth of dead tissue and evaluate whether it lies close to other organs, bone, or important body features. The area may be flushed with a saline solution before debridement begins, and a topical anesthetic gel or injection may be applied if surgical or mechanical debridement is being performed.
Aftercare
After surgical debridement, the wound will be packed with a dry dressing for a day to control bleeding. Afterward, moist dressings are applied to promote wound healing. Moist dressings are also used after mechanical, chemical, and autolytic debridement. Many factors contribute to wound healing, which frequently can take considerable time. Debridement may need to be repeated.
Risks
It is possible that underlying tendons, blood vessels or other structures will be damaged during the examination of the wound and during surgical debridement. Surface bacteria may also be introduced deeper into the body, causing infection.
Normal results
Removal of dead tissue from pressure ulcers and other wounds speeds healing. Although these procedures cause some pain, they are generally well tolerated by patients and can be managed more aggressively. It is not uncommon to debride a wound again in a subsequent session.