Jwc ewma final indd

J O U R N A L  O F WO U N D  C A R E   Vo l   2 2 .  N o   1 .  E W M A   D o c u M E N t   2 0 1 3

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outine care of non-healing acute and 

chronic wounds often comprises either 

cleaning or debridement. Consequently, 

debridement is a basic necessity to induce the 

functional process of tissue repair, which makes it a 

central medical intervention in the management of 

acute and chronic, non-healing wounds.

The last years many different new debridement 

techniques have been introduced; primarily 

applying physical principles and forces to promote 

the development from acute infl ammatory phase to 

the reparative condition.

1

However, despite the central role of debridement 

in the fi eld of wound healing, there is still no 

document that gathers this information. With this 

document, the European Wound Management 

Association (EWMA) aims to provide an overview 

of the various options, including a clarifi cation of 

the principal role of debridement (why and when to 

debride, evidence for debridement), the defi nition 

of possibilities and limitations for standard and new 

debridement options with specifi c potentials in 

their practical use, health-economic aspects and an 

algorithm for the clinical routine.

Definitionofdebridement

The word debridement derives from the French 

débridement, which means to remove a constraint. 

In clinical medicine this term was fi rst used by 

Henri Le Dran (1685–1770), in the context of 

an incision to promote drainage and relieve of 

tension.

2

 Today, debridement refers to deeply 

removing adherent, dead or contaminated tissue 

from a wound and must be clearly separated from 

the act of cleansing, defi ned as the removal of 

dirt (loose metabolic waste or foreign material).

3

 

Furthermore, debridement does not encompass 

revision of a wound, resection of functional tissue 

or amputation. Thus, we defi ne debridement as 

the act of removing necrotic material, eschar, 

devitalised tissue, serocrusts, infected tissue, 

hyperkeratosis, slough, pus, haematomas, foreign 

bodies, debris, bone fragments or any other type 

of bioburden from a wound with the objective to 

promote wound healing. 

Debridement is sometimes referred to as a form of 

wound bed preparation;

4

 however, from a global 

perspective it becomes clear that not only the 

wound bed but also the wound edges and the 

peri-wound skin are important for the successful 

healing of a wound. This supports a defi nition 

of debridement that does not only refer to the 

removal of bioburden from the wound bed, but 

also the liberation of wound edges as well as of 

peri-wound skin. This document will show that 

this broader view on debridement opens new 

possibilities and perspectives within the fi eld of 

wound healing.

When adapting a global approach to wound 

healing, debridement must be understood as 

a process, possibly used in conjunction with 

other treatment approaches, with the aim to 

create a benefi cial situation supporting various 

clinical goals related to wound management. 

We believe that this approach increases the 

Introduction

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