Debridement Resources

Preventing and managing wound infection has sometimes resulted in inappropriate prescribing of antibiotics and overuse of topical antimicrobial wound dressings. This is partly due to the difficulties in identifying the early signs of wound infection and uncertainty as to who is at risk. This article guides the reader through the importance of considering antimicrobial stewardship (AMS), how to identify at-risk patients, how to reduce the risk through wound bed preparation, and how to identify wound infection. When reviewing wound infection management strategies, it particularly focuses on the role of non-medicated wound dressings, which are becoming a viable alternative to traditional antimicrobial dressings such as silver and iodine.

The ability to recognise the need for debridement is a vital skill for general practice nurses (GPNs), since it is an important part of preparing the wound for healing. Debridement removes dead tissue within the wound that can otherwise provide a physical barrier to healing, while also providing an ideal environment for micro-organisms, increasing the risk of infection. In order for healing to progress, it is important to debride the wound promptly. Failure to do so can result in wound chronicity and an associated impact on resources and patient quality of life. While there are different methods of debridement available, this article focuses on autolytic and mechanical, explaining how they work and their benefits and limitations.

Debridement is a key component of wound bed preparation, which should not be seen as a one-off procedure, but rather as something to be done on a regular basis and included in the patient care pathway. It plays a vital part in removing dead and contaminated tissue, which harbour bacteria posing a barrier to timely healing. Debridement can also remove the presence of biofilm. Wound cleansing is also an integral part of wound care practice. However, there is little evidence about the best method, frequency, or solution to use, which causes wound cleansing often to be seen as a controversial procedure. With developments in the wound care product market and smarter dressings and wound care therapies becoming available, little attention has been given to the use of cleansing solutions. Wound cleansing is technically defined as the use of fluids to remove loosely adherent debris and necrotic tissue from the wound bed to create an optimal wound healing environment.

With wound and skin care taking up a considerable part of general practice nursing time, the new GPN ‘nurse consultation’ series follows the therapy chain for the management of patients with venous leg ulcers and looks at the skills needed to ensure safe, competent and professional consultations with patients.

Here, Kimberley Socrates, tissue viability nurse specialist, Oxleas NHS Foundation Trust, looks at the first link, i.e. the importance of accurate wound assessment aided by skin/ wound cleansing and debridement, and offers a simple, clinical and cost-effective method of debridement.

Indications Debrisoft® is a rapid, highly effective, safe and easy method of debridement for acute andchronic wounds. Debrisoft® is also very effective in the removal of hyperkeratosis from the skin.