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Autolytic debridement
The natural process of autolytic debridement is the most
common method and can be done by nurses without
specialist skills. All wound dressings that optimise a moist
wound environment by adding moisture to the wound
bed, or removing excess fluid, aid the process of autolysis,
where the body’s enzymes break down the non-viable tissue.
Autolytic debridement is often used as the sole source of
debridement, but this can require numerous treatments over
a long period of time. This option is selective, painless, non-
invasive and easy to perform. But it can also be slow, which
can potentially increase the risk of infection or maceration.
Larval
Larval therapy or maggot therapy biologically debrides the
wound bed. The maggots liquefy and digest neurotic tissue,
kill and consume bacteria, and stimulate wound healing by
promoting fibroblast growth (Broadus, 2013). They come
either ‘free range’ (placed directly onto the wound bed)
or contained within bags. Larval therapy provides rapid,
selective debridement, but attracts higher unit costs and may
not be readily accepted by some patients.
Mechanical
Mechanical debridement physically removes debris from
the wound bed and does so rapidly compared with other
methods. But it was thought to be painful and non-selective,
and fell out of favour.
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