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Debridement
The literal meaning of ‘debride’ is to remove constraint (ie. ‘to
unbridle’). In relation to wound management, debridement
means to remove adherent, dead or contaminated tissue
from the wound. It is completely separate from the act of
cleansing, which is defined as the removal of dirt, loose
metabolic waste or foreign material (Strohal et al, 2013). For
many years, debridement has been recommended by clinical
guidelines from bodies such as the European Wound Healing
Society (Strohal et al, 2013) and Wounds UK (2013). But
there has been a lack of evidence to investigate whether or
not debridement really does accelerate wound healing.
A recent study, however, provides evidence that it does.
Wilcox et al (2013) analysed 154 644 patient records over
a 4-year period. All the patients attended a wound-healing
clinic for a variety of wound types, the most common being
venous leg ulcer (26.1%) followed by diabetic foot ulceration
(19%). Their retrospective study showed that nearly twice
as many venous leg ulcer and diabetic foot ulcerations
completely healed with frequent debridement compared
with those treated less frequently—50% versus 30% in the
venous leg ulcer group and 30% versus 13% in the diabetic
foot ulceration group, respectively. Wilcox et al (2013)
concluded that frequent debridement resulted in shorter
healing times for all wound types (P<0.001).
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