Surgical Debridement of Wounds

In this all-important component of our wound-healing treatments, our wound physicians remove any dead or infected tissue, scar tissue and calluses, or tissue that’s otherwise unable to heal from the wound. Debridement can be done through various methods, but the most effective method, and the one used at the Winthrop Wound Center, is to debride the wound surgically with a scalpel.

Debridement is an essential step in treating wounds that are having difficulty healing when treated with medications alone. It accelerates the healing process by eliminating dead (necrotic) tissue that prevents the wound from healing (and that can also mask underlying abscesses or fluid collections) as well as infected tissue that is also hindering the healing process. At the same time, debridement stimulates the release of healing growth factors at the edge of the wound, and also prepares the wound bed for healing by leaving behind only tissue that is capable of regenerating and filling the wound.

As part of each debridement procedure, once the nonviable tissue has been removed, our wound healing team will administer antibiotics to the wound site as needed, as well as regenerative medications to stimulate the growth of new, healthy tissue. With some patients, a single debridement procedure may be enough to cause the wound to heal completely. With other patients, multiple debridement procedures may be needed over time to continue the healing process.

Our surgeons are among the most skilled in the world at debridement, and they prepare meticulously for every debridement procedure, carefully reviewing the patient's data and lab reports. By doing a cellular analysis of tissue samples taken during the debridement process—an approach our wound healing team has helped to pioneer—we’re able to determine with extreme precision exactly how much tissue to remove so that only tissue capable of healing is left behind. This allows us to maximize the benefits of each debridement procedure, thereby reducing the total number of procedures needed to heal a chronic wound.

Most of our debridement procedures are done on an outpatient basis and take an hour or less to complete. Recently we have also been pioneering the use of regional anesthesia for debridement of some patients’ wounds, eliminating the need for general anesthesia. In the weeks following debridement, we track each patient's healing process with our innovative Online Wound Electronic Medical Record (OWEMR). If the OWEMR data indicates that the healing process has stalled, another debridement procedure may be scheduled to ensure that the wound continues to heal.

 

Illustration31EDIT2Left: A diabetic ulcer of the left big toe. Below: Callus and surrounding tissue that was debrided from the patient's wound. Bottom left: A number of months later, the wound has healed completely.

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