- Autolysis uses the body's own enzymes and moisture to re-hydrate, soften and finally liquefy hard eschar and slough. Autolytic debridement is selective; only necrotic tissue is liquefied. It is also virtually painless for the patient. Autolytic debridement can be achieved with the use of occlusive or semi-occlusive dressings which maintain wound fluid in contact with the necrotic tissue. Autolytic debridement can be achieved with hydrocolloids, hydrogels and transparent films.
- In stage III or IV wounds with light to moderate exudate
- Very selective, with no damage to surrounding skin.
- The process is safe, using the body's own defense mechanisms to clean the wound of necrotic debris.
- Effective, versatile and easy to perform
- Little to no pain for the patient
- Not as rapid as surgical debridement
- Wound must be monitored closely for signs of infection
- May promote anaerobic growth if an occlusive hydrocolloid is used
- Chemical enzymes are fast acting products that produce slough of necrotic tissue. Some enzymatic debriders are selective, while some are not.
- On any wound with a large amount of necrotic debris.
- Eschar formation
- Fast acting
- Minimal or no damage to healthy tissue with proper application.
- Requires a prescription
- Application must be performed carefully only to the necrotic tissue.
- May require a specific secondary dressing
- Inflammation or discomfort may occur
- This technique has been used for decades in wound care. Allowing a dressing to proceed from moist to wet, then manually removing the dressing causes a form of non-selective debridement.
- Hydrotherapy is also a type of mechanical debridement. It's benefits vs. risks are of issue.
- Wounds with moderate amounts of necrotic debris
- Cost of the actual material (ie. gauze) is low
- Non-selective and may traumatize healthy or healing tissue
- Time consuming
- Can be painful to patient
- Hydrotherapy can cause tissue maceration. Also, waterborne pathogens may cause contamination or infection. Disinfecting additives may be cytotoxic.
- Sharp surgical debridement and laser debridement under anesthesia are the fastest methods of debridement.
- They are very selective, meaning that the person performing the debridement has complete control over which tissue is removed and which is left behind
- Surgical debridement can be performed in the operating room or at bedside, depending on the extent of the necrotic material.
- Wounds with a large amount of necrotic tissue.
- In conjunction with infected tissue.
- Fast and Selective
- Can be extremely effective
- Painful to patient
- Costly, especially if an operating room is required
- Requires transport of patient if operating room is required.
These images were supplied by David Janssen, M.D.
Dr. Janssen used to have a very detailed website, but now it's gone.
Place your mouse over each image for an explanation.