When to Stop Debriding: Knowing the Line Between Help and Harm
Summary: Debridement clears nonviable tissue to promote healing but can harm if overdone in ischemic or fragile wounds. Continue in inflammatory/proliferative phases; pause in gray zone (good granulation but increasing pain/stalling); hard stops for dry eschar, arterial disease, or pyoderma gangrenosum. Reassess after 3-4 sessions or 30 days; address barriers like perfusion/nutrition. Shift to preservation when goals prioritize QoL.
Key Highlights:
- Continue: Devitalized tissue, slough, biofilm, slow granulation with perfusion.
- Pause: Granulating well but pain/bleeding worsens, progress stalls.
- Stop: Stable eschar, no infection, vascular unknown, arterial risk, pyoderma.
- Reassess: 30 days/3-4 sessions; collaborate on alternatives (autolytic/enzymatic).
- Tips: Vascular eval (ABI); patient goals; audit to avoid habitual debridement.
Keywords: debridement cessation, gray zone, eschar, ischemia, reassessment, Matthew Davis