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  

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Fig 1.Woundmargincoveredbydriedexudate

andhyperkeratosiswhichmayimpairthe

physiologicalprocessofwoundhealing

Fig 2.Lowerlegwithwidelydisseminated,adherentcrusts

ofexudate,largeskinscales,hyperkeratosisanddebris,

whichmayimpairthephysiologicalprocessofwoundhealing.

Nodefinedulcer.

probability to achieve clinical benefi ts such as 

increased quality of life of the patient, fewer 

odours, improved microcirculation, normalised 

biochemistry including normalising the matrix 

metalloproteinase (MMP) balance, decreased 

access of moisture and stimulated wound edges. A 

global approach to debridement offers advantages 

with regards to the possibility to clearly defi ne 

wound phase targets for debridement and review 

whether these targets have been achieved. 

Primary targets for debridement have been 

summarised in Table 1.

Indicationsfordebridement

As debridement represents a central step in the 

management of wounds it can be applied to all kinds 

of wounds, irrespective of their diagnoses and origin. 

The question arises with regards to the indication 

for debridement and timing of the procedure. A 

clear indication can be generated via the diagnosis 

of different kinds of tissue types and bioburden 

which cover the wound bed, the state of the wound 

edges and the peri-wound skin. A tissue type related 

defi nition of debridement allows the clinicians to 

defi ne the right time point for debridement and to 

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