Evaluation of Monofilament Debridement Pad Use for Nonviable Tissue Management in Wound Healing Center Patients

Introduction: Debridement directly contributes to removal of senescent cells and decreases biofilm and infectious material in the wound bed. Methods of debridement vary in levels of effectiveness, cost, and degrees of discomfort.^2,3,4

Objective: WOC nurses in a hospital outpatient wound healing center identified limitations in nonviable tissue management in patients unable to participate in sharp or enzymatic debridement. This case review aimed to evaluate the efficacy of monofilament debridement pads in decreasing nonviable tissue and gauge patient reaction.

Methods: The patients included historically struggled with sharp and/or enzymatic debridement.  A monofilament debridement pad was used for mechanical debridement per manufacturer guidelines.  An app-based wound measurement program analyzed tissue composition in pre- and post- debridement photographs controlling for distance, lighting, and angle.  Patients were asked to rate their pain following the procedure, whether they would be willing to use the product again, and to share ad hoc comments regarding response to treatment.

Results: Five cases (age range 46-75, etiologies including venous and pressure) were included, using monofilament debridement pads for mechanical debridement.  This resulted in an average decrease of 31.6% in nonviable tissue (which includes app-identified “yellow” or “black” tissue) and a reciprocal increased percentage in “red” tissue.  All patients expressed willingness to re-use the product and no increase in pain was reported. 

Conclusions: Monofilament pads present a low-cost mechanical debridement option that has demonstrated efficacy in slough removal without pain in the Wound Healing Center cases reviewed.  Higher quality comparative studies between monofilament pads and other mechanical debridement techniques are recommended measuring slough removal, pain, cost and clinical outcomes.