Debridement--is it time to revisit clinical practice?

Debridement is the removal of non-viable tissue from a wound bed. It is an essential procedure in order to achieve wound healing and symptom control. The clinical presentation of non-viable tissue varies in content, appearance, depth and level of hydration. There may be a risk of systemic infection if non-viable tissue is not removed in a timely fashion. There are various methods of debridement each with its own advantages and limitations. The competence of the practitioner undertaking the debridement is crucial and is a key consideration along with availability of the necessary equipment and the provision of the optimal environment. Client choice and involvement are vital to the debridement process. There should be no hierarchy of debridement methods and the chosen method should achieve timely optimal pain-free removal of non-viable tissue. There is a need to question the current situation in which the specialist nurse is highly skilled in the debridement process while the generalist nurse potentially carries a higher caseload of patients who require this procedure.