Debridement and Wound Care: Important Terms to Know

by the WoundSource Editors

Autolytic debridement: A method of debridement that uses the body’s own enzymes and the moisture trapped beneath the dressing to liquefy non-viable tissue. Although it is the safest method, it is also very slow and therefore not the best option for wounds with large amounts of necrotic tissue.

Biofilm: A complex microbial community containing bacteria and fungi. The microorganisms synthesize and secrete a protective matrix that attaches the biofilm firmly to a living or non-living surface. The biofilm contributes to underlying wound infection, chronic inflammation, and delay in healing, and it is present in 60% of chronic wounds and 6% of acute wounds.

Biological (biosurgical) debridement: A debridement technique in which live, sterile bottle fly larvae are introduced into a wound. The maggots eat the dead tissue while leaving healthy surrounding tissue intact.

Chronic paresthesias: The presence of an abnormal sensation, such as numbness, tingling, or burning, or the loss of sensation on the extremities. It is commonly present with neuropathic foot ulcers.

Cross-hatch: A method of scoring eschar when using an enzymatic agent on eschar that aids with its mechanism of debridement.

Eschar: Desiccated compressed dead tissue.

Inflammatory period: This stage in wound healing is marked by re-epithelization. It occurs after hemostasis and generally lasts one to five days. Physiological effects during this stage include erythema, warmth, edema, and pain.

Ischemic wounds: Wounds that occur as a result of diminished or blocked blood supply to vascular beds in the body. In the absence of an active infection, debridement is not recommended.

Mechanical debridement: A non-selective, physical method of removing both viable and non-viable tissue and debris from a wound. This type of debridement uses abrasive force (generally gauze, soft fiber, wet-to-dry dressings, and pulse lavage) to remove necrotic tissue.

Periwound: The tissue immediately surrounding the wound itself. Ideally, this tissue should provide a barrier to the wound, thus preventing the wound from spreading, although many chronic wounds display periwound edema with swelling and discoloration.

Protease: An enzyme that breaks down proteins. Chronic wounds often have a high level of proteases.

Pyoderma gangrenosum: A rare condition in which large, painful sores or ulcers develop. Although the exact cause is unknown, it is generally thought to be a disorder of the immune system. Debridement is not recommended for this type of wound.

Revascularization: A procedure that can be completed on the lower extremities to restore perfusion through surgical intervention.

Sharp conservative debridement: Done outside the operating room, this type of debridement is not so aggressive a procedure that it renders a wound acute, but it removes any clearly identifiable necrotic tissue or debris above the level of viable tissue by using sharp instruments including but not limited to scalpels, scissors, or curettes.

Sharp surgical debridement: Performed in the operating room, it is the most efficient debridement method to convert a chronic wound to an acute wound.

Slough: A moist composite of fibrin, bacteria, cell debris, leukocytes, and exudate.

Surgical dehiscence: A type of wound that may potentially become chronic. It occurs when a surgical incision breaks apart along the suture and the edges of the wound start to separate rather than close.

The views and opinions expressed in this blog are solely those of the author, and do not represent the views of WoundSource, Kestrel Health Information, Inc., its affiliates, or subsidiary companies