Another week has passed, and this week we turn to sharp debridement in our brief series on the different techniques available for debriding wounds.
Sharp debridement refers to the use of forceps, scissors, or a scalpel to remove devitalized tissue, debris or other foreign materials from a wound bed.(1–3) After surgical debridement, sharp debridement is the most aggressive form of debridement available to clinicians, and also the most rapid. Nationally, sharp debridement may be performed by either physicians or podiatrists, with other medical practitioners permitted to perform the procedure in certain states according to the laws and practice acts of the individual state.(1)
Vigorous and repeated sharp debridement of necrotic tissue and debris is considered the standard of care for many patients with open wounds.(1) The technique is indicated in wounds presenting with significant necrosis, callus, advancing cellulitis or sepsis, or thick adherent eschar.(1) Chronic wounds tend to require repeated debridement because of the likely re-emergence of necrotic tissue and bioburden in the wound bed.(1)
Sharp debridement has a number of contraindications, and should not be used when area cannot be adequately visualized or when the material to be debrided is unidentified. The technique should be used with caution in patients who are immunosuppressed, thrombocytopenic, or receiving anticoagulant therapy.(1)
As sharp debridement can be stressful for the patient, the procedure should be halted if the patient experiences uncontrolled pain or if there is extensive bleeding. Importantly, the procedure should not proceed if the clinician fatigues, and should only be undertaken if sufficient time is available to both clinician and patient.(1)
Next week we turn from sharp debridement to surgical debridement, the most aggressive form of debridement available to clinicians.
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- Myers BA. Wound management principles and practice. 2nd ed. Upper Saddle River, NJ: Pearson; 2008.
- Ayello EA, Baranoski S, Cuddigan J, Sibbald RG. Wound Debridement. In: Baranoski S, Ayello EA, eds. Wound Care Essentials: Practice Principles. 2nd Edition. Lippincott Williams & Wilkins, Ambler PA. 2008.
- Ramundo JM. In: Bryant RA and Nix DP. Acute and chronic wounds. Current management concepts. 3rd ed. St Louis, Missouri; Mosby Elsevier; 2007.