Open wounds to the skin are a type of trauma; sometimes the trauma is serious enough that skin tissue in and around the wound begins to die, a condition called necrosis. Removing the dead skin from a wound is a process called debridement, and may be performed both through surgery or using a variety of non-surgical methods. According to lead author Elzabeth Ayello in a September 2002 Nursing article, the appropriate method depends on the severity, shape and size of thewound, whether an infection is present and state regulations regarding debridement.
Use a mechanical method of debridement with "wet-to-dry dressings" to remove dead skin from a wound. Take a pain reliever before you begin. Moisten a gauze bandage with sterile water, place on the wound and allow the bandage to dry. Remove the dry dressing from the ulcerated area; the dead tissue will come off with the bandage. You may need to apply several bandages throughout the day to remove all of the necrotic tissue.
Perform another form of mechanical debridement that will pull the dead skin away from your wound if you have access to a physical therapy facility. Hydrotherapy and pulsed lavage are two types of debridement that use water to gently slough off dead tissues. Hydrotherapy sessions take place in a whirlpool; you can do pulsed lavage treatments more easily with a portable irrigation system. Each of these methods takes 20 to 30 minutes, and should be done several times a day.
Opt for enzymatic treatment for your wound if you are not an ideal candidate for surgical removal of necrosis. Clean the affected area with a sodium chloride solution, and apply an ointment that your doctor will prescribe for you. Cover the wound with a bandage and change dressings as directed by your doctor. The enzymes in the medication will break down the dead skin tissue.
The Wesley Medical Center in Wichita, Kansas, explains another form of enzymatic treatment called autolytic debridement, for wounds that contain and weep fluids. Place an occlusive dressing on your wound to keep moisture locked in; over time your body will clear away the dead skin tissue by itself. When the wound fluid seeps through the bandage, it's time to apply a fresh dressing.
Undergo surgical removal of dead skin if your wound is infected, very deep or if you are in danger of developing a system-wide infection called sepsis. Surgery is required for immediate debridement, as the other, non-surgical methods progress more gradually.
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