Surgical debridement of wounds has evolved over the past two centuries. About 250 years ago, amputation of extremities was considered a life-saving procedure to treat major wounds. This persisted until after World War I.

With improvements in survival of patients with diabetes and other chronic conditions, as well as advances in therapies for chronic wound management, debridement became the pivotal aspect of surgical wound care.

Debridement is known to enhance wound-healing and to promote the efficacy of advanced therapies and surgical closure. Until the last 20 years, sharp excision with cold steel was the principal option for debridement. However, the early 2000s brought with them a high-power waterjet that yielded more precise debridement of wound surfaces. With enhancement in our understanding of biofilms, it became clear that biofilms are stratified within the wound and the anaerobic species develop deeper within the wound.

Another surgical instrument for wound debridement, the direct contact low frequency ultrasound device (DCLFU), has recently been introduced. A vacuum sheath added to the active tip contains spray dispersion. The device can remove all of the wound tissue including the biofilm, to expose a healthy base. This facilitates optimal wound preparation prior to deployment of an advanced therapy, graft, or flap. While this instrumentation is specifically designed for the operating room, a less powerful yet effective version has also been introduced for use in the outpatient clinic.

These advances in surgical debridement techniques have facilitated more effective subsequent interventions for the management of chronic wounds.

Source: Granick MS, Tran BNN, Alvarez OM. Latest Advances in Wound Debridement Techniques. Surg Technol Int. 2020 Apr 6;36.