Types of on-excisional debridement
Patient has an infected stage 4 decubitus ulcer of the buttock. The ulcer was debrided as an outpatient the week prior to admission. Patient is now admitted for IV antibiotic's. The ulcer is described by the surgeon as having a small amount of adherent necrotic slough. The surgeon ordered daily wet-to-dry saline dressings to debride the remaining amount of minimal necrotic slough.
Are wet-to-dry saline dressings considered a form of non-excisional debridement? If so, would extirpation of skin alone or subcutaneous and fascia be used for the body site.
Appreciate any thoughts/suggestions.
Paula Scheiderich, RHITClinical Documentation Improvement
Oneida Healthcare
Comments
I would refer to it as a non-excisional debridement. Here is a good NIH article on wound dressings. If you go about half way down they specify about slough and the wet-to-dry dressings calling it "mechanical".
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4717498/
" Types of debridement include mechanical, which employs a wet-to-dry dressing, usually with normal saline; surgical, with a sharp scalpel or curette; enzymatic; and autolytic. "
As for the depth of extirpation I'd recommend querying the physician to see if they can make a determination exactly which layers are being removed.
Erik Kilbo, CCS, CPC-I, CDIP, CCDS
Manager - Enterprise HIM Coding
Greenville Health System
Thank you for your response and the link to article!
Paula Scheiderich, RHIT
Clinical Documentation Improvement
Oneida Healthcare