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

M

echanical wound debridement involves 

the use of dry gauze dressings, wet 

to dry gauze dressings, impregnated 

gauze/tulle dressings or a monofilament fibre pad 

to remove non-viable tissue from the wound bed. 

Following a review of the literature, a large 

proportion of the articles were excluded, as they 

did not contain specific information on the ability 

to debride non-viable tissue (Edsrtom et al., 1979; 

Xakellis and Chrischilles, 1992; Brown, 2000; Piaggesi 

et al., 2000; Caravaggio et al., 2003; Eginton et al., 

2003; Wanner et al., 2003; Allie et al., 2004; Cohn et 

al., 2004; Mouës, 2004; Brigido et al., 2006; Huang et 

al., 2006; Yao et al., 2006; Mouës et al., 2007; Koller et 

al., 2008; Wang and Teng, 2008; El-Nahas et al., 2009; 

Saba et al., 2009; Martin et al., 2010; Perez et al., 

2010; Solway et al., 2010; Brenes et al., 2011; Uccioli 

et al., 2011; Warriner et al., 2011; Zhen et al., 2011. 

Full references can be found in Appendix 4).

Wet-to-dry debridement

Background

Mechanical debridement has been reported to be 

the most commonly used debridement technique 

in the USA

14

 and is a method that has been used 

for decades.

15,16

 A wet-to-dry method of wound 

cleansing has also been decribed,

17

 but should 

not be confused with the traditional wet-to-dry 

method of debridement.

Action

One technique used to achieve mechanical 

debridement is the wet-to-dry method. A moist 

Mechanicaldebridement

gauze pad is applied to the wound. As the 

devitalised tissue dries, it re-hardens and becomes 

attached to the gauze; when the dressing is 

removed, the adhered material is pulled free. 

Indications

Wet to dry dressings are recommended only as a 

short-term therapy for infected necrotic wounds.

15,18

One case study reports using wet-to-dry as a 

debridement method in a patient with a category III 

pressure ulcer.

19

 In addition, there is one case 

reporting success in using wet-to-dry gauze as one 

component of a debridement regimen.

20

Limitations

The wet-to-dry debridement method often 

results in a lack of procedural concordance, with 

an increased risk of infection; also, the gauze 

remnants can potentially act as foreign bodies 

within the wound bed. The disadvantages of this 

method are described as injury to normal tissue 

and pain, along with the necessity for frequent 

dressing changes.

15

 In addition, while cost of 

the gauze is low, application is said to be time 

consuming and costly.

15,18

Paraffin tulle

Donati and Vigano

21

 provide anecdotal reports of 

paraffin tulle dressings causing pain and damage 

to new tissue, bleeding at the wound bed on 

removal, as well as an increased risk of infection 

and a delay in re-epithelialisation.

21

 Barnea et 

al.,

22

 in a study comparing a 

Hydrofiber dressing 

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