Jwc ewma final indd

J O U R N A L  O F WO U N D  C A R E   Vo l   2 2 .  N o   1 .  E W M A   D o c u M E N t   2 0 1 3

considered. Therefore, the consent of the patient 

should be obtained whenever possible.

Costeffectiveness

There is little evidence available on these methods 

with regard to clinical efficacy and economic 

effectiveness in comparison to other methods 

of debridement. However, the resources needed 

to perform these procedures may provide an 

approximate indication of the level of cost.

Sharp debridement is relatively cheap with regard 

to staff resources and materials. It can be performed 

by a single staff member. Materials required 

include a scalpel or scissors, forceps, curette and 

sterile materials, such as drapes, gauzes, gloves, 

and containers for tissue biopsy and swabs. In 

addition, antiseptic medications for pre-procedure 

site preparation, wound cleansing following the 

procedure and proper dressings are required. Special 

procedure packs, containing drapes, gauzes and 

disposable instruments, are available on the market. 

In comparison, costs related to surgical 

debridement are high. They include, but are 

not limited to, the cost of the surgical team 

(surgeon, nurse, anaesthesiologist, anaesthesia 

nurse etc), labour, and cost of the operating 

theatre, anaesthesia and materials for surgery. 

Surgical debridement also requires a set of surgical 

instruments, usually including various sizes of 

scissors, scalpels, curettes, saws, drills, osteotomes, 

forceps, needle holders and others. The need to 

stop bleeding often occurs and an electrocautery 

machine is, therefore, an important part of the 

equipment. Surgery also requires sterile materials 

(surgical coats and gloves, drapes, gauzes), 

antiseptic medications and dressings.

conclusions

Surgical and sharp debridement are rapid 

methods of dead tissue removal from the wound, 

including devitalised, necrotic tissue or fibrin 

from the wound and peri-wound skin. These 

methods can be used for all types of wounds. 

Although clinically effective, both sharp and 

surgical methods should be used with some 

precautions, due to the risk of over-excision 

and wound damage, which might delay later 

wound healing. Alternative methods to sharp 

and surgical debridement should be considered, 

if non-viable tissue demarcation does not extend 

deeper than the deep-dermal layer, or the 

wound bed is covered by fibrin or slough. These 

situations usually require more gentle methods of 

debridement, to avoid excess wound-bed damage 

during the procedure. 

‘

Despitethemajorroleof

surgicaldebridementin

currentwoundmanagement,

thereislittleevidenceavailable

todocumentthebenefits.

’

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