Effectiveness of Necrotic Tissue Removal with Dynamic Gel Dressing and Monofilament Debridement

Effectiveness of Necrotic Tissue Removal with Dynamic Gel Dressing and Monofilament Debridement
Traci Brackin, DNP, APRN, FNP-BC, APCWCN Maryville, TN

Aim
Barriers to wound healing are explored every day by wound care providers. One of the most important barriers to wound healing is the removal of devitalized or necrotic tissue from the wound bed. This study reviews the difficulty in removal of necrotic tissue with two debridement methods; a monofilament debridement pad and a dynamic gel dressing. Additionally, this study explores a treatment timeline using other products and debridement methods, a cost analysis of previous treatment when compared to the employment of the dynamic gel dressing and monofilament debridement, and other qualitative factors from the patient perspective, including pain amelioration and symptom relief, in the sample size that has cognitive ability to understand and perform the Pain Rating Scale (PRS).

Method
Sample size of 15 patients with at least 50% necrotic tissue on wound bed. The slough percentage was documented, and before/after pictures are taken to visualize the results of 2-4 minutes of monofilament debridement. Afterward, we employ a dynamic gel dressing for 5-7 days and re-evaluate the slough, noting the necrotic tissue removal. At the 5-7 day point, monofilament debridement is done again, utilizing before and after images and measurements. Objective data will include photographic documentation and surface area reduction of wound and necrotic tissue. The results also include the pain scale with monofilament debridement, and application of hydrogel dressing to determine pain amelioration.

This study will also measure cost of treatment before monofilament debridement and dynamic gel dressing (product time and nursing time) and the cost of monofilament debridement and dynamic gel dressing for the same time period. We stratify size, necrotic tissue reduction and comparative cost between former treatments and current treatment.

Results
This study has proven that there is a statistically significant reduction in necrotic tissue using the dynamic gel dressing and the monofilament fiber pad or lolly when compared to previous treatments. The employment of a dynamic gel dressing in conjunction with monofilament debridement has also proven to be surprisingly cost effective when compared to other treatments. There was also a notable reduction in pain symptoms based upon previous treatments. The results of this study should be shared given the significance, and wound care providers should consider altering their practices for rapid, cost effective, and gentle removal of necrotic tissue.