Okay, you got me on that one ... I will have to "Parrot" a textbook (actually 2): ...
"Debridement" is a medical term referring to the removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue. The word "débridement" is originally French. It was used for the first time during the eighteenth century in the surgical context and meant "wound incision." For French surgeons, it has retained to this day its original meaning.
Eh, yes, it is "-bride" but pronounced with a short "i" by the purists ... Perhaps to avoid snide allusions to the "Droit de Cuissage" (right of a feudal lord to sleep with the bride of a vassal on her wedding night ... You know, "de-bride" ... Oh, never mind!)
Left untreated, high velocity projectile wounds with much tissue destroyed and bacterial contamination would likely become infected. Gas gangrene can ensue, resulting in ... amputation ... death.
Surgically removing as much dead tissue you can find (and may be some that looks "marginal") and delaying closing of the wound has been shown to be the best way to prevent infection in the pre-antibiotic days.
With improvements in antibiotics etc, adjustments have been made to try and preserve more viable tissue.
However, if you don't have anything else to deal with an infected wound, maggots (fly larvae) have been used. Johns Hopkins pioneered it in the 1930's and now (after a hiatus of many years due in part to people being "grossed out") there is now a "growing" business for supplying disinfected Lucilia sericata larvae as "medicinal maggots" to practitioners for dealing with things like infected diabetic leg ulcers ...
The maggots basically eat the dead and infected tissue and leave healthy tissue unaffected. This biological "debridement" help prevent worsening of the infection. Medicinal maggots have saved many an infected limbs from amputation ... (I will spare you the published references but there are many). When the dead tissue is gone, the maggots starve and die - sad (for the fly), but conventient (for the patient).
There are stories of medics in POW camps lacking medical supplies and surgical facilities using maggots to treat infected high velocity projectile wounds.
There were descriptions of dressings left opened to allow flies to lay eggs in the wounds. When you had no other options (the wound is infected and a known proportion of patients is expected to die of infection anyway), the incremental risk of the fly bringing bacteria to the wound is outweighed by the potential good of the maggots debriding the wound.
It's pretty gruesome but during WWII and the Korean War, lives and limbs in POW camps have been saved this way. It was one of the dirty/clean little secrets that the medics kept to themselves ... (Imagine getting the patient's consent for this procedure!)
Excellent.
