What is the medical term for the removal of tissue?

Debridement is the removal of unhealthy tissue from a wound. It will improve wound healing. There are different ways to do debridement.

Reasons for Procedure

Debridement may be done to:

• Remove infected areas or dead cells, or clean away crust, dirt or debris
• Create a neat wound edge—to decrease scarring
• Help very severe burns or pressure sores heal
• Get a sample of tissue for testing

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will discuss problems that could happen such as:

• Excess bleeding
• Pain
• Infection
• Loss of healthy tissue
• Delayed healing

Things that may raise the risk of problems are:

• Smoking
• Drinking alcohol
• Long term diseases such as diabetes or obesity

What to Expect

Prior to Procedure

The doctor may meet with you to talk about:

• Anesthesia options
• Any allergies you may have
• Current medicines, herbs, and supplements that you take and whether you need to stop taking them before the procedure
• Fasting before the procedure, such as avoiding food or drink after midnight the night before
• Whether you need a ride to and from procedure

Anesthesia

Anesthesia may be used for deep wounds. Local anesthesia will numb the area. General anesthesia will make you sleep.

Description of Procedure

There are different types of debridement. Treatment may include more than one step. Methods may be:

Surgery—often used on large, deep, or painful wounds. Tools will be used to remove dead tissue. Some wounds may need help to close after tissue is removed. To do this, some skin will be removed from another area of the body and placed on the wound.

Non-surgical—will use medicine or water to remove dead tissue. Medical whirlpool or syringes may be used to brush away dead skin. Wet to dry dressing is another option. A wet dressing is packed in the wound and left until it is dry. When the dry dressing is pulled away it will take dead tissue with it.

A medicine may also be used over the wound. It will help to dissolve dead tissue. It can also help the body heal the wound itself. All methods may need to be repeated several times.

How Long Will It Take?

Surgical debridement is the quickest method. Nonsurgical debridement may take 2 to 6 weeks or longer.

Will It Hurt?

There may be some soreness after the procedure. Pain medicine can help.

Average Hospital Stay

Most can go home the same day, unless they were already in the hospital.

Post-procedure Care

It may take the wound many weeks to heal. Wound care will need to continue at home.

Call Your Doctor

Call your doctor if you are not getting better or you have:

• Signs of infection, such as fever and chills
• Redness, swelling, excess bleeding, or discharge from the wound
• A chalky white, blue, or black appearance around the wound
• If general anesthesia was used—problems breathing, chest pain, or lasting nausea or vomiting
• Pain that you cannot control with the medicine

If you think you have an emergency, call for medical help right away.

Resources

VNAA—Visiting Nurse Associations of America
http://www.vnaa.org

Wound Ostomy and Continence Nurses Society
http://www.wocn.org

Canadian Resources

Health Canada
https://www.canada.ca

Wounds Canada
https://www.woundscanada.ca

References

Debridement. University of California San Francisco Department of Surgery website. Available at: https://surgery.ucsf.edu/conditions--procedures/debridement.aspx. Accessed September 28, 2021.

Gupta S, Andersen C, et al. Management of chronic wounds: diagnosis, preparation, treatment, and follow-up. Wounds. 2017;29(9):S19-S36.

Treatment of chronic wounds. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/treatment-of-chronic-wounds-18. Accessed September 28, 2021.

Removal of a small piece of living tissue from an organ or other part of the body for examination under a microscope to confirm or establish a diagnosis, estimate a prognosis, or follow the course of a disease. There are different methods for performing a biopsy depending on the tissue to be removed; the most typical is by puncture or aspiration. This is a simple technique that in some cases could require local anesthesia, and does not require fasting.

Resection is the medical term for surgically removing part or all of a tissue, structure, or organ. Resection may be performed for a wide variety of reasons. A resection may remove a tissue that is known to be cancerous or diseased, and the surgery may treat or cure a disease process. Depending on the tissue or organ, resection surgery may be an open surgery or may be done with a scope through a small incision or a natural entry point, such as the urethra or cervix.

Types 

One very common type of resection is a small bowel resection, a procedure where one or more segment of the small intestine is removed. For people who are experiencing bowel problems in a specific area of the intestine (e.g. stricture, perforation, diverticulitis, etc), removing that area may make it possible for it to function normally after the healing process is complete. The surgery can be done through an open incision or through small incisions using a laparoscope.

Another common resection occurs when cancer is found in the large bowel, or colon. Treatment for cancer may include the surgical removal of the cancerous area and a margin of surrounding tissue, called a colectomy. This may be done as a treatment or may be a cure for the problem.

Resections can be performed on areas of the body other than the digestive tract as well. If there was a diseased area of the liver, a partial liver resection could be done to remove the bad tissue and leave the good and healthy tissue of the liver in place. A lung resection would remove an area of diseased lung tissue.

Other common types of surgeries that are resections:

• Mastectomy: Removal of a breast for breast cancer.
• Prostatectomy: Removal of the prostate gland in cases of prostate cancer. The TURP surgery is transurethral resection of the prostate.
• Gastrectomy: Removal of the stomach, either full or partial, can be done for stomach cancer, ulcers, or bleeding.
• Lung Resection: Removal of a lung in cases of lung cancer, tuberculosis, or other lung diseases. A pneumonectomy is the removal of an entire lung. A lobectomy is the removal of one lobe of a lung. There are also resections for a wedge, slice, or a segment of lung tissue as well.
• Adrenalectomy: Removal of one or both adrenal glands, located on top of the kidney. It may be done for adrenal cancer or syndromes such as Cushing's syndrome where too much hormone is being produced.
• Appendectomy: Removal of this pouch of the large intestine due to infection, bleeding, or inflammation.
• Oophorectomy: Removal of one or both ovaries for cancer, ovarian cyst, chronic pelvic pain, or pelvic inflammatory disease.
• Thyroidectomy: Removal of all of the thyroid gland or one lobe of an overactive thyroid, goiter, nodules, or thyroid cancer.
• Hysterectomy: Removal of the uterus, sometimes including other structures. It is done for cancer, fibroids, chronic pelvic pain, and heavy bleeding.

Medical Coding of Excision vs. Resection

In the ICD-10-PCS medical coding system, an excision indicates a procedure where a portion of the body is cut out or cut off. A resection is when an entire body part is cut out or cut off. But this doesn't have to be an entire organ or tissue, as often they are coded as a portion of an organ. For example, the right and left lobes of the liver each have their own code. Therefore, removal of one lobe is a resection rather than an excision. In the case of medical coding, a wedge resection of the lung is an excision, not a resection.

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