Debridement.
Debridement is defined as the removal of nonviable material, foreign bodies, and poorly healing tissue from a wound. Although surgeons recognize the importance of debridement, few data have been generated in randomized trials to support its use. Debridement provides for removal of tissue with the highest bacterial count, reliable cultures, and identification of osteomyelitis. The most direct form of debridement is surgical excision. For patients who are poor candidates for surgical debridement or have limited access to a surgeon, other forms of debridement (including mechanical, autolytic, enzymatic, and biologic) can be used. Although operative debridement is best performed by those with surgical training, the other forms of debridement can be accomplished by other allied health care professionals. Debridement remains an important adjunct to good wound care, but questions of what type, how much, and how often it should be performed remain unresolved.