The debridement of chronic wounds: a systematic review


A wide variety of debridement methods and products are available, all of which have diverse properties, costs and levels of acceptability. There is currently wide variation in their use and a lack of consensus on how to treat specific wound types. The objectives of this review were to summarise the evidence for the relative effectiveness and cost-effectiveness of different debriding agents on wound healing, and to identify areas for future research.


No studies were found that compared debridement with no debridement and without these studies it is unclear whether wound debridement is a beneficial process that expedites healing.

There is insufficient evidence to promote the use of one debriding agent over another. There was only a single comparison between two debriding agents that produced a significant result (hydrogel significantly reduced necrotic wound area compared with dextranomer polysaccharide paste).

Conducted by: M Bradley1, N Cullum2, T Sheldon3

1. NHS Centre for Reviews and Dissemination; 2. Centre for Evidenced Based Nursing, University of York; 3. York Health Policy Group

Further details

Project page on HTA Programme website


Bradley M, Cullum N, Sheldon T. The debridement of chronic wounds: a systematic review. Health Technol Assess. 1999;3(17) Pt.1:1-78


Commissioned by the HTA Programme