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

A list of references, including information on 

the study and document type, can be found at 

www.ewma.org (Appendix 2).

As a general conclusion with regards to the 

literature search we acknowledge that more  

high-level evidence is needed to further support 

the content of this document. However, until this 

has been provided, we have to rely on existing 

information and experience to define existing 

methods of debridement. 

Patient consent for debridement

A comprehensive and holistic patient assessment 

is a necessary pre-requisite to evaluate the most 

appropriate method of debridement. Patient 

involvement in the assessment and planning of 

treatment will optimise success, as the patient will 

be more informed and more likely to accept and 

comply with treatment resulting in greater success 

in removing necrotic tissue.

5

Informed consent must be obtained before 

commencing any treatment or investigation, or 

in providing personal care.

6

 For consent to be 

valid, the person giving consent must be capable 

of making the decision or deemed competent. 

The consent should be given voluntarily, without 

coercion and the person should be provided with 

adequate information to make that decision. 

Information should be available regarding the 

type of debridement treatment, including benefits 

and risks, implications of having treatment and 

alternatives that maybe available.

7

It should be noted that a parent or guardian 

can initiate consent if the person receiving the 

debridement treatment is too young (< 16 years 

old) or is incapable of making the decision for 

themselves (due to physical or mental illness).

8

 

It is important that parents and their children 

are informed about the proposed treatment and 

that children are listened to so that they can be 

involved in the decision making. Ensuring consent 

is legally and ethically obtained will reduce risk of 

litigation and improve patient satisfaction.

9

Informed consent maybe expressed or implied. 

Implied consent may be inferred by the patient’s 

actions, for example voluntary attendance to the 

clinic for larval therapy dressings.

10

 Expressed 

consent can be either written or verbal.

11

 In the 

USA and UK, for example, it is common practice 

for patients to sign a consent form, indicating 

that they have been given information and that 

they are consciously giving their permission to 

receive care, for example, sharp debridement of a 

necrotic diabetic foot ulcer.

Documentation of consent provides evidence that 

processes involved in obtaining consent have 

Decision parameters

Pain

Skillofthecaregiver

Patientsenvironment

Resourcesofthecaregiver

Patientschoiceandconsent

Regulations

Biologicalageandcomorbidities

Guidelines

Qualityoflife