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</ul> </li> <li id="toc-Mechanical_debridement" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Mechanical_debridement"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.4</span> <span>Mechanical debridement</span> </div> </a> <ul id="toc-Mechanical_debridement-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Maggot_therapy" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Maggot_therapy"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.5</span> <span>Maggot therapy</span> </div> </a> <ul id="toc-Maggot_therapy-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-See_also" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#See_also"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>See also</span> </div> </a> <ul id="toc-See_also-sublist" class="vector-toc-list"> </ul> </li> <li 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Available in 17 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-17" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">17 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A5%D9%86%D8%B6%D8%A7%D8%B1" title="إنضار – Arabic" lang="ar" hreflang="ar" data-title="إنضار" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-az mw-list-item"><a href="https://az.wikipedia.org/wiki/Debridement" title="Debridement – Azerbaijani" lang="az" hreflang="az" data-title="Debridement" data-language-autonym="Azərbaycanca" data-language-local-name="Azerbaijani" class="interlanguage-link-target"><span>Azərbaycanca</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/D%C3%A9bridement" title="Débridement – German" lang="de" hreflang="de" data-title="Débridement" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Desbridamiento" title="Desbridamiento – Spanish" lang="es" hreflang="es" data-title="Desbridamiento" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%AF%D8%A8%D8%B1%DB%8C%D8%AF%D9%85%D8%A7%D9%86" title="دبریدمان – Persian" lang="fa" hreflang="fa" data-title="دبریدمان" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Parage_(m%C3%A9decine)" title="Parage (médecine) – French" lang="fr" hreflang="fr" data-title="Parage (médecine)" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Sbrigliamento" title="Sbrigliamento – Italian" lang="it" hreflang="it" data-title="Sbrigliamento" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%94%D7%98%D7%A8%D7%99%D7%94" title="הטריה – Hebrew" lang="he" hreflang="he" data-title="הטריה" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-kk mw-list-item"><a href="https://kk.wikipedia.org/wiki/%D0%A1%D0%B0%D1%83%D1%8B%D2%9B%D1%82%D1%8B%D1%80%D1%83" title="Сауықтыру – Kazakh" lang="kk" hreflang="kk" data-title="Сауықтыру" data-language-autonym="Қазақша" data-language-local-name="Kazakh" class="interlanguage-link-target"><span>Қазақша</span></a></li><li class="interlanguage-link interwiki-mk mw-list-item"><a href="https://mk.wikipedia.org/wiki/%D0%94%D0%B5%D0%B1%D1%80%D0%B8%D0%B4%D0%BC%D0%B0%D0%BD" title="Дебридман – Macedonian" lang="mk" hreflang="mk" data-title="Дебридман" data-language-autonym="Македонски" data-language-local-name="Macedonian" class="interlanguage-link-target"><span>Македонски</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E3%83%87%E3%83%96%E3%83%AA%E3%83%BC%E3%83%89%E3%83%9E%E3%83%B3" title="デブリードマン – Japanese" lang="ja" hreflang="ja" data-title="デブリードマン" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Desbridamento" title="Desbridamento – Portuguese" lang="pt" hreflang="pt" data-title="Desbridamento" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%A1%D0%B0%D0%BD%D0%B0%D1%86%D0%B8%D1%8F_(%D0%BC%D0%B5%D0%B4%D0%B8%D1%86%D0%B8%D0%BD%D0%B0)" title="Санация (медицина) – Russian" lang="ru" hreflang="ru" data-title="Санация (медицина)" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/Debridman" title="Debridman – Serbian" lang="sr" hreflang="sr" data-title="Debridman" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Debridman" title="Debridman – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Debridman" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%A1%D0%B0%D0%BD%D0%B0%D1%86%D1%96%D1%8F_(%D0%BC%D0%B5%D0%B4%D0%B8%D1%86%D0%B8%D0%BD%D0%B0)" title="Санація (медицина) – Ukrainian" lang="uk" hreflang="uk" data-title="Санація (медицина)" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E6%B8%85%E5%89%B5%E6%89%8B%E8%A1%93" title="清創手術 – Chinese" lang="zh" hreflang="zh" data-title="清創手術" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a href="https://www.wikidata.org/wiki/Special:EntityPage/Q1270448#sitelinks-wikipedia" title="Edit interlanguage links" class="wbc-editpage">Edit links</a></span></div> </div> </div> </div> </header> <div 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dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical removal of dead, damaged, or infected tissue</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">For cleaning of teeth, see <a href="/wiki/Debridement_(dental)" title="Debridement (dental)">Debridement (dental)</a>. For the drug marketed under the name <i>Debridat</i>, see <a href="/wiki/Trimebutine" title="Trimebutine">Trimebutine</a>.