Mechanical debridement uses physical force to remove dead tissue. It’s usually done in one of three ways: wet-to-dry dressings, pulsatile lavage, and wound irrigation.
The key feature, and the one worth understanding, is that it is non-selective. That means it removes both dead tissue and living tissue. Compare that with autolytic debridement, which is highly selective and affects only dead tissue. Mechanical methods don’t make that distinction.
It’s used for acute and chronic wounds with moderate to large amounts of dead tissue, whether or not there is an active infection.
The most common of these methods is familiar to anyone who has had a wet-to-dry dressing. A wet or moist gauze dressing is put on the wound and allowed to dry, and wound drainage and dead tissue can be removed when you take off the old dressing. At a wound center, wet-to-dry dressings are applied to the area, and the dressing absorbs dead tissue as it dries and is pulled off along with it.
The irrigation methods include sitting or placing a limb in a whirlpool bath, and using a syringe to wash away dead tissue.
Knowing that the method is non-selective explains something patients often notice and worry about: these dressing changes can be the uncomfortable ones, and a small amount of bleeding can come with them. Your wound should not bleed much when you are cleaning it, and a small amount of blood is OK.