Surgical debridement of a foot

The development of painful pressure sores may lead to the need for debridement. Debridement is the medical term for cutting away dead tissue from a pressure sore. It is pronounced as if the “I” is a long “e” or “ee”. Debridement can be performed by chemical or mechanical means. Chemical debridement agents use enzymes to digest dead tissue. Mechanical debridement can be performed by surgeons, by maggots, or nurses. Medicinal maggots (called maggot debridement therapy) clean the wounds by dissolving dead and infected tissue. Some doctors call them microsurgeons. Many people find this concept repulsive. I worked on a case involving infected breast tissue. The patient asked the nurses to remove the maggots because she felt them biting her. The photograph I inserted into my report summarizing medical records, which showed a jar full of maggots, helped to settle the case.

Surgeons perform debridement at the bedside or in the OR (Operating Room). Bedside debridement’s can be the most painful as there is no anesthesia and only occasionally do the surgeons order pain medication in advance. They cut tissue until it bleeds.

Nurses perform debridement when they use wet to dry dressings, a practice which was no longer recommended as of 1994 but is still being done today. This practice is not advised because allowing the dressing to dry pulls off healthy tissue.

Practice tip for personal injury attorneys: Have your legal nurse consultant look in the medical record for evidence of maggots, bedside debridement or wet to dry dressings. Ask the patient or family about whether these procedures were performed. These are painful procedures that have great jury impact.

Med League provides medical expert witnesses to trial lawyers. Please call us at (908)788-8227 or contact us today to discuss your next case.