</div> <style data-mw-deduplicate="TemplateStyles:r1251242444">.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid #36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output .ambox-speedy{border-left:10px solid #b32424;background-color:#fee7e6}.mw-parser-output .ambox-delete{border-left:10px solid #b32424}.mw-parser-output .ambox-content{border-left:10px solid #f28500}.mw-parser-output .ambox-style{border-left:10px solid #fc3}.mw-parser-output .ambox-move{border-left:10px solid #9932cc}.mw-parser-output .ambox-protection{border-left:10px solid #a2a9b1}.mw-parser-output .ambox .mbox-text{border:none;padding:0.25em 0.5em;width:100%}.mw-parser-output .ambox .mbox-image{border:none;padding:2px 0 2px 0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}</style><table class="box-More_citations_needed plainlinks metadata ambox ambox-content ambox-Refimprove" role="presentation"><tbody><tr><td class="mbox-image"><div class="mbox-image-div"><span typeof="mw:File"><a href="/wiki/File:Question_book-new.svg" class="mw-file-description"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/50px-Question_book-new.svg.png" decoding="async" width="50" height="39" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/75px-Question_book-new.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/99/Question_book-new.svg/100px-Question_book-new.svg.png 2x" data-file-width="512" data-file-height="399" /></a></span></div></td><td class="mbox-text"><div class="mbox-text-span">This article <b>needs additional citations for <a href="/wiki/Wikipedia:Verifiability" title="Wikipedia:Verifiability">verification</a></b>.<span class="hide-when-compact"> Please help <a href="/wiki/Special:EditPage/Debridement" title="Special:EditPage/Debridement">improve this article</a> by <a href="/wiki/Help:Referencing_for_beginners" title="Help:Referencing for beginners">adding citations to reliable sources</a>. Unsourced material may be challenged and removed.<br /><small><span class="plainlinks"><i>Find sources:</i> <a rel="nofollow" class="external text" href="https://www.google.com/search?as_eq=wikipedia&q=%22Debridement%22">"Debridement"</a> – <a rel="nofollow" class="external text" href="https://www.google.com/search?tbm=nws&q=%22Debridement%22+-wikipedia&tbs=ar:1">news</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?&q=%22Debridement%22&tbs=bkt:s&tbm=bks">newspapers</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?tbs=bks:1&q=%22Debridement%22+-wikipedia">books</a> <b>·</b> <a rel="nofollow" class="external text" href="https://scholar.google.com/scholar?q=%22Debridement%22">scholar</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.jstor.org/action/doBasicSearch?Query=%22Debridement%22&acc=on&wc=on">JSTOR</a></span></small></span> <span class="date-container"><i>(<span class="date">May 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.infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox"><tbody><tr><th colspan="2" class="infobox-above" style="background-color: lightblue">Debridement</th></tr><tr><td colspan="2" class="infobox-image"><span class="mw-default-size" typeof="mw:File/Frameless"><a href="/wiki/File:Necrotizing_fasciitis_left_leg_debridement.JPEG" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/7/73/Necrotizing_fasciitis_left_leg_debridement.JPEG/280px-Necrotizing_fasciitis_left_leg_debridement.JPEG" decoding="async" width="280" height="193" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/7/73/Necrotizing_fasciitis_left_leg_debridement.JPEG/420px-Necrotizing_fasciitis_left_leg_debridement.JPEG 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/7/73/Necrotizing_fasciitis_left_leg_debridement.JPEG/560px-Necrotizing_fasciitis_left_leg_debridement.JPEG 2x" data-file-width="2132" data-file-height="1470" /></a></span><div class="infobox-caption"><a href="/wiki/Necrosis" title="Necrosis">Necrotic tissue</a> from the left leg is being surgically debrided in a patient with <a href="/wiki/Necrotizing_fasciitis" title="Necrotizing fasciitis">necrotizing fasciitis</a>.