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DEBRIDEMENT
knowledge of other debridement
options, rather than because it is
in the best interests of the patient
(Gray et al, 2011; Fumarola, 2012).
In the current climate where
evidence-based practice and
cost- and clinical-effectiveness
are expected, it is important that
clinicians question whether their
chosen method of debridement will
result in the removal of non-viable
tissue in the most efficient and
timely manner, or if their practice is
ritualistic and limited to their past
experience, skill-set and availability
(Young, 2011; 2012).
Of course, autolytic
debridement might suit some
clients’ needs following an open
discussion and exploration of
potential methods, but practitioners
should revisit their skill-set and
knowledge to ensure that they
are able to offer patients the most
appropriate debridement method
for their individual needs (Young,
2012; Wounds UK, 2013).
NICE guidelines
on Debrisoft
®
The National Institute for Health
and Care Excellence (NICE, 2014)
has recently recommended the use
of Debrisoft
®
(Activa Healthcare), a
monofilament debridement pad, in
the community for the management
of acute and chronic wounds in
adults and children. When compared
with existing alternatives for wound
debridement, such as autolytic
debridement using dressings, or
wound irrigation with saline or
cleansing with gauze, NICE found
that Debrisoft offers patient benefits
and savings to the NHS.
Using Debrisoft, debridement
can take an average of 2–4 minutes,
with a range of 2–12 minutes
(Strohal et al, 2013), compared
with the days or even weeks taken
using dressings to promote autolytic
debridement. This makes it a
time-efficient method of debriding
many wounds encountered in
the community nurse’s daily
caseload, including leg ulcers and
the build up of dead skin cells,
or hyperkeratosis that frequently
fewer nurse visits needed compared
with other debridement methods.
In addition, the Debrisoft pad is
convenient and easy to use, and is
well tolerated by patients’.
Cost-savings to the NHS
Debrisoft has been shown to
reduce specialist nurse, general
nurse and equipment costs by
assisting in accurate categorisation
of pressure ulcers (Swan and Orig,
2013), and reduce costs and time
when compared to larval therapy
(Hawkins, 2012). It has also been
found to potentially prevent hospital
admission and shorten inpatient
stays related to wounds (Callaghan
and Stephen-Haynes, 2012;
Hawkins, 2012; Wilson, 2012; Girip
and McLoughlin, 2013) and break
the cycle of chronic ulceration by
‘When compared with
existing alternatives for
wound debridement... NICE
found that Debrisoft offers
patient benefits and savings
to the NHS’
surrounds venous leg ulceration. No
specialist training is required, giving
any clinician the ability to perform
quick and easy skin cleansing and
wound debridement. The use of
Debrisoft causes the patient little or
no pain (Bahr et al, 2011; Flinton,
2011; Haemmerle et al, 2011;
Denyer, 2013). It can also be used
by patients (Whitaker, 2012) and
healthcare assistants (Whiteside
and McIntyre, 2013) to utilise
resources more effectively, and to
promote patient self-care (Stephen-
Haynes and Callaghan, 2012).
The NICE evaluation considered
evidence from clinical experts on
the clinical- and cost-efficacy of
Debrisoft, and from 15 multiple-
patient case-series reports
(five peer-reviewed papers and
10 posters), it found that Debrisoft:
Is more effective at debridement
than the common practice of
using hydrogel or other autolytic
dressings and irrigating wounds
with saline or gentle cleansing
with gauze
Gives quicker debridement,
allowing earlier visibility of the
wound bed and therefore better
management of the wound
May reduce pain associated
with debridement
Enables faster treatment (on
average, two to four minutes per
wound) resulting in less frequent
and fewer overall care visits
Reduces risk of trauma to
healthy tissue and reduces
bleeding
Reduces overall number of
wound dressings used
Contributes to overall cost-
savings compared with
current practices.
The conclusion of the NICE
guidance committee was that by
using Debrisoft on appropriate
wounds, these wounds would be
‘fully debrided more quickly, with
JCN supplement
2014,Vol 28, No 6
5
›
DEBRISOFT... FACTS
Debrisoft
®
is a monofilament
fibre debridement pad designed
to mechanically remove slough
and devitalised tissue from
the wound bed and
surrounding skin.
It is a single-use, soft,
polyester fibre pad that is
moistened with tap water,
sterile water or saline and
gently wiped across the
wound or skin, where more
than 18 million flexible
monofilament fibres remove
and retain exudate (Wiegand
et al, 2013), dead cells and
wound debris.
Debrisoft can be used to
prepare the wound bed for
assessment, for healing and to
improve the condition of the
periwound skin (Callaghan
and Stephen-Haynes, 2012;
Dowsett et al, 2013).
Debrisoft is safe to use for the
removal of devitalised tissue
from the wound bed and its
gentle action leaves healthy
granulation tissue intact,
including small islands of
epithelial tissue (Haemmerle et
al, 2011).