Tissue Non-viable

Devitalised or non-viable tissue has no blood supply and will not repair with time or treatment, and presence of this tissue will delay healing and prevent granulation.1 To help optimise treatment efficacy, non-viable tissue must first be removed to allow the wound to heal1-4

Debridement

Debridement choice should take into consideration the patient’s circumstances and wellbeing, practitioner expertise and available resources. Options available include:

  • Autolytic: Dressings that optimise a moist wound environment and aid autolysis to break down non-viable tissue. Selective and easy, but can be slow and increase the risk of infection1
  • Sharp: Scissors, forceps or a scalpel can provide fast and selective debridement, but require the appropriate level of skill and knowledge1
  • Surgical: Carried out in the operating theatre, often by a surgeon, involving complete debridement of the wound bed down to healthy, viable tissue through instant removal of all dead tissue. It may occasionally cause a larger wound due sacrificed viable tissue, and often requires anaesthetic and continued analgesia1
  • Larval: The use of maggots to kill bacteria and promote fibroblast growth.1 Biological debridement can be quick and selective, but potentially costly and is not readily accepted by all patients1
  • Hydrosurgery: Delivers pressurised saline as a cutting tool for quick, selective debridement with minimal loss of viable tissue. Although not necessarily carried out in theatre,* hydrosurgery may require anaesthetic to manage patient pain1,5-6
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Assess the wound to identify the right treatment or intervention

Related Products

Disclaimer

The products used in the T.I.M.E. clinical decision support tool may vary in different markets. Not all products referred to may be approved for use or available in all markets. Please consult your local Smith & Nephew representative for further details on products available in your market.

Intended for healthcare professionals outside of the US only.

*Refer to precautions: only the 45-degree VERSAJET II Exact instrument is suitable for use outside of the operating room – conditions apply to use. Please refer to the Instruction for Use.
**Use appropriate secondary dressings according to your local protocol.

A healthcare professional must always rely on his or her own professional clinical judgment when deciding whether to use a particular product when treating a particular patient. Smith & Nephew does not dispense medical advice and recommends that healthcare professionals be trained in the use of any particular product before using it on patients.

For detailed product information, including indications for use, contraindications, effects, precautions, warnings, and important safety information, please consult the Instructions for Use (IFU) prior to use.

Citations
  1. Atkin L. British Journal of Nursing, 2014; 23, pp. S10-5.
  2. Wilcox JR, et al. JAMA Dermatol 149(9).

  3. Grothier L. British Journal Of Community Nursing, 20, Sup9, pp. S25-31.
  4. European Wound Management Association (EWMA). Position Document: Wound Bed Preparation in Practice. London: MEP Ltd, 2004.
  5. Granick MS, et al. “Efficacy and cost-effectiveness of a high-powered parallel waterjet for wound debridement”, Wound Repair And Regeneration, 2006, 14, 394-397.
  6. Madhok BM, et al. Int Wound J, 2013; 10: 247–251.

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