Surgical debridement is the removal of unhealthy or dead tissue from a wound to allow for faster healing or to prevent infection; the surgeon may also remove bone or fluid from the area. This method of debridement is only used for large or deep wounds or in urgent situations in which the tissue must be removed immediately. The procedure is usually performed bedside or in an operating room, and local or general anesthesia typically is administered, depending on the severity of the wound and the amount of tissue removal necessary. Patients should consult with their physicians on the risks associated with this procedure.
There are five types of wound debridement: mechanical, autolytic, chemical, enzymatic and surgical. In surgical debridement, the dead or nonviable tissue is removed using scalpels, forceps or other surgical instruments — lasers have even been used in some surgeries. Other debridement procedures, such a applying wet to dry dressings or whirlpool bath therapy, typically are performed in conjunction with the surgical method to remove the affected tissue. Most types of debridement take two to six weeks to complete, but because doctors can directly remove specific tissue when performing surgical debridement, hospital stays and recovery times are typically faster with this method.
Debridement procedures are used to treat skin injuries and burns or conditions caused by other diseases, such as bed sores or ulcers. Surgical debridement not only removes dead tissue, but also tissue that has been infected with bacteria; it is important to remove infected tissue immediately because of the risk that the infection will spread to surrounding tissue or enter the blood stream. The procedure usually is performed while the patient is under local or general anesthesia because most wounds that require surgical debridement are deep or require a large amount of tissue to be removed.
The procedure typically is performed by a physician. These doctors must be well-skilled at this method so as to not remove healthy, viable tissue or to damage underlying tissue or tendons. Depending on the severity of the wound or infection, however, a surgeon may be called upon to complete the tissue removal procedure.
Debridement can be painful, and like all surgical procedures, there is a risk of infection. Patients with clotting disorders or those taking anticoagulants should be especially careful when undergoing this procedure, as excessive bleeding can occur. Sometimes, a skin graft is performed after surgery to replace and promote healing and regeneration of the skin. Of the five types of debridement, the surgical procedure requires the shortest hospital stay, but patients must follow the physician’s post-procedure instructions to ensure the wound does not become infected again.