Debridement Resources

Selection of the most appropriate wound dressing is vital for promoting effective wound healing. With the vast number of options of wound dressings currently available, healthcare professionals may find it confusing to select the most appropriate dressing (World Union of Wound Healing Societies [WUWHS], 2020a). This article discusses the importance of wound assessment, focusing on identifying goals of treatment and the selection of an appropriate dressing to manage any identified barriers to healing. In turn, this will help community nurses provide person-centred care that promotes healing and improves overall patient wellbeing.

Chronic wounds are complex by nature and require thorough assessment and carefully planned management. Part of that management often includes preparing the wound and periwound skin for healing, for which debridement is frequently required. While there are several methods of debridement available, often requiring specialist referral, there are some that can be used by generalist nurses and patients and carers  themselves. This article describes one of those methods, mechanical debridement,

Debridement is the removal of non-viable tissue from the wound bed and surrounding skin and is an important part of wound healing and wound bed preparation. Devitalised tissue, such as necrosis, slough and hyperkeratosis, interfere with the process of wound
healing. When a wound fails to progress, there is a need to assess the wound bed and surrounding tissue and promote an optimum environment that encourages the formation of healthy granulation tissue (Young, 2014). Recent advances in debridement techniques
using monofilament fibre technology can be practised by nonspecialist nurses and used safely and effectively in a patient’s home. In a recent audit, a dataset of 486 patients who had been newly prescribed a monofilament fibre debridement pad was obtained to
validate clinical effectiveness and cost efficiency. The total cost of wound care prescribing fell by 14% or £101,723 in the six months after the intervention compared with the six months before. The average monthly expenditure per patient fell from £244 before the intervention to £209 after (Burnett et al, 2021). This evidence reinforces the National Institute for Health and Care Excellence (NICE) recommendations for use of monofilament fibre debridement in the community, based on evidence of its effectiveness and estimated cost savings (NICE, 2019).