WK10-Debridement Flashcards
Define Debridement
the removal of necrotic tissue in a wound bed
What are the purposes of debridement ?
Decreased bacterial load/risk of infection, improve body’s ability to heal, decrease energy required to heal, remove physical barrier to healing, decrease odor
What is the difference between selective and non-selective debridement ?
Selective debridement is specific removal of necrotic tissue, where as non selective removes healthy tissue as well.
What are the indications for debridement ?
presence of devitalized tissue
What are contraindications to debridement ?
granular or hypergranular wounds
stable, hard, or dry eschar in ISCHEMIC limbs
when surgical debridement is more appropriate
when “ “ is scheduled
debridement of bone, nerves, tendon, muscle, fascia, ligaments, capsules, or blood vessels
When tissue is unidentifiable
Large category III or IV pressure ulcers with significant undermining or tunneling
What is sharp debridement ?
use of a scalpel, forceps, and or scissors to selectively remove devitalized tissue, debris, or foreign materials
When would you sharp debride ? When shouldn’t you ?
Indications: large amounts of eschar, necrotic tissue, calluses
contraindications: ischemic ulcers with low ABIs, lack of clinical competency, inability to identify tissue to be debrided, inability to visualize debridement area, wound closure not consistent with POC, hypergranular tissue
use caution on immunosuppressed, thrombocytopenic, and those on anticoagulant medications
What is autolytic debridement ?
using body’s own enzymes to digest necrotic tissue
When is autolytic debridement GOOD and when is it BAD
GOOD for patients who cannot tolerate other forms of debridement
GOOD for dry eschar removal
NOT for infected wounds or deep cavity wounds
NOT for wounds requiring surgical or sharp debridement.
What is enzymatic debridement ?
Chemical or enzyme debridement applied to remove devitalized tissue ( exogenous substance)
When is enzymatic debridement GOOD ? when is it BAD ?
GOOD for: infected and uninfected wounds, in conjunction with antimicrobial, in conjunction with cross hatched eschar.
BAD: Not for use on wounds with deep tissue exposure, calluses and facial burns
What is biological debridement ?
Use of sterile maggots to remove necrotic tissue
What is surgical debridement ?
sharp debridement done in a sterile environment by surgeons to explore deeper structures.
What is surgical debridement used for ?
ascending cellulitis
osteomyelitis
extensively necrotic wounds
wounds with undermining
wound near vital organs or structures
NOT for those on palliative care
What is mechanical debridement ?
use of force to remove devitalized tissue without consideration of healthy wound tissue
