The Clean, Beefy-Red Wound Bed

  A clean, beefy-red wound bed often represents a good sign of wound healing. However, many interventions may be necessary before a wound reaches this point. As a general surgeon, I am often asked to consult on wounds that clearly require debridement. Although many necrotic wounds can benefit from surgical debridement, some patients are not candidates for this procedure because of their overall condition, the care setting lacks access to a surgeon or other appropriate licensed provider, or the overall wound treatment objective is not compatible.   Nonsurgical debridement strategy options offer specific advantages and disadvantages. As clinicians, we must select the strategy that offers the patient the best results with the least amount of pain, while staying on course with the patient’s overall treatment objective in their particular care setting. When signs of infection or wound deterioration are present, we may turn to strategies that include autolytic, enzymatic, or other mechanical debridement to clean up a wound bed and remove nonviable tissue to facilitate optimum wound healing.

  Selecting the appropriate debridement strategy should be based on the clinical experience and competency, plus the “where” and “who” will manage these patients as they move through the healthcare continuum. Your strategy can include a blend of approaches, such as a light surgical debridement along with application of autolytic agents combined with application of any number of suitable dressing alternatives. Ultimately, the final goal should be based on what will benefit the patient most while maintaining a cost-effective approach. Keeping this in mind, the beefy-red wound bed is not far behind.