Excisional Debridement


Debridement is a well-established concept in problem wound bed preparation. It involves the removal of all necrotic tissue (skin, tendon, bone, muscle), biofilm, slough, fibrinous exudates, and hypovascular fibrous tissue from the wound site (burns, ulcers, etc) to reduce the risk of infection, facilitate healing, or permit the effective application of advanced wound products. Ultimately, debridement is aimed at improving wound healing outcomes. Wound debridement is performed by our wound care specialist in Los Angeles, Dr. Haimesh Shah.


When a wound is exposed to the air, the dead tissue forms a hard crust known as an eschar that can hamper the healing process and lead to abscesses, bacteria, and infection.

Wound debridement is usually done in 4 different ways, and the physician chooses the most appropriate one depending on the amount of tissue to be removed. These include:

1. Mechanical Debridement

Mechanical debridement is one of the oldest forms of wound debridement. This method uses a procession of moist to wet dressings, which are then manually removed. This causes non-selective debridement of necrotic tissue and slough (and sometimes healthy tissue as well).

2. Autolytic Debridement

Autolytic debridement uses the body’s own enzymes to break down tough eschar and slough. It does not damage healthy skin, but breaks down dead and devitalized tissue over time quite effectively. The idea behind autolytic debridement is to keep wound fluids in constant contact with the wound. This is achieved with the use of semi-occlusive or occlusive dressings.

3. Enzymatic Debridement

Enzymatic debridement utilizes chemical agents to break down necrotic tissue. They are most useful for debriding wounds with a large amount of necrotic tissue or slough formation.


Also referred to as sharp debridement, excisional debridement involves the use of a scalpel, scissors, or ultrasonic device to remove all unhealthy tissue that is dead or severely infected at the wound base or margin to provide a healthy, active wound that supports healing. It is done in the office, under local anesthesia.


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