Choosing the Right Dressing at the Right Time to Reduce Cost and Environmental Impact

 7th August 2025

Written by Carole Taylor (Lead Nurse, Tissue Viability Service)

The Tissue Viability team completed a successful quality improvement project and reduced unnecessary wound dressings by 67% in Newham. By introducing a more advanced dressing which reduces the need for a filler dressing, the team have reduced cost, avoided clinical waste going to landfill, and offered patients the option for self-managing their wound care.

Figure 1. Sharon Smith & the Extended Primary Care Team at East Ham Care Centre

The current financial climate within the NHS and the rising demand for wound care where resources are limited necessitates a greater emphasis on evidence-based care and quality-driven treatments.

A large proportion of a district nurse’s caseload is dedicated to wound care. Choosing the right dressing has become a complex task due to the constant availability of new and advanced dressings, personal preferences, habitual practices and lack of education often hinder evidence-based treatment decisions.

Led by one of the pressure ulcer nurses Sharon Smith in Newham, the Tissue Viability team embarked on a QI project. The aim was to reduce the percentage of service users who have more than one primary dressing by 15%. Over a six-month period, the aim was achieved, and we saw a sustained 67% reduction in patients with inappropriate dressings, from a baseline of 33% to 11% (see Figure 2). Although the project has now closed, the team continue to monitor progress, and the March data shows that only 6% of patients have more than one primary dressing.

Figure 2. Percentage of patients with inappropriate dressings

One of the change ideas included targeted education for district nurses, supported by a dressing manufacturer, on the science behind a Silicone 3DFIT® dressing which is currently listed on the ELFT wound dressing formulary. Using a 3DFIT® dressing removes the need for a filler dressing when the wound depth is 2cm deep or less, and provides a cost saving opportunity compared with using a filler as the primary dressing with a foam as the secondary dressing.

This feeds into system-wide savings by switching from two dressings to one dressing where clinically indicated and offers a simplified and cost-effective solution. A budget impact model by Voegeli et al. (2024), has previously demonstrated cost reductions between 18% and 48% when wound filler consumption was minimised and replaced by a silicone foam dressing with 3DFIT® technology.

Reducing the number of dressings and packing also has an environmental impact by sending less clinical waste to landfill, contributing to the Trust’s Green Plan.

This initiative also has the potential to enhance patient empowerment and quality of life. As the dressings are relatively simple to change, some patients can self-manage their wound care. Not only does this reduce disruption to patients’ daily routine but also reduces pressure on district nurses.

 

To watch a 5-minute presentation about this project by Sharon Smith (Pressure Ulcer Improvement Facilitator), please visit this link.

 

Reference:

Voegeli D, Hornbak Landauro, Sperup T. (2024). Clinical performance and cost-effectiveness of a Silicone foam with 3DFit™ technology in chronic wounds compared with standard of care: An open randomised multicentre investigation. International Wound Journal  pp 1-14