Table 2 Delphi results regarding benefits, procedures, risks and complications, and alternatives

Surgical debridement is a procedure for removing dead tissue and foreign bodies from wounds and the fastest and most effective way to clean wounds. Surgical debridement may prevent infection and improve the wound healing process.

The procedure may be performed at the bedside or in the operating room if the wound is too deep, large, or involves important tissue, such as nerves, vessels or muscle, to decrease the possibility of wound infection and other complications.

When local anesthesia is chosen, the surgeon will inject the medication to anesthetize the region where the procedure will be performed.

Epidural anesthesia may be chosen to anesthetize the lower part of the body by injecting the medication into the lumbar spinal cord when the procedure will be performed in the lower part of the body.

General anesthesia blocks the feeling of pain throughout the body, and you may fall asleep during the surgical procedure.

The surgeon will clean the wound and remove as many contaminants as possible with normal saline.

The surgeon may use surgical instruments to repeatedly remove dead tissue until the wound is clean.

When the procedure is finished, the surgeon will close the wound layer by layer. If the wound is not closed immediately, the wound will be cared for openly.

The timing of wound closure will depend on the injury mechanism, location of the wound, and possibility of wound infection.

The skin will be closed by suture, adhesive tape, or staples and covered with a sterile gauze or dressing.

When debridement is performed, deep tissues, such as vessels, tendons, and nerves, might be injured, and complications can include bleeding, tendon injury, nerve injury, postoperative range ofmotion limitation in the limbs, wound pain, permanent scarring, etc.

Bacteria from the skin might affect the deep tissues and cause infection, and the rate of infection might differ depending on the cause of the injury, mechanism, and location of the wound.

Pre-existing illnesses, such as diabetes mellitus and immune-compromised diseases, and using steroids, anti-immune drugs, and anti-coagulants might increase the risks of the procedure and postoperative complications.

Smoking, poor nutrition, and poor circulation might increase the risks of the procedure and postoperative complications.

Unforeseen disorders might occur, such as shock and arrhythmia.

Complicated wounds require regular trips to the clinic to decrease the complications.

Wound management might be performed in other ways, such as using a bio-artificial dressing to debride the wound, but this takes 2~4 weeks and has an increased risk of wound infection. If you have any questions concerning the treatment, please discuss them with your physician.