Medi-Solfen^® technology has the potential to deliver a rapid onset

Surgical debridement uses sharp instruments (such as a scalpel, scissors and other sharp instruments) to remove necrotic tissue from the wound bed, either at the patient’s bedside or in specialised clinics. The advantages of such approaches include excellent control over the selection of tissue type to be removed and how much tissue to remove. It is the fastest way to achieve a clean wound bed and an increased frequency of debridement of this kind has the potential to speed up the healing process^1,2 which presents clinical, patient and economic advantages. A major disadvantage is that the use of sharp instruments may be painful for the patient. The pain type is described as procedural/operative pain which by definition causes pain that results from routine procedures such as dressing changes or wound cleansing, or is associated with significant wound interventions, such as biopsies or debridement³. Rapid control of such pain will impact on the patient’s overall experience of the procedure and also improve subsequent compliance to attend future events of this nature and adhere to dressing changes. It is possible that patients will deny future consent for the sharp debridement if the first experience was painful. This poses difficulties in providing optimal care and in achieving healing in a timely manner. Delayed healing eventually creates additional costs and deterioration in the patient’s quality of life. Some anaesthetic containing creams such as EMLA can take up to 1 hour post application to attain sufficient levels of anaesthesia to allow the debridement process to commence. This extends considerably the procedure duration times, levels of anticipation surrounding what the patient may be expecting to happen (especially if pain has been encountered in previous visits) and affect resource utilisation strategies within the clinical facility. With the increasing number of venous ulcers being treated questions can be raised about the ability of healthcare professionals to meet, for example, CQUIN wound care goals with the additional timings required for routine but essential procedures such as debridement⁴.

Having access to a proven, rapid onset, multimodal anaesthetic gel with additional bacterial agents and adrenaline such as Medi-Solfen® allows faster turnaround times for debridement procedures within any clinic situation. This will positively impact on clinical resource utilisation initiatives increasing productivity. The rapid onset of effective anaesthesia also offers great benefits to the patient, avoiding previous negative experiences associated with pain and making the overall experience more accommodating to enhance overall compliance with treatment. This also aligns itself to the UK NHS advocating a patient- centred approach, an approach that promotes physical comfort, including pain management⁵.

References

1. Steed DL, Donohoe D, Webster MW, Lindsley L (1996) Diabetic Ulcer Study Group. Effect of extensive debridement and treatment on the healing of diabetic foot ulcers. J AmColl Surg; 183(1): 61-64.
2. Wilcox JR, Carter MA and Covinton S (2013) Frequencies of debridement and time to heal. A retrospective cohort study of 312744 wounds. JAMA Dermatol; 149(9): 1050- 1058.
3. Brown A. (2014) Strategies to reduce or eliminate wound pain. Nursing times; 110 (15): 13-15.
4. Commissioning for Quality and Innovation (CQUIN). Guidance for 2017-2019 Publications Gateway Reference 06023. Nov 2016
5. NHS Paper summarising Patient experience Framework (2011). Gateway reference 17273.

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