</div></td></tr><tr><th scope="row" class="infobox-label">Pronunciation</th><td class="infobox-data"><span class="rt-commentedText nowrap"><span class="IPA nopopups noexcerpt" lang="en-fonipa"><a href="/wiki/Help:IPA/English" title="Help:IPA/English">/<span style="border-bottom:1px dotted"><span title="'d' in 'dye'">d</span><span title="/ɪ/: 'i' in 'kit'">ɪ</span><span title="/ˈ/: primary stress follows">ˈ</span><span title="'b' in 'buy'">b</span><span title="'r' in 'rye'">r</span><span title="/iː/: 'ee' in 'fleece'">iː</span><span title="'d' in 'dye'">d</span><span title="'m' in 'my'">m</span><span title="/ə/: 'a' in 'about'">ə</span><span title="'n' in 'nigh'">n</span><span title="'t' in 'tie'">t</span></span>/</a></span></span><sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> </td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/ICD-10_Procedure_Coding_System" title="ICD-10 Procedure Coding System">ICD-10-PCS</a></th><td class="infobox-data">0?D</td></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></th><td class="infobox-data"><span class="reflink plainlinks nourlexpansion"><a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D003646">D003646</a></span></td></tr><tr class="noprint"><td colspan="2" class="infobox-full-data"><div style="text-align: right;">[<a href="https://www.wikidata.org/wiki/Q1270448" class="extiw" title="d:Q1270448">edit on Wikidata</a>]</div></td></tr></tbody></table> <p><b>Debridement</b> is the medical removal of <a href="/wiki/Dead" class="mw-redirect" title="Dead">dead</a>, damaged, or <a href="/wiki/Infect" class="mw-redirect" title="Infect">infected</a> <a href="/wiki/Tissue_(biology)" title="Tissue (biology)">tissue</a> to improve the healing potential of the remaining <a href="/wiki/Health" title="Health">healthy</a> tissue.<sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> Removal may be <a href="/wiki/Surgery" title="Surgery">surgical</a>, mechanical, chemical, <a href="/wiki/Autolysis_(biology)" title="Autolysis (biology)">autolytic</a> (self-digestion), or by <a href="/wiki/Maggot_therapy" title="Maggot therapy">maggot therapy</a>. </p><p>In <a href="/wiki/Podiatry" title="Podiatry">podiatry</a>, practitioners such as <a href="/wiki/Chiropodists" class="mw-redirect" title="Chiropodists">chiropodists</a>, <a href="/wiki/Podiatrists" class="mw-redirect" title="Podiatrists">podiatrists</a> and <a href="/wiki/Foot_health_practitioner" class="mw-redirect" title="Foot health practitioner">foot health practitioners</a> remove conditions such as <a href="/wiki/Callus" title="Callus">calluses</a> and <a href="/wiki/Verrucas" class="mw-redirect" title="Verrucas">verrucas</a>. </p><p>Debridement is an important part of the healing process for <a href="/wiki/Burn" title="Burn">burns</a> and other serious wounds; it is also used for treating some kinds of snake and spider bites. </p><p>Sometimes the boundaries of the problem tissue may not be clearly defined. For example, when excising a tumor, there may be <a href="/wiki/Micrometastasis" title="Micrometastasis">micrometastases</a> along the edges of the tumor that are too small to be detected, but if not removed, could cause a relapse. In such circumstances, a surgeon may opt to debride a portion of the surrounding healthy tissue to ensure that the tumor is completely removed. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Types">Types</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Debridement&action=edit&section=1" title="Edit section: Types"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>There is lack of high quality evidence to compare the effectiveness of various debridement methods on time taken for debridement or time taken for complete healing of wounds.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Surgical_debridement">Surgical debridement</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Debridement&action=edit&section=2" title="Edit section: Surgical debridement"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Surgical or "sharp" debridement and laser debridement under anesthesia are the fastest methods of debridement. They are very selective, meaning that the person performing the debridement has nearly complete control over which tissue is removed and which is left behind. Surgical debridement can be performed in the operating room or bedside, depending on the extent of the necrotic material and a patient's ability to tolerate the procedure. The surgeon will typically debride tissue back to viability, as determined by tissue appearance and the presence of blood flow in healthy tissue.