Debridement: Technical Considerations and Treatment Options for the Interprofessional Team

Abstract

ABSTRACT Debridement is a critical component in the management of both acute and chronic wounds. Six reviewed methods of debridement exist, and specific techniques are more appropriate to match patient needs with available clinical resources. Accurate differentiation between healable, maintenance, and nonhealable wounds is paramount when determining whether a wound would benefit from debridement. Clinical assessment includes review of the patient’s underlying medical conditions/ previous surgeries along with the history and progression of the wound. Awareness of the physiologic wound bed preparation components that contribute to the current wound status will direct treatment of the abnormal components. Optimal wound status includes complete healing or reduced abnormal wound-related symptoms or signs. Debridement competency requires an awareness of the six types of debridement, their clinical utility, and appropriate patient selection. Providers need to assess patients’ wounds, triage them, and refer them as necessary to an interprofessional setting. For stalled but healable wounds, specialized testing may be necessary when managing patients who would benefit from more invasive or advanced forms of wound care. This article informs providers on the training and experience required for specific debridement techniques depending on the wound etiology. GENERAL PURPOSE To enhance the learner’s chronic wound debridement competence as an interprofessional team member. TARGET AUDIENCE This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. LEARNING OBJECTIVES/OUTCOMES After participating in this educational activity, the participant will: 1. Differentiate healable, maintenance, and nonhealable wounds to create a holistic debridement treatment plan using the Wound Bed Preparation paradigm. 2. Evaluate active debridement options including the potential need for an interprofessional referral or specialized investigations. 3. Assess chronic wound debridement options. 4. Analyze case studies for appropriate clinical application of debridement modalities.