Safe debridement in the community

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Wounds Essentials 2012, Vol 2

Clinical 

REVIEW

will help to remove any offensive 

odour emanating from the dead 

tissue. For individuals with malignant 

wounds, the debridement process 

may take place on consecutive 

occasions due to the skin failure that 

accompanies the progression of the 

disease process (Young, 2011).

Tissue type 

It is important that non-viable tissue 

is recognised and not confused with 

other tissue types, such as exposed 

tendon. Gray et al (2011) described 

six different manifestations of 

devitalised tissue likely to require 

debridement in a wound bed — wet 

slough, superficial wet slough, dry 

slough, wet necrosis, dry necrosis 

and haematoma. Hampton (2011) 

suggests that the slough may be either 

soft and easily removed or thick and 

tenacious. Necrotic eschar is where 

the tissue has dried out and has a 

thick, leathery, brown or black texture 

(Benbow, 2011a,b). 

In certain circumstances, necrotic 

tissue should not be debrided, such as 

in gangrenous toes or necrotic pressure 

ulcers on the heel of patients with 

ischaemic limbs. Diabetic patients who 

have wet necrotic tissue (wet gangrene) 

require immediate debridement to 

prevent the rapid spread of infection 

(Haycocks and Chadwick, 2012).