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Autolytic_debridement">Autolytic debridement</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Debridement&action=edit&section=3" title="Edit section: Autolytic debridement"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Autolysis_(biology)" title="Autolysis (biology)">Autolysis</a> uses the body's own enzymes and moisture to re-hydrate, soften and finally liquefy hard <a href="/wiki/Eschar" title="Eschar">eschar</a> and <a href="/wiki/Sloughing" class="mw-redirect" title="Sloughing">slough</a>. Autolytic debridement is selective; only <a href="/wiki/Necrotic_tissue" class="mw-redirect" title="Necrotic tissue">necrotic tissue</a> 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 <a href="/wiki/Hydrocolloids" class="mw-redirect" title="Hydrocolloids">hydrocolloids</a>, <a href="/wiki/Hydrogels" class="mw-redirect" title="Hydrogels">hydrogels</a> and transparent films. It is suitable for wounds where the amount of dead tissue is not extensive and where there is no infection.<sup id="cite_ref-Wound_Practice_2013_6-0" class="reference"><a href="#cite_note-Wound_Practice_2013-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Enzymatic_debridement">Enzymatic debridement</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Debridement&action=edit&section=4" title="Edit section: Enzymatic debridement"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Chemical enzymes are fast acting products that slough off necrotic tissue. These enzymes are derived from micro-organisms including <i><a href="/wiki/Clostridium_histolyticum" class="mw-redirect" title="Clostridium histolyticum">Clostridium histolyticum</a></i>; or from plants, examples include <a href="/wiki/Collagenase" title="Collagenase">collagenase</a>, <a href="/wiki/Varidase" class="mw-redirect" title="Varidase">varidase</a>, <a href="/wiki/Papain" title="Papain">papain</a>, and <a href="/wiki/Bromelain" title="Bromelain">bromelain</a>. Some of these enzymatic debriders are selective, while some are not. This method works well on wounds (especially burns) with a large amount of necrotic debris or with <a href="/wiki/Eschar" title="Eschar">eschar</a> formation. However, the results are mixed and the effectiveness is variable. Therefore, this type of debridement is used sparingly and is not considered a standard of care for burn treatments.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="Mechanical_debridement">Mechanical debridement</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Debridement&action=edit&section=5" title="Edit section: Mechanical debridement"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>When removal of <a href="/wiki/Tissue_(biology)" title="Tissue (biology)">tissue</a> is necessary for the treatment of wounds, <a href="/wiki/Hydrotherapy" title="Hydrotherapy">hydrotherapy</a> which performs selective mechanical debridement can be used.<sup id="cite_ref-APTAfive_8-0" class="reference"><a href="#cite_note-APTAfive-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> Examples of this include directed wound irrigation and <a href="/wiki/Therapeutic_irrigation" title="Therapeutic irrigation">therapeutic irrigation</a> with suction.<sup id="cite_ref-APTAfive_8-1" class="reference"><a href="#cite_note-APTAfive-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> Baths with <a href="/wiki/Whirlpool" title="Whirlpool">whirlpool</a> water flow should not be used to manage wounds because a whirlpool will not selectively target the tissue to be removed and can damage all tissue.<sup id="cite_ref-APTAfive_8-2" class="reference"><a href="#cite_note-APTAfive-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> Whirlpools also create an unwanted risk of bacterial infection, can damage fragile body tissue, and in the case of treating arms and legs, bring risk of <a href="/wiki/Complication_(medicine)" title="Complication (medicine)">complications</a> from <a href="/wiki/Edema" title="Edema">edema</a>.<sup id="cite_ref-APTAfive_8-3" class="reference"><a href="#cite_note-APTAfive-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p><p>Hydrosurgery uses a high‐pressure, water‐based jet system to remove burnt skin. This should leave behind the unburned, healthy skin. A 2019 <a href="/wiki/Cochrane_(organisation)" title="Cochrane (organisation)">Cochrane</a> <a href="/wiki/Systematic_review" title="Systematic review">systematic review</a> aimed to find out if burns treated with hydrosurgery heal more quickly and with fewer infections than burns treated with a knife. The review authors only found one <a href="/wiki/Randomized_controlled_trial" title="Randomized controlled trial">randomised controlled trial</a> (RCT) with very low certainty evidence that investigated this. Based on this trial, they concluded that it is uncertain whether or not hydrosurgery is better than conventional surgery for early treatment of mid‐depth burns. More RCTs are needed to fully answer this question.