An Audit to Assess the Impact of Prescribing a Monofilament Fibre Debridement Pad for Patients with Unhealed Wounds After Six Months
Summary: Published May 2, 2021 in the Journal of Wound Care (Vol. 30, No. 5, pp. 381–388; DOI: 10.12968/jowc.2021.30.5.381; PMID: 33979215) by Joanna Burnett, Andrew Kerr, Margaret Morrison, and Abbe Ruston, this NHS prescribing audit provides real-world economic evidence for the impact of introducing the Debrisoft monofilament fibre debridement pad into wound-care practice in England. Debrisoft — a sterile pad of densely packed monofilament fibres (Lohmann & Rauscher) — has robust evidence as a rapid and effective mechanical method for removing dry skin, biofilm, and devitalised tissue from acute and chronic wounds with minimal patient discomfort. It received NICE Medical Technology Guidance (MTG17) recommending adoption based on modelled cost savings versus comparators including saline/gauze, hydrogels, and larval therapy. However, the NICE guidance itself acknowledged that post-implementation, real-world evidence of prescribing impact was limited at the time of evaluation. This audit addresses that gap. Using a dataset obtained from the NHS Business Services Authority for 486 uniquely identified patients who had been newly prescribed the monofilament fibre debridement pad, the audit analysed prescribing records over 6 months following first prescription. The analysis focused on changes in wound-care prescribing costs, prescription frequency, and dressing product use before and after Debrisoft introduction. Results demonstrated a significant reduction in overall wound-care prescribing costs associated with Debrisoft introduction, supporting the NICE cost-saving model in a real-world NHS community setting. The authors note several methodological considerations: the dataset reflects prescribing patterns rather than direct clinical outcomes (wound healing or wound area reduction); confounding factors such as concurrent clinical interventions cannot be fully isolated; and the population reflects patients with unhealed wounds of mixed aetiology and severity. Nevertheless, the audit provides the kind of health system-level prescribing data that complements clinical effectiveness studies and reinforces the economic argument for Debrisoft adoption in community wound care pathways.
Key Highlights:
- NHS prescribing database: 486 patients newly prescribed Debrisoft monofilament fibre debridement pad across England; data sourced from NHS Business Services Authority — provides real-world prescribing impact evidence absent from earlier NICE MTG17 modelling
- Cost reduction finding: introduction of Debrisoft associated with significant reductions in overall wound-care prescribing costs over 6-month follow-up period — consistent with and supporting the NICE cost-saving projections (£77–£484 per patient versus comparators in earlier modelling)
- Debrisoft mechanism context: monofilament fibres physically disrupt and lift devitalised tissue, slough, biofilm, and debris; NICE-recommended as the best-evidenced mechanical debridement method for community use; effective across wound aetiologies including venous ulcers, DFUs, pressure injuries, and post-surgical wounds
- Evidence context: the 2021 Burnett audit is one of only a few post-NICE real-world prescribing studies; complements the earlier Roes et al. 2019 clinical outcome and practitioner satisfaction studies and the Schultz et al. 2018 biofilm removal evidence
- Methodological note: outcomes are prescribing-based rather than wound healing endpoints; confounders present; population is heterogeneous — authors recommend complementary prospective trials with standardised wound assessment tools to confirm cost-effectiveness and clinical healing outcomes
- Access: article published in the Journal of Wound Care (MAG Online Library/Magonlinelibrary); full text requires journal subscription or institutional access; abstract and PMID 33979215 available via PubMed
Keywords: monofilament debridement pad NHS, wound care prescribing costs, Debrisoft clinical evidence, NICE MTG17 wound debridement, wound bed preparation community nursing, chronic wound debridement audit
Joanna Burnett, Andrew Kerr, Margaret Morrison, Abbe Ruston