New NICE medical technology guidance published today (25 March), supports a device that aims to help improve the treatment of wounds.

The NICE guidance supports the case for adopting the Debrisoft monofilament debridement pad as part of the management of acute or chronic wounds in community settings. There are hundreds of thousands of patients with acute or chronic wounds who could benefit from Debrisoft, and if used for all of these patients with wounds that require debridement the device could save the NHS in the region of £15 million annually.

Debridement is a procedure to remove dead, damaged, or infected tissue from a wound to give the remaining healthy tissue a better chance to heal. Debrisoft is a single-use polyester fibre pad, which is wiped across the wound with gentle pressure. The dead cells, wound debris and pus are removed by sticking to the pad's monofilament fibres. Using this device, debridement takes 2 to 4 minutes per wound, and is done without need for analgesia. There are several standard methods of debridement used which depend on the clinical setting and the type of wound, including using a scalpel, hydrogel, gauze swabs and jets of water.

The benefits that the Debrisoft pad is likely to provide compared with other debridement methods include enabling faster debridement with reduced frequency and number of episodes of care, particularly nurse visits, good tolerance by patients and convenience and ease of use. Based on modelling, the savings from using the Debrisoft pad in the community setting are estimated to be between £99 and £484 per patient for complete debridement compared with current practice.

Professor Carole Longson, Director of the NICE Centre for Health Technology Evaluation, said: “We are pleased to publish final medical technology guidance supporting NHS use of the Debrisoft pad to treat acute or chronic wounds in the community. Chronic wounds, such as pressure and leg ulcers, and acute wounds such as those resulting from a burn or as a complication of surgery, affect hundreds of thousands of people.

“The independent Medical Technologies Advisory Committee concluded that the available evidence indicates that Debrisoft pad offers faster debridement than existing methods and that the savings demonstrated through cost modelling were credible. Using the device is estimated to potentially save the NHS up to £484 per patient for the complete debridement of a wound, compared to standard management. Overall, this is estimated to save the NHS in England £15 million annually.

“There are a range of benefits from using the pad including faster debridement of wounds, and fewer nurse visits needed. In addition, the manufacturer also claims that the device is more acceptable to patients than standard debridement methods, leading to reduced fear and anxiety associated with treatment. We hope that this positive NICE guidance encourages the NHS to use the Debrisoft pad, for the benefit of patients and the health service.”

ENDS

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Notes to Editors

About the NICE guidance

1. The medical technologies guidance, “The Debrisoft monofilament debridement pad for use in acute or chronic wounds”, is available at mtg17. Embargoed copies are available from the NICE Press Office.

2. The full recommendations are:

(i) The case for adopting the Debrisoft monofilament debridement pad as part of the management of acute or chronic wounds in the community is supported by the evidence. The available evidence is limited, but the likely benefits of using the Debrisoft pad on appropriate wounds are that they will 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. Debridement is an important component of standard woundcare management as described in Pressure ulcers (NICE clinical guideline 29) and Diabetic foot problems (NICE clinical guideline 119).

(ii) The Debrisoft pad is indicated for adults and children with acute or chronic wounds. The available evidence is mainly in adults with chronic wounds needing debridement in the community. The data show that the device is particularly effective for chronic sloughy wounds and hyperkeratotic skin around acute or chronic wounds.

(iii) The Debrisoft pad is estimated to be cost saving for complete debridement compared with other debridement methods. When compared with hydrogel, gauze and bagged larvae, cost savings per patient (per complete debridement) are estimated to be £99, £152 and £484 respectively in a community clinic and £222, £347 and £469 respectively in the home.

3. The Debrisoft pad is manufactured by Activa Healthcare.

4. Around 200,000 people each year have chronic wounds, and those with acute wounds include an estimated 250,000 burns patients.

5. The annual savings from using the device are estimated at £26,000 per 100,000 population. For the population of England this is £15 million (the 2012 GP registered population is around 55 million).

6. The cost of 1 Debrisoft monofilament debridement pad stated in the sponsor's submission is £6.19 (excluding VAT).

7. NICE clinical guideline CG29 on pressure ulcers states that standard practice in the management of chronic wounds includes wound debridement to remove dead tissue, and that clinicians should recognise the potential benefit of debridement in the management of pressure ulcers. This guideline is currently being updated and is dues for publication in spring 2014. NICE includes the technique of debridement in the pressure ulcer management pathway.

NICE clinical guideline CG119 on diabetic foot problems recommends that diabetic foot ulcers can be managed using debridement. The guideline states that debridement should be performed only by healthcare professionals from a multidisciplinary foot care team, using the technique that best matches their specialist expertise, clinical experience, patient preference, and the site of the ulcer.

About the Medical Technologies Evaluation Programme

8. Established by NICE in 2009, the focus of this area of work is specifically on the evaluation of innovative medical technologies, including devices and diagnostics. The types of products which might be included are medical devices that deliver treatment such as those implanted during surgical procedures, technologies that give greater independence to patients, and diagnostic devices or tests used to detect or monitor medical conditions. The independent Medical Technology Advisory Committee has two core remits: selecting medical technologies for evaluation by NICE guidance programmes and also developing medical technologies guidance itself. The guidance applies to the NHS in England, and is not mandatory.

More information is available at /guidance/mtg3/resources/medical-technologies-evaluation-programme.

About NICE

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