Wounds are typically debrided in one of two ways depending on the amount of tissue that needs to be removed.
In non-excisional debridement, the wound is vigorously washed or scrubbed without using a knife or scissors. Non-excisional debridement is performed by the nurse and then by the patient or family after discharge. Pain medicines are given by mouth one hour prior to the procedure, and often additional pain medicines are given by IV during the procedure. The ability to tolerate non-excisional debridement without intravenous pain medications is one of the criteria for discharge from the hospital.
Excisional or sharp debridement is done with a knife or scissors in the operating room under anesthesia. The goal is to remove all the tissue that is not healthy, i.e., any tissue that is dead or severely infected. Oftentimes this type of debridement will require reconstruction with skin grafts or flaps.