Debridement is the process of removing dead tissue and debris from the body. This is most often necessary in wound infections, burns, and dirty lacerations or abrasions (i.e. "road rash"). Removal of all dead tissue and other foreign materials allows for faster, better wound healing.

There are three types of debridement:

Chemical debridement is debridement through the use of enzymes which dissolve away necrotic tissue, and is not used too often.

Mechanical debridement is what the poor devil who just skidded 40 feet on an asphalt surface is going to get - scrubbing, and lots of it (to get the asphalt particles out of his skin). Mechanical debridement also includes the use of a whirlpool to flush away necrotic tissue from ulcers or burns, as well as dressings such as wet-to-dry which are designed to remove effluents and necrotic tissue fragments.
Mechanical debridement is also the province of the oft-cited maggot therapy - fly eggs are introduced into a wound; when the maggots hatch, they eat away the necrotic tissue without damaging the still-living parts. Gross, yet effective.

Surgical debridement is the removal of necrotic or irreparably damaged tissue through surgery to ensure better wound healing or decreased risk of infection. Surgical debridement is the province of the physician, not the nurse.

Most types of debridement are very painful, and patients should be well premedicated before the procedure.

Debriding wounds is some of the hardest work for me as a nurse, psychologically speaking. If I had wanted to cause people pain, I would have gone into Physical Therapy. I know that getting every bit of debris out of the wound will be necessary for my patient to have a good outcome, but it is very, very hard to stand there and scrub someone who has been dragged over the road already until they bleed more, unable to be merciful and stop when they scream (because premedication doesn't always work or, in some cases, cannot be used...). If ever I have to debride you, remember, it hurts me inside, but I will not stop. You wouldn't thank me for it later.

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