Debridement – a review of current techniques



debridement, debris, wound, wound bed, biofilm, healing, non-healing.


Debridement is the removal of nonviable material, foreign bodies, and poorly healing tissue from a wound to enhance healing. This article focusses on the indications, precautions, advantages and disadvantages of the variety of currently available debridement options.

Author Biography

Sajad Ahmad Salati, Unaizah College of Medicine and Medical Sciences , Qassim University , Saudi Arabia

Associate Professor , Department of SurgeryUnaizah College of Medicine and Medical Sciences , Qassim University , Saudi Arabia


Granick M, Boykin J, Gamelli R, Schultz G, Tenenhaus M. Toward a common language: surgical wound bed preparation and debridement. Wound Repair Regen. 2006;14 Suppl 1: S1-10.

Aiello EA, Cuddigan JE. Debridement: controlling the necrotic/cellular burden. Adv Skin Wound Care. 2004;17(2):66-75.

Knox KR, Datiashvili RO, Granick MS. Surgical wound bed preparation of chronic and acute wounds. Clin Plast Surg. 2007;34(4):633-41.

Hoppe I, Granick M. Debridement of chronic wounds: A qualitative systematic review of randomized controlled trials. Clin Plast Surg. 2012; 39: 221-28.

Panuncialman J, Falanga V. The science of wound bed preparation. Surg Clin North Am. 2009;89(3):611-26.

Calianno C, Jakubek P. Wound bed preparation: laying the foundation for treating chronic wounds, part I. Nursing. 2006;36(2):70-1.

Dieter S. Debridement for chronic wounds. A review of common uses. Adv Nurse Pract. 2001;9(9): 65-6.

Gwynne B, Newton M. An overview of the common methods of wound debridement. Br J Nurs. 2006;15(19): S4-S10.

Schultz GS, Sibbald RG, Falanga V , Ayello E A , Dowsett C, Harding K, Romanelli M, Stacey MC, Teot . Vanscheidt W . Wound bed preparation: a systematic approach to wound management. Wound Repair and Regeneration 2003; 11 (Suppl 1): S1-28.

Halim AS, Khoo TL, Mat Saad AZ. Wound bed preparation from a clinical perspective. Indian J Plast Surg. 2012; 45(2): 193-202.

Hess C T. QUICK TIPS: Dressings for autolytic debridement. Advances in Skin & Wound Care 2004;17(5): 222

Reyzelman AM, Vartivarian M. Evidence of intensive autolytic debridement with a self-adaptive wound dressing. Wounds. 2015;27(8):229-35.

Cuschieri L, Debosz J, Miiller P, Celis M. Autolytic debridement of a large, necrotic, fully occluded foot ulcer using a hydrocolloid dressing in a diabetic patient. Adv Skin Wound Care. 2013; 26(7):300-4.

Romando J. (2012). Wound debridement. In R. A. Bryant & D. P. Nix (Eds.), Acute & chronic wounds. Current management concepts (4th ed., pp. 279-288). St. Louis, MO: Elsevier-Mosby.

Atkin L, Rippon M. Autolysis: mechanisms of action in the removal of devitalised tissue. Br J Nurs. 2016 ;25(20 Suppl): S40-S47.

Motta G, Dunham L, Dye T, et al. Clinical efficacy and cost-effectiveness of a new synthetic polymer sheet wound dressing. OWM. 1999;45(10): 44-9.

Brown-Etris M, Milne C, Orsted H, et al. A prospective, randomized, multisite clinical evaluation of a transparent absorbent acrylic dressing and a hydrocolloid dressing in the management of stage II and shallow stage III pressure ulcers. Adv Skin Wound Care. 2008;21(4):169-74.

Kerihuel JC. Effect of activated charcoal dressings on healing outcomes of chronic wounds. J Wound Care. 2010;19(5): 210-5.

Heuer, Heike; Heuer, Lutz (2011). "Blowfly Strike and Maggot Therapy: From Parasitology to Medical Treatment". In Mehlhorn, Heinz (ed.). Nature Helps. Parasitology Research Monographs. pp. 301

Bowling FL, Salgami EV, Boulton AJ. Larval therapy: a novel treatment in eliminating methicillin-resistant Staphylococcus aureus from diabetic foot ulcers. Diabetes Care. 2007;30(2):370-1.

Sherman RA. Mechanisms of maggot-induced wound healing: what do we know, and where do we go from here? Evid Based Complement Alternat Med. 2014; 2014:592419.

