QUESTIONS AND ANSWERS SURE A+
✔✔benefits of enzymatic debridement - ✔✔faster than autolysis, good option for those
at high risk for bleeding, safe in infected wounds
✔✔disadvantages of enzymatic debridement - ✔✔costly, daily application, can sting,
takes longer than sharp or mechanical debridement
✔✔contraindications of enzymatic debridement - ✔✔not compatible with metal products,
some antiseptic cleansers reduce its activity/effectiveness
✔✔chemical debridement by sodium hypochlorite - ✔✔a type of non-instrumental
debridement using sodium hypochlorite (diluted bleach) to dissolve collagen anchors
between necrotic tissue and the wound bed
✔✔indications for chemical debridement by sodium hypochlorite - ✔✔grossly necrotic or
infected wounds
✔✔benefits of chemical debridement by sodium hypochlorite - ✔✔reduces wound odor,
cheap, non-cytotoxic
✔✔disadvantages of chemical debridement by sodium hypochlorite - ✔✔use is
controversial, is cytotoxic to fibroblasts
✔✔contraindications of chemical debridement by sodium hypochlorite - ✔✔do not use
in clean wounds
✔✔chemical debridement by silver nitrate - ✔✔a type of non-instrumental debridement
using silver nitrate to reduce fibroblast proliferation and overgrowth
*silver nitrate is a non-selective, caustic, chemical which burns and contacted tissues
, ✔✔benefits of chemical debridement by silver nitrate - ✔✔removes excess granulation
tissue, removes necrotic tissue, can open up epibole, reduces bioburden
✔✔disadvantages of chemical debridement by silver nitrate - ✔✔use is controversial,
painful, can stain skin, absorption of toxic silver is possible
✔✔contraindications of chemical debridement by silver nitrate - ✔✔avoid use in
pediatric patients as it can cause silver toxicity and is painful
✔✔biosurgical debridement - ✔✔a type of non-instrumental debridement using medical
grade maggots to liquify necrotic tissue through proteolytic enzymes
✔✔disadvantages of biosurgical debridement - ✔✔distasteful to most
patients/caregivers, bleeding, pain, crawling sensation
✔✔contraindications or biosurgical debridement - ✔✔poorly perfused wounds, exposed
blood vessels, necrotic bones, limb-threatening infections
✔✔mechanical debridement by wet-to-dry dressing - ✔✔a type of non-instrumental
debridement done by using damp gauze in the wound bed that is allowed to dry out to
trap tissue which is then pulled off during dressing changes
✔✔benefits of mechanical debridement by wet-to-dry dressing - ✔✔cheap, dressing
change is easy to perform, use in heavily necrotic or infected wounds without
granulation tissue
✔✔disadvantages of mechanical debridement by wet-to-dry dressing - ✔✔painful, non-
selective (will pull off healing tissue with necrotic tissue), time consuming (multiple
dressing changes daily for weeks)
✔✔contraindications of mechanical debridement by wet-to-dry dressing - ✔✔clean
granulation wounds
✔✔mechanical debridement by irrigation/pulsatile lavage - ✔✔a type of non-
instrumental debridement using fluid and pressure to remove surface debris and
bacteria form the wound base without damaging healthy tissue
✔✔benefits of mechanical debridement by irrigation/pulsatile lavage - ✔✔wound
cleansing
✔✔disadvantages of mechanical debridement by irrigation/pulsatile lavage -
✔✔potential for splash contamination - wear PPE!
✔✔goal PSI for pulsatile lavage - ✔✔4-15 psi