Surgical Debridement to Remove Unhealthy Tissue

Debridement is the word used to describe a specific surgical procedure. In a debridement, the surgeon removes damaged tissue from the body to promote healing. Tissue removed may be:

  • Dead
  • Infected
  • Contaminated
Surgeon in the operating room
Seb Oliver / Getty Images

By removing this tissue, the body is left with healthy tissue to try to speed healing. If dead, infected, or contaminated tissue is left in the body after an injury or medical condition, those tissues are likely to lead to infection. The tissues will be of no benefit in the long run, therefore it's best to remove them from the body to support a more timely healing process.

A debridement is often performed along with a "wash out" procedure, often referred to as an irrigation. Therefore, many surgeons refer to this combination as an irrigation and debridement, or I&D.

Orthopedic surgeons commonly perform debridement surgery after an open fracture or after an infection. Open fractures (sometimes called compound fractures, occur when there is a wound that allows the fracture site to communicate with the outside of the body. All open fractures are contaminated, and because of the degree of soft-tissue injury, many open fractures have necrotic (dead) tissue that has been so badly damaged that it will not survive. In these situations, surgeons will remove the contaminated and necrotic tissue to promote fracture healing and to prevent infection.

Debridement for Infections

Infection can be the result of injury or recent surgery. When infection occurs deep inside the body, the infection can become so involved in the soft-tissues that the only way to adequately remove the infection is to debride some of these tissues. Furthermore, infection can also lead to tissue necrosis, or death, and again require that unhealthy tissue to be removed in order to cure the infection. Infection is particularly troublesome when there have been metal implants inserted, such as is the case with hip replacement or knee replacement surgery. In these cases, in addition to debridement of the infected tissues, sometimes the metal must also be removed to cure the infection.

2 Sources
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  1. Fernandes Mde C, Peres LR, de Queiroz AC Jr, Lima JQ Jr, Turíbio FM, Matsumoto MH. Open fractures and the incidence of infection in the surgical debridement 6 hours after traumaActa Ortop Bras. 2015;23(1):38–42. doi:10.1590/1413-78522015230100932

  2. Sousa R, Abreu MA. Treatment of Prosthetic Joint Infection with Debridement, Antibiotics and Irrigation with Implant Retention - a Narrative ReviewJ Bone Jt Infect. 2018;3(3):108–117. doi:10.7150/jbji.24285

By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.