The intact surrounding skin should be protected with a liquid barrier or film dressing. Autolytic debridement involves the use of occlusive or semi-occlusive synthetic dressings to cover a wound and allow the body's own enzymes and moisture to rehydrate and soften devitalized tissue. Enzymes normally found in wound fluids are then better able to digest the tissue. Autolytic debridement is contraindicated if the wound is infected. This method may be used for patients who are not candidates for surgical debridement and for those who have clean wounds and are residents of long-term care facilities or are receiving care at home.
Enzymatic debridement is most effective when combined with mechanical or surgical debridement.
Although debridement is often essential, it must eventually be discontinued so that granulation tissue can grow and the wound can heal. After any type of debridement, a moist environment should be maintained to facilitate granulation and wound healing. However, among patients who are ambulatory, these benefits must be weighed against the loss of functional muscle from the donor site. Extensive pressure sores may require more than one musculocutaneous flap procedure to establish closure. Postoperative care includes monitoring the patient for infection and keeping pressure off the flap site.