Whitaker IS, Twine C, Whitaker MJ, Welck M, Brown CS, Shandall A. Larval therapy from antiquity to the present day: mechanisms of action, clinical applications and future potential. Postgrad Med J. 2007;83(980):409-13.

Sherman RA, Hall MJ, Thomas S. Medicinal maggots: an ancient remedy for some contemporary afflictions. Annu Rev Entomol. 2000;45:55-81.

Donnelly J. Wound healing--from poultices to maggots. (a short synopsis of wound healing throughout the ages). Ulster Med J. 1998;67 (S1):47-51.

Orkiszewski M. Maggots of Lucilia sericata in treatment of intractable wounds. Wiad Lek. 2007;60(7-8):381-5.

Heitkamp RA, Peck GW, Kirkup BC. Maggot debridement therapy in modern army medicine: perceptions and prevalence. Mil Med. 2012;177(11):1411-6.

Wang SY, Wang JN, Lv DC, Diao YP, Zhang Z. Clinical research on the bio-debridement effect of maggot therapy for treatment of chronically infected lesions. Orthop Surg. 2010;2(3):201-6.

Sherman RA. Maggot therapy for treating diabetic foot ulcers unresponsive to conventional therapy. Diabetes Care. 2003;26(2):446-51.

Tantawi TI, Gohar YM, Kotb MM, Beshara FM, El-Naggar MM. Clinical and microbiological efficacy of MDT in the treatment of diabetic foot ulcers. J Wound Care. 2007;16(9):379-83.

Parnes A, Lagan KM. Larval therapy in wound management: a review. Int J Clin Pract. 2007;61(3):488-93.

Gill SE, Parks WC. Metalloproteinases and their inhibitors: regulators of wound healing. Int J Biochem Cell Biol. 2008;40(6-7):1334-47

Isabela Avila-Rodriguez M, Melendez-Martinez D, Licona-Cassani C, Manuel Aguilar-Yanez J, Benavides J, Lorena Sanchez M. Practical context of enzymatic treatment for wound healing: A secreted protease approach (Review). Biomed Rep. 2020;13(1):3-14.

Kravitz SR, McGuire J, Zinszer K. Management of skin ulcers: understanding the mechanism and selection of enzymatic debriding agents. Adv Skin Wound Care. 2008;21(2):72-4.

Ramundo J, Gray M. Collagenase for enzymatic debridement: a systematic review. J Wound Ostomy Continence Nurs. 2009;36(6 Suppl):S4-11.

Marazzi M, Stefani A, Chiaratti A, Ordanini MN, Falcone L, Rapisarda V. Effect of enzymatic debridement with collagenase on acute and chronic hard-to-heal wounds. J Wound Care. 2006;15(5):222-7.

Patry J, Blanchette V. Enzymatic debridement with collagenase in wounds and ulcers: a systematic review and meta-analysis. Int Wound J. 2017;14(6):1055-65.

Perera E, Rodriguez-Viera L, Montero-Alejo V, Perdomo-Morales R. Crustacean Proteases and Their Application in Debridement. Trop Life Sci Res. 2020;31(2):187-209.

Melendez-Martinez D, Plenge-Tellechea LF, Gatica-Colima A, Cruz-Perez MS, Aguilar-Yanez JM, Licona-Cassani C. Functional Mining of the Crotalus Spp. Venom Protease Repertoire Reveals Potential for Chronic Wound Therapeutics. Molecules. 2020 ;25(15):3401.

Moore Z. Mechanical debridement: a brief overview. Br J Nurs. 2015 ;24(12): S38, S40.

Atkin L, Ousey K. Wound bed preparation: A novel approach using HydroTherapy. Br J Community Nurs. 2016 ;21(Sup12): S23-S28.

Hodgson H, Davidson D, Duncan A, Guthrie J, Henderson E, MacDiarmid M, McGown K, Pollard V, Potter R, Rodgers A, Wilson A, Horner J, Doran M, Simm S, Taylor R, Rogers A, Rippon MG, Colgrave M. A multicentre, clinical evaluation of a hydro-responsive wound dressing: the Glasgow experience. J Wound Care. 2017;26(11):642-50.

Ousey K, Rogers AA, Rippon KG . HydroClean plus: a new perspective to wound cleansing and debridement. Wounds UK 2016;12(1):94-104

Rennekampff HO, Schaller HE, Wisser D, Tenenhaus M. Debridement of burn wounds with a water jet surgical tool. Burns. 2006 ;32(1):64-9.

