Debridement of hard-to-heel wounds provided in the home-care setting. Practical and legal possibilities

The initial stage of wound healing is wound bed preparation by removing devitalised necrotic tissues. Debridement should be performed as quickly as possible to shorten the inflammatory phase and create optimal conditions for tissue regeneration. The implementation of the most favourable method of debridement should be thought out, potentially safe for the patient, and achieved in the shortest possible time. Wound debridement with surgical instruments combined with subsequent biodebridement is a safe and convenient method performed in patients under home care. The objective of the study was to review the literature on larvae therapy and wound debridement in patients under home care as well as related legal acts. A review of scientific papers and existing legislation was conducted based on the PubMed, Cochrane Library, and Termedia databases. Legal regulations and the competence of nurses create opportunities for specialised home care. Debridement with surgical instruments reduces the time of wound bed preparation and bacterial burden, thus accelerating regenerative processes in a wound. Advanced nursing care can improve the functioning of the health care system by greater involvement of nursing personnel in wound treatment and prophylaxis against wounds, which will result in decreased costs of hospital treatment.