When the skin is burned, the affected tissue will die depending on the severity of the injury. The dead tissue will naturally fall of as part of the healing process of the skin. However, in some cases where burns are severe (second and third degree burns), wound debridement is necessary. This dead tissue if not removed, will be a good medium for bacteria to grow and flourish, predisposing the wound for infection and other complications. Debridement is defined as the process of removing dead tissue and contaminated material from and around a wound to expose the healthy tissue.
There are four debridement methods which are : Surgical, Chemical, Mechanical and Autolytic debridement. The wound will be assessed to determine the best debridement method by examining the depth, extent and location of the wound; whether it lies close to other structures like bones, the risk of infection and antibiotic use, and the type of pain management that will be used during and after the procedure.
- Surgical debridement:
This is done using scalpels, forceps, scissors and other instruments to cut dead tissue from the wound. It is the most effective method used if the wound is large, has deep tissue damage, and may be done if the wound debridement is urgent. The wound will be cleaned with saline and then the dead tissue will be cut, this method may need to be repeated more than once and sometimes skin grafts may need to be transplanted into the debrided site.
- Mechanical debridement:
This is done by applying a saline moistened dressing over the wound and allowing it to dry and adhere to the dead tissue, when the dressing is removed the dead tissue will be pulled with it, this method is one of the oldest and can be very painful.
- Chemical debridement:
This is done by using enzymes and other compounds to dissolve dead tissue in the wound.
- Autolytic debridement:
This method involves using dressings that retain wound fluids, allowing the body itself to naturally get rid of the dead tissue. This method is not used if the wound is infected or quick treatment is needed, it takes more time than the other methods and is a good method if the body cannot tolerate more forceful treatment.
Debridement is done under general or local anesthesia, pain medications may be given if there is pain.
It is important to take good care of the debrided burned area by keeping the wound and the dressing clean and dry. Contact the doctor if there are signs of infection (discharge from the wound, color change, swelling, redness, increasing pain, excessive bleeding, fever and chills).
This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.