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>Allowing a dressing to proceed from moist to dry, then manually removing the dressing causes a form of non-selective debridement. This method works best on wounds with moderate amounts of necrotic debris (e.g. "dead tissue").<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (April 2016)">citation needed</span></a></i>]</sup> </p> <figure typeof="mw:File/Thumb"><a href="/wiki/File:Maggot_debridement_therapy_on_a_diabetic_foot.jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/4/4d/Maggot_debridement_therapy_on_a_diabetic_foot.jpg/267px-Maggot_debridement_therapy_on_a_diabetic_foot.jpg" decoding="async" width="267" height="145" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/4/4d/Maggot_debridement_therapy_on_a_diabetic_foot.jpg/401px-Maggot_debridement_therapy_on_a_diabetic_foot.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/4/4d/Maggot_debridement_therapy_on_a_diabetic_foot.jpg/534px-Maggot_debridement_therapy_on_a_diabetic_foot.jpg 2x" data-file-width="1434" data-file-height="780" /></a><figcaption>Maggot debridement being used on a diabetic foot ulcer.</figcaption></figure> <div class="mw-heading mw-heading3"><h3 id="Maggot_therapy">Maggot therapy</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Debridement&action=edit&section=6" title="Edit section: Maggot therapy"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In <a href="/wiki/Maggot_therapy" title="Maggot therapy">maggot therapy</a>, a number of small maggots are introduced to a wound in order to consume necrotic tissue, and do so far more precisely than is possible in a normal surgical operation. Larvae of the <a href="/wiki/Green_bottle_fly" class="mw-redirect" title="Green bottle fly">green bottle fly</a> (<i>Lucilia sericata</i>) are used, which primarily feed on the necrotic (dead) tissue of the living host without attacking living tissue. Maggots can debride a wound in one or two days. The maggots derive nutrients through a process known as "extracorporeal digestion" by secreting a broad spectrum of proteolytic enzymes that liquefy necrotic tissue, and absorb the semi-liquid result within a few days. In an optimum wound environment maggots molt twice, increasing in length from 1–2 mm to 8–10 mm, and in girth, within a period of 3–4 days by ingesting necrotic tissue, leaving a clean wound free of necrotic tissue when they are removed. </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Debridement&action=edit&section=7" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239009302">.mw-parser-output .portalbox{padding:0;margin:0.5em 0;display:table;box-sizing:border-box;max-width:175px;list-style:none}.mw-parser-output .portalborder{border:1px solid var(--border-color-base,#a2a9b1);padding:0.1em;background:var(--background-color-neutral-subtle,#f8f9fa)}.mw-parser-output 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data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite class="citation web cs1"><a rel="nofollow" class="external text" href="http://www.merriam-webster.com/dictionary/debridement">"Merriam-Webster Dictionary"</a>. <i>merriam-webster.com</i>. 27 May 2024.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=merriam-webster.com&rft.atitle=Merriam-Webster+Dictionary&rft.date=2024-05-27&rft_id=http%3A%2F%2Fwww.merriam-webster.com%2Fdictionary%2Fdebridement&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADebridement" class="Z3988"></span></span> </li> <li id="cite_note-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-2">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" 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rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/32882071">32882071</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Cochrane+Database+of+Systematic+Reviews&rft.atitle=Hydrosurgical+debridement+versus+conventional+surgical+debridement+for+acute+partial-thickness+burns&rft.volume=2020&rft.issue=9&rft.pages=CD012826&rft.date=2020-09-03&rft_id=https%3A%2F%2Fwww.ncbi.nlm.nih.gov%2Fpmc%2Farticles%2FPMC8094409%23id-name%3DPMC&rft.issn=1465-1858&rft_id=info%3Apmid%2F32882071&rft_id=info%3Adoi%2F10.1002%2F14651858.cd012826.pub2&rft.aulast=Wormald&rft.aufirst=Justin+CR&rft.au=Wade%2C+Ryckie+G&rft.au=Dunne%2C+Jonathan+A&rft.au=Collins%2C+Declan+P&rft.au=Jain%2C+Abhilash&rft_id=https%3A%2F%2Fdoi.org%2F10.1002%2F14651858.CD012826.pub2&rfr_id=info%3Asid%2Fen.wikipedia.org%3ADebridement" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 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