Continuing our review of techniques used for wound debridement, this week we take a brief look at mechanical debridement.
What is Mechanical Debridement?
As its name suggests, mechanical debridement requires the use of a certain amount of force to remove devitalized tissue, as well as debris and other foreign material, from a wound bed. (1–3) Mechanical debridement is known as a non-selective technique because it involves the removal of non-specific areas of devitalized tissue. A number of techniques for applying the force required for mechanical debridement are available, including the use of wet-to-dry dressings, scrubbing, wound cleansing, wound irrigation, pulsatile lavage, whirlpool, and use of hydrogen peroxide.(1–3)
Wet-to-Dry Debridement
Wet-to-dry debridement has been used less over recent years as other wound debridement techniques have gained in popularity.(1) The major disadvantage of the wet-to-dry technique is that viable tissue can be traumatized on the removal of the dressing, but the process can also be extremely painful and may lead to bleeding, wound bed desiccation, and periwound maceration. Wound cleansing, irrigation, pulsatile lavage and whirlpool all rely on the mechanical force of water to debride the wound bed, while the force used in the scrubbing technique should be as little as possible to minimize trauma.(1)
Mechanical debridement is one of the oldest forms of debridement still practiced, and offers the advantage of the low cost of the materials required. However, as well as potentially damaging healthy tissue, the technique can be time-consuming and painful for the patient. For these reasons, other types of debridement are generally preferred.(1)
Next week, we will turn to sharp debridement.
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References
- 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.
Skin Tear – Cat 2B? Hard to tell without a moist swab to roll that skin out, but it doesn’t look like we could get close enough to steri-strip. Cleanse gently with NSS. Apply petrolatum to wound edges. Skin prep to peri-wound and apply soft, silicone dressing. PLEASE do not apply a clear occlusive!
So would you consider scrubbing a wound with saline moistened gauze as a mechanical debridement?
I just had a wound from a dog bite squeezed multiple times by the doctor.. extremely painful. This was due, supposedly, to a hematoma. Is there another, less painful method? I’m also concerned about damage done to good tissue.
Elaine,
We are very sorry to hear this. We know first-hand how challenging it can be to deal with a stubborn wound. In addition to following doctor’s orders for home care, you can always get a second opinion and search for a wound certified specialist through this directory – https://portal.abwmcertified.org/ABWMweb/Directory/ABWMcontent/Directory.aspx
Best of luck, and quick healing!