Test your knowledge on this subject by completing our multiple choice quiz.
This quiz is based on the article Assessment and management of older people with venous leg ulcers (Nursing Older People, June 2018).
Debridement is the removal of dead, non-viable/devitalised tissue, infected or foreign material from the wound bed and surrounding skin (Strohal et al 2013). It is a key component in the healing process for both chronic and acute wounds.
Non-viable tissue is a physical barrier to healing and it prevents full assessment of the wound, (Wounds UK 2013). The removal of non-viable tissue leaves the area clear for healing and promotes development of healthy tissue, disrupting invisible barriers such as bacteria and biofilms. It is particularly relevant when clinicians are establishing the correct categorisation in cases of pressure damage.
Debridement at an early and appropriate stage is likely to accelerate wound healing and improve patient care, which will in turn reduce treatment costs.
Nurses have an active role to play in debridement. They have, however, tended to rely on autolytic debridement, which is recognised as one of the slower ways to clean the wound bed (Strohal et al 2013). This can extend the time the patient has to suffer the symptoms of malodour, excess exudate production, and the increased risk of developing an infection (Young 2012).
As a consequence of the apparent dependence on ritualistic autolytic debridement, in 2013, two important Consensus documents reviewed the practice of debridement. The first Consensus was produced by the European Wound Management Association (EWMA), the second, the UK Consensus document - ‘Effective debridement in a changing NHS’
Both recommend that nurses should be empowered to carry out debridement in a timely, safe and appropriate manner. They recognised that modern mechanical debridement is the fastest debridement method and recommended Debrisoft® as the tool of choice for this. (Strohal et al 2013, Wounds UK 2013).
Debrisoft is a debridement pad made of soft polyester fibres. The Debrisoft patented monofilament fibre technology uses 18 million monofilament fibres in each pad, all cut to a specific angle and length to reach uneven areas of the skin or wound bed.
The unique mode of action lifts debris and superficial slough from the skin or wound bed, binds them within the pad and thereby removes these barriers to healing — all without damaging new granulation tissue and epithelial cells.
The National Institute for Health and Care Excellence (NICE) aim to encourage Best Practice by using clinically and cost effective treatments. They reviewed the evidence and concluded that by using Debrisoft on appropriate wounds, these wounds would be ‘fully debrided more quickly, with 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.’
The NICE guidance also highlights significant cost savings for the NHS through the use of Debrisoft, estimating that using Debrisoft within the community can save the NHS up to £484 per patient for complete debridement of a wound, compared to current standard practice. This could equate to as much as £15million annually. (Medical Technology Guidance 17 2014)
The toolkit below aims to assist you in your debridement decisions, support you in using Debrisoft and explaining this to your patients, and provide further evidence on the clinical and economic benefits of using Debrisoft:
For more resources such as these, or to learn more about effective debridement (including accredited e-learning modules) please visit www.debrisoft.co.uk