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California PT Wound Debridement
The Physical Therapy Board of California (Board) (name change effective January 1, 1997) was requested to address the issue of physical therapists performing sharp debridement of nonviable tissue in relation to their scope of practice. The issue was discussed at the February 3, 1995, meeting of what was then named the Physical Therapy Examining Committee (Committee). The position of the Board on this issue is as follows.
Dorland's Medical Dictionary, 27th edition, defines debride as "To remove foreign material and contaminated or devitalized tissue, usually by sharp dissection."
Debridement is performed by the use of sharp instruments including, but not limited to, scalpel, scissors, forceps or tweezers. Debridement of devitalized tissue is not to be confused with surgical debridement, which is to be performed by a physician and includes the removal of both devitalized and vitalized tissues. Physical therapists by education and training should be able to differentiate between necrotic, nonviable tissue, and viable tissues.
It is the official position of the Physical Therapy Board of California that, with appropriate training, physical therapists can perform debridement of nonviable tissue. Furthermore, it is the position of the Board that physical therapists may utilize sharp instruments such as scalpels, scissors, forceps, tweezers and other appropriate instruments to perform debridement.
Practice by PTAs
The Physical Therapy Board of California was also requested to address the issue of properly supervised physical therapist assistants performing debridement of nonviable tissue.
A physical therapist assistant is a person who is approved, by the Board "to assist in the provision of physical therapy under the supervision of a physical therapist who shall be responsible for the extent, kind and quality of the services provided by the physical therapist assistant."
It has been determined that a physical therapist assistant may assist the licensed therapist in any physical therapy services without limitation, subject to adequate supervision by the licensed physical therapist, the physical therapist assistant in accordance with the Physical Therapy Practice Act and the Physical Therapy Regulations may, with appropriate training, perform debridement.
Therefore, the Board concludes that with appropriate training, debridement may be performed by a physical therapist and may be delegated to a properly trained physical therapist assistant.