Mosti G, Iabichella ML, Picerni P, Magliaro A, Mattaliano V. The debridement of hard to heal leg ulcers by means of a new device based on Fluidjet technology. Int Wound J. 2005; 2(4):307-14.

Schoeb DS, Klodmann J, Schlager D, Müller PF, Miernik A, Bahls T. Robotic waterjet wound debridement - Workflow adaption for clinical application and systematic evaluation of a novel technology. PLoS One. 2018;13(9):e0204315.

Bahls T, Frohlich FA, Hellings A, Deutschmann B, Albu-Schaffer AO. Extending the Capability of Using a Waterjet in Surgical Interventions by the Use of Robotics. IEEE Trans Biomed Eng. 2017;64(2):284-94.

Lee CK, Hansen SL. Management of acute wounds. Surg Clin N Am. 2009;89: 659-76.

Schultz GS, Woo K, Weir D, Yang Q. Effectiveness of a monofilament wound debridement pad at removing biofilm and slough: ex vivo and clinical performance. J Wound Care. 2018 ;27(2):80-90.

Roes C, Calladine L, Morris C. Biofilm management using monofilament fibre debridement technology: outcomes and clinician and patient satisfaction. J Wound Care. 2019; 28(9):608-22.

Roes C, Calladine L, Morris C. Rapid debridement with monofilament fibre debridement technology: clinical outcomes and practitioner satisfaction. J Wound Care. 2019 ;28(8):534-41.

Dissemond J, Eberlein T, Bültemann A, Riepe G, Stoffels I, Stephen-Haynes J, Roes C, Abel M. A purpose-designed monofilament-fibre pad for debridement of hard-to-reach wounds: experience in clinical practice. J Wound Care. 2018;27(7):421-25

Meads C, Lovato E, Longworth L. The debrisoft monofilament debridement pad for use in acute or chronic wounds: A NICE Medical Technology Guidance. Appl Health Econ Health Policy. 2015;13(6):583-94.

Browning A. Debrisoft is a wound debridement product, not a wound dressing. Nurs Stand. 2014;28(36):35.

Bahr S, Mustafi N, Hättig P, Piatkowski A, Mosti G, Reimann K, Abel M, Dini V, Restelli J, Babadagi-Hardt Z, Abbritti F, Eberlein T, Wild T, Bandl K. Clinical efficacy of a new monofilament fibre-containing wound debridement product. J Wound Care. 2011;20(5):242-8.

Falabella AF. Debridement and wound bed preparation. Dermatol Ther. 2006;19(6):317-25.

Butcher G, Pinnuck L. Wound bed preparation: ultrasonic-assisted debridement. Br J Nurs. 2013 ;22(6): S36, S38-43.

Granick M, Rubinsky L, Parthiban C, Shanmugam M, Ramasubbu N. Dispersion Risk Associated with Surgical Debridement Devices. Wounds. 2017;29(10): E88-E91.

Lazaro-Martinez JL, Alvaro-Afonso FJ, Garcia-Alvarez Y, Molines-Barroso RJ, García-Morales E, Sevillano-Fernández D. Ultrasound-assisted debridement of neuroischaemic diabetic foot ulcers, clinical and microbiological effects: a case series. J Wound Care. 2018 ;27(5):278-86.

Messa CA 4th, Chatman BC, Rhemtulla IA, Broach RB, Mauch JT, D'Angelantonio AM 3rd, Fischer JP. Ultrasonic debridement management of lower extremity wounds: retrospective analysis of clinical outcomes and cost. J Wound Care. 2019;28(Sup5): S30-S40.

Ramundo J, Gray M. Is ultrasonic mist therapy effective for debriding chronic wounds? J Wound Ostomy Continence Nurs. 2008 ;35(6):579-83.

Swanson T, Lázaro-Martínez JL, Braumann C, Kirchhoff JB, Gächter B, van Acker K. Ultrasonic-assisted wound debridement: report from a closed panel meeting. J Wound Care. 2020;29(2):128-35.




How to Cite

Salati SA. Debridement – a review of current techniques. J Pak Assoc Dermatol [Internet]. 2021Aug.6 [cited 2024Feb.26];31(2):262-7. Available from:



Review Articles

Most read articles by the same author(s)

1 2 3 > >>