Jwc ewma final indd

J O U R N A L  O F WO U N D  C A R E   Vo l   2 2 .  N o   1 .  E W M A   D o c u M E N t   2 0 1 3

gauze. However, the quality of the cost-effectiveness 

analyses in the studies was found to be poor.

27

However, several studies show that the need for staff 

resources, in relation to a high number of dressing 

changes, decreases the cost effectiveness of gauze.

26

Monofilament fibre pad

Background

The monofilament fibre product has recently been 

introduced as a modern, wound-debriding product, 

designed to mechanically remove slough and 

devitalised cells from the wound bed.

28

 Case studies 

suggest that slough, hyperceratotic debris and 

crusts of desiccated exudate are bound in the fibre 

composite and thereby removed from the wound 

and surrounding skin.

29

Action

The wound-contact side is fleecy in appearance 

and, once wetted, is gently wiped over the surface 

of the wound for 2–4 minutes.

30

Indications

The monofilament fibre pad has been used 

in debriding a variety of wound types, 

including venous leg ulcers, diabetic foot ulcers 

(neuropathic and neuro-ischaemic), arterial ulcers, 

mixed aetiology ulcers, pressure ulcers  

and traumatic wounds.

29,31

A number of smaller, prospective, pilot, non-

comparative studies and case studies

29

 suggest 

good debridement results after one use on a variety 

of tissue types, such as slough and necrotic, and 

effective removal of hyperkeratosis. It is also claimed 

that the monofilament fibre pad leads to removal 

of debris, leaving healthy granulation tissue intact, 

including small epithelialised islands of vital tissue.

29

In the case of thick, tenacious slough and hard 

necrosis it is recommended that the tissue is 

softened prior to using the pad.

28

 A larger study 

of 60 patients with chronic wounds, of which 

57 (95%) were included in the analysis, the 

monofilament fibre pad was effective in 93.4% 

(n=142) of the debridement episodes.

32

Benefits

The debridement process using a monofilament 

pad is found to be quick (range 2–12 minutes).

32,33

In addition, the monofilament pad is claimed to be 

easy to use, causing little-to-no pain.

31

Sideeffects

Some pain responses following the debridement 

procedure have been reported.

32

conclusions

The use of wet-to-dry, plain gauze and paraffin 

tulle as debriding agents has little to support their 

use. The limitations should preclude their use in 

clinical practice; however, the monofilament fibre 

pad shows the potential to advance mechanical 

debridement as a viable technique, by providing 

a rapid, safe and easy-to-use method with limited 

pain for the patient. However, further research, 

including clinical use on a variety of acute and 

chronic wound types, is needed.

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