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What is Autolytic Debridement?

Wound debridement is the process of removing non-viable, damaged and infected tissue from the wound bed to promote a healthy wound-healing process. It is an essential part of wound healing and is considered a standard in the management of all types of wounds.

Debridement is important because dead tissue can accommodate infections by giving bacteria a place to grow. Devitalized tissue in a wound can also hinder the growth of healthy tissue. removing the devitalized tissue improves the healing potential of the wound. 

There are many types of wound debridement, each with unique benefits and limitations. Understanding these options is essential for selecting the most effective method for your specific wound care needs:

  • Enzymatic debridement involves applying chemical agents that mimic the body’s natural enzymes to break down unhealthy tissue. While effective, it can also harm healthy tissue, making safer alternatives preferable. 
  • Sharp debridement, performed by a trained healthcare professional, uses surgical instruments like scalpels or scissors to quickly and selectively remove necrotic tissue. Though efficient, it is invasive and can be painful, so it is typically reserved for wounds requiring rapid intervention. 
  • Autolytic debridement is the least aggressive method, relying on the body’s own enzymes and moisture to break down dead tissue. 

For some acute wounds, the autolytic debridement process is a natural bodily response and occurs automatically during the second stage of healing — the inflammatory stage. For other types of wounds, such as chronic wounds, autolytic debridement must be induced externally. This is done by applying dressings that provide a moist environment conducive to optimal healing. [1] 

Read on to learn more about autolytic debridement, its benefits, and how it supports the healing process.

How does autolytic debridement work?

The mechanisms of autolytic debridement can be broken down into three key stages: 

1. Retaining moisture: The first stage is to create a moist wound environment, which is required to facilitate autolytic debridement. Advanced dressings such as Hydrofera Blue CLASSIC® [link to CLASSIC product page] are used to create and maintain moisture by trapping the wound fluid. 

2. Enzyme activity: Wound fluid contains naturally occurring enzymes, such as collagenolytic and proteolytic enzymes, which digest and liquefy the necrotic tissue. In doing so, the enzymes aid the removal of dead tissue from the body by breaking down the proteins that bind the tissue to the body. 

3. Removal: The liquified necrotic tissue can then be absorbed into the wound dressing. It will either come off with the dressing or can be gently cleaned off. Alternatively, the liquified dead tissue can be engulfed and removed by white blood cells called macrophages and neutrophils. 

What are the benefits of autolytic debridement?  

There are various benefits to using autolytic debridement, making it a useful tool in wound healing.

Selective tissue removal 

A main advantage of autolytic debridement is that it is highly selective. This means the debridement process targets only necrotic, unhealthy tissue and does not harm the healthy tissues in and around the wound. 

  • Hydrofera Blue CLASSIC® dressing manages exudating wounds and aids in the removal of devitalized tissue from the wound bed.  
  • As this action occurs, the Hydrofera Blue CLASSIC® dressing helps disrupt biofilm that is associated with slough and devitalized tissue.

Safe and non-aggressive 

Autolytic debridement is considered the safest method of debridement because it is non-invasive and conservative.[2] It provides a slow debridement process with reduced pain and risk of further trauma. This means this method is beneficial for patients who: 

  • have an overall condition that requires a slower healing process
  • have a lower pain threshold, such as pediatric patients or those with chronic pain conditions
  • have fragile and thin skin, such as elderly patients

Autolytic debridement is a natural, effective and vital form of wound care. Recognizing the type of wound and choosing the appropriate treatment plan and dressing can lead to better patient outcomes. Learn more about Hydrofera products [link to product overview page] today to see how your wound healing journey can be best supported.  

References

[1] Atkin, L. (2014) ‘Understanding methods of wound debridement,’ British Journal of Nursing, 23(sup12), pp. S10–S15. https://doi.org/10.12968/bjon.2014.23.sup12.s10

[2] Wounds UK et al. (2013) EFFECTIVE DEBRIDEMENT IN a CHANGING NHS. Edited by R. Som, J. Francis, and S. Gordon. Wounds UK. https://www.lohmann-rauscher.com/fileadmin/content/pdf/Veranstaltungen/National_debridement_day/Effective_debridemen.pdf