Learn about Debridement

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Dr. Jerry Laster, M.D.
"Each patient is going to be a little different when you approach them and see necrotic tissue or slough in the wound. If I think that the patient is going to benefit from having that tissue removed and there’s no contra-indications such as being on anti-coagulants medication that might lead to bleeding. I also want to make sure that pain control is adequate in that patient. I don’t want to hurt them by taking off that dead tissue. I want to make sure that I think they have adequate blood supply to heal that area. And, those kind of patients we will go ahead and sharply debride either with a knife or a curette or with scissors or forceps. And, if there’s any tissue left behind that needs to be debrided we can apply certain topical agents that will help dissolve. And, when I come back the next week hopefully we’re looking and more dead tissue and looking at more healthy tissue and we can start to trying to stimulate that wound to grow. "

Enzymatic debriding agents will work but they take a lot longer. They don’t work nearly as fast as the sharp debridement does. The longer you leave dead tissue in a wound, it releases chemicals that actually impede healing. Dead tissue is a fertile ground for bacteria to grow in. If you do get infected, it’s going to slow healing down. So, by cleaning up and removing that you stimulate the wound, to lay down healthier tissue. Plus, when you do get just a tiny amount of bleeding in the wound, platelets release. Platelets drive growth factors into the wound that stimulate it to grow. Removing that tissue, any dead tissue in that wound is an impediment to healing.
Basically, when you debride it, you’re going to get the bulk of it out and I like to use the chemical agents to kind of clean up what